When to Call Midwife in Labor

⏳ When to Call Your Midwife (or Go In): A Real Talk Guide to Timing Labor Right

If you’ve been told to follow the 5-1-1 rule (contractions every 5 minutes, lasting 1 minute, for at least 1 hour), you’re not alone.

But here’s the truth: for most first-time vaginal births, that rule is usually way too early. And for people who’ve birthed before—especially those with fast labors—it might already be too late.

Labor doesn’t always follow a textbook pattern. So how do you know when it’s actually time to call your midwife, go to the birth center, or head to the hospital?

Let’s break it down.

🧡 Birth Timing Isn’t One-Size-Fits-All

Every body—and every birth—is unique. Some labors start with strong, spaced-out contractions. Others begin with frequent, mild ones. What matters most is how the labor feels, how you’re coping, and what your body and baby are telling you.

Here are a few real-life scenarios I’ve seen:

• Every 2–3 minutes, but only 30–45 seconds long, and you can talk through them?
  Probably still early labor—even if they’re close together.

• Every 6–8 minutes, but you’re moaning, can’t speak, and need to stop everything during a wave?
  That’s active labor, even if they’re spaced out.

So, instead of using a stopwatch alone, pay attention to:

• The intensity of the surges

• How you feel emotionally

• Whether you can rest, eat, or talk during them

🏡 If You’re Planning a Homebirth or Birth Center Birth

Stay in regular contact with your midwife. You’ll check in early and then again when things shift. You don’t need to call at the very first signs of labor or your bloody show—especially in the middle of the night.

Unless something feels urgent, it’s okay to wait until morning to connect—so you, your partner, and your team can rest for the journey ahead.

When to Call:

• You feel like things are picking up steadily over time

• You’re feeling emotional, intense, vocal

• You’ve had a previous fast labor

• You feel pushy or like you have to poop

• Water breaks and fluid is green/brown

• You notice less baby movement even after a snack, juice, or some rest

• You’re just not sure and need to talk it out

Your midwife knows you and your history. Often, after just a short phone call, I can tell exactly where a mama is in labor.

🏥 If You’re Planning an Unmedicated Hospital Birth

Unless you’ve had a precipitous birth before (start to baby in under 3 hours), your best bet is to stay home as long as possible in healthy labor—especially if everything is normal and baby is moving as usual.

Why?

Because hospitals are great at managing emergencies—but not so great at supporting undisturbed physiological birth. Their priority is quick, efficient delivery. And that can trigger the cascade of interventions: early admission → more monitoring → less freedom → higher risk of things you may not want.

You labor best when:

• You’re undisturbed

• You feel safe and private

• You can move, eat, vocalize, and ride the waves your own way

If you're coping well, let things unfold at home where your oxytocin can flow.

🌙 What to Do at Night in Early Labor

If you’re in early labor at night:

• Keep the lights off

• Breathe and rest between contractions

• Try to sleep or doze, even for 10–15 minutes at a time

You’ll need your energy later. So will your partner. You’ll be in touch with your midwife when the time is right.

🔔 A More Useful Gauge for Active Labor

Especially for first-time vaginal birthers, look for:

• Contractions every 3–4 minutes

• Lasting 60–90 seconds

• For at least an hour

• You can’t talk through them, you’re moaning, roaring, moving instinctively

And most importantly: They’re getting longer, stronger, and closer together.

If you’re not sure—it’s always okay to call your doula or midwife and talk it through.

👶🏽 If You’ve Given Birth Before

The focus shifts more toward intensity and emotional cues than just timing.

Some mamas have on-and-off early labor for days or weeks, but once things pick up—they can go fast. If you’ve had quick births before, stay in close contact. I often prefer to get there early and wait nearby than risk a car or bathroom baby.

🚗 Don’t Forget the Practical Stuff

Always consider:

• How far away you are

• Traffic and parking

• Time of day or night

• Snow, storms, or anything that might delay travel

Sometimes arriving “too early” is better than rushing—or not making it at all.

🧠 Trust Your Gut, Stay in Contact

You don’t need to overthink this. Stay in contact with your midwife or birth team, and trust that together, you’ll know when it’s time to go or have them come to you.

Call if:

• You’re worried

• Something feels off

• You feel pushy

• Baby isn’t moving normally

• You just need reassurance

We’re here for all of that.

💪 You’ve Got This

No matter where or how you give birth, when you understand how labor works—and what your body really needs—you can rock your birth.

You don’t need to follow outdated formulas.
You don’t need to rush into the hospital too soon.
You do need rest, trust, a supportive team, and the freedom to birth your way.

📘 Want to go deeper?
I dive into all of this—and so much more—in my Online “Love Your Birth” Comprehensive Prep Course, where you’ll learn how to prepare, cope, advocate, and thrive during your birth journey.

Image by Megan Hancock Photography

Don’t forget to check out my LOVE YOUR BIRTH Online Childbirth Education Course! With 10 educational and empowering videos, and many additional bonus materials, it is everything you need to prepare yourself for the birth YOU want, to feel confident and empowered for however your birth unfolds, and not only ROCK, but also LOVE your journey. I have a whole section on what to do if you have a precipitous labor and birth that occurs before your provider arrives or before you get to your birth setting. The section is devoted to you and to your partner about this topic in much more depth, so that you are both prepared for the most exciting adventure of a lifetime. Learn more here.

In adjunct to my course, get my Natural Birth Secrets book second edition - your best childbearing reference for the entire journey to having a baby…..from holistic modalities to common discomforts to in depth discussions on hot topics.

Questions to Ask When Interviewing Your Provider, Red Flags and Choosing Your Best Provider

Here are some key questions to ask your midwife or obstetrician if you want a natural birth. Listen to them and within you. You will get your answers about best provider for the birth you want. And do pay attention to red flags.

Do you have training and experience supporting natural physiologic undisturbed birth when all is well?

What’s your rate of primary cesarean?

If I need a cesarean, are you or your collaborative obstetricians experienced and do with gentle/family centered version?

Do you encourage VBAC? What’s your rate?

Are you skilled and supportive of physiologic breech and twin birth? What’s your rates?

Do you support my birth preferences and my right to decline interventions?

Do you advocate for doulas and other support persons I want?

Do you support and have training/skills for vaginal breech and twin birth?

What’s your rate and policy for induction of labor - like going past due date, suspected big baby, water breaking before labor etc.

Is your setting when you practice in alignment with you? What restrictions might be placed on me becasue their protocol?

Most importantly, do support my legal and ethical right to autonomy over my body, birth and baby?

Will my rights to make informed decisions about my and my baby’s care be respected?

If they don't support natural undisturbed health birth or evidence based care, their rate of primary cesarean section is above 10-15%, they don't support your birth preferences & right to decline interventions, they don't advocate for doulas & any other support person you want, they don't encourage VBAC and have rates lower than 70-80%, they have high induction rates for things like going past due date, suspected big baby, water breaking before labor, they don't support and have lots of experience with vaginal breech and twin birth, and/or the setting where they practice is not in alignment with them & they place a lot of restrictions on you because of protocols and policies you have your answer. You can switch providers anytime and hire one that is most in alignment with what you want, who will work collaboratively with you.

Here are some red flags, but here are so many others, especially when all is well with mama and baby such as:

They don’t support natural physiological birth.

They don’t care to read your birth plan or respect your birth preferences.

They don’t do VBAC.

They don’t do vaginal breech or twin birth.
They advise frequent ultrasound, routine multiple tests and procedures without discussion.

They perform weekly internal exams at 36 weeks.
They induce everyone at 41 weeks or sooner.
They do not believe in or practice natural physiological birth.
They don’t like or support doulas.
They do routine episiotomies on all first time vaginal birthers.
They do immediate cord clamping, or rush clamping without waiting until it is limp, white and pulseless.

Their cesarean rate greater than 10-15%.
scheduling a cesarean because they tell you your baby is too big

Unless you are planning to birth in an out of hospital freestanding birth center or at home with authentic midwives, most maternity care practitioners and the settings they work have not seen natural undisturbed birth - and they are trained and quite used to disturbing it. They think it’s necessary to fix what isn’t broken when all is well. It’s like everyone trying to interfere with your heart beating or your lungs breathing when it’s doing just fine on it’s own. It is a sad state of affairs with what’s going on in most modern hospitals especially in the US. I’ve had obstetricians, nurses and even medwives (midwives who practice more medically like many OBs) tell me they have never seen a natural undisturbed birth. Some actually want to shadow me to see one! I love when I do hospital shifts and the med students follow me - it may be their only chance to see natural undisturbed normal physiological birth. That’s the vast majority of what I see and I don’t get how it can be otherwise. Why is this happening as if it were some cool freak show, when the research supports it, when it’s evidence based care, when this is how birth occurred for thousands of years since the beginning of time, and still is the way it happens for the majority worldwide.

Here is a wonderful testimony sent to me from a mama who took my online Guide to Pregnancy, Birth and Postpartum, prepared, informed and empowered herself to tell her obstetrician (the only provider in her rural area) who never saw natural birth, to do nothing but be a fly on the wall, just in case of emergency. He said he never did that, does mostly inductions, medicates births and cesareans. But she respectfully spoke up and he finally agreed. And who was touched to tears, crying the most at her beautiful natural birth? Think of the ripple effect that has on his care for other mamas? If you want a natural birth without disturbance-ask your provider if they’ve seen one. You’ll get your answer whether you should run or not, to a provider and setting where it’s the norm.

“I want to thank you for your online course. Because of it I was able to do a home waterbirth in Nicaragua where it is not common at all. I live abroad so it was my dream to have a natural birth in my home. Little did I know there are no doulas or certified midwives in the country. Your course helped me through it! My father-in-law who is an OBGYN in Brazil caught the baby and also has never done a home or natural birth. He only does cesarean. What a special moment for the family! Thank you again for the knowledge I was able to achieve online!!! Here’s a video of our special day :)
”

— — Brittany S, Nicaragua

If you choose to stay with such a provider with so many red flags, you have to prepare even more, fight even more for what you want, make sure to have an advocate, and know your legal rights to autonomy and informed refusal so you don't allow anyone to dictate you to do anything against your will or manipulate you with playing the fear of dead baby card when there is nothing wrong. Dig deep - is this what you want to be doing during your pregnancy and such a sensitive time as labor?

For more information on how to best prepare for having your baby, feel well educated and informed , confident and empowered, bust through fears and trust the process, and have the most beautiful birth of your dreams take my online signature comprehensive prep course - Anne’s Guide to Pregnancy, Birth and Postpartum and read my Natural Birth Secrets 2nd book edition. I created them for you to do just that, based on over two decades of holistic nurse midwifery experience and attending over 1000 births.

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Whether you’re an experienced or new parent, there are hours of videos, workbooks, and PDFs to answer all of your questions. Everything is searchable, so you can just type or talk and it’ll bring you right to the exact moment in the video where I answer your question. It’ll blow your mind! If English is not your strongest language, you can even change the captions or even the audio to the language you prefer. You can get my Love Your Birth Prenatal, Birth & Postpartum Guides - ALL of the guides for a limited-time offer of 50% off -> RIGHT HERE!

The key to a positive birth is feeling confident, strong, relaxed, and empowered during the entire process, regardless of the twists and turns it may take. I give my full heart and all I know in everything I do to support Mommas.

Can't Make up This Hospital Birth Story

True story TRIGGER WARNING

There are many wonderful, supportive obstetricians and I adore the ones I am blessed to work with. But sometimes I do hospital shifts, or help advocate for people in the hospital and have personally seen things that make me cringe.

I was to labor at home with a friend’s daughter expecting her first baby as long as possible. I brought her in fully dilated with no urge to push yet. At midnight, the only door open was through the emergency room. We were told to go the waiting room. Wearing eye pads and head phones in a public area, mama slow danced with me over 2 hours. Then she suddenly roared baby’s coming. I asked the person sitting at the desk several times to please get her up to the maternity unit as soon as possible. The staff person kept saying she needs to be seen first in triage, so need to go back to waiting room.

I said “she is pushing and saying her baby is coming as you can see. There is no more time to wait. We've been waiting over two hours.” Lady said it's hospital policy - she has to be seen first by a doctor in triage to determine if she needs to be admitted.” I said “I don't care about policies that make no sense. You can see this mama is having a baby, now. I'm a midwife, I know how to catch a baby here in the waiting room but I don't have privileges in this hospital and here is not the best place for her to give birth.” She rolled her eyes, told me there is nothing she can do, and said “next” to the person behind me. Mama is continuing to roar, saying “baby’s coming out!!!”

I rushed to a security guard standing in front of a bunch of wheel chairs. I told him I needed one stat to take this imminently birthing lady up to labor and delivery. He was at least nicer about it but said “he's sorry that he's not authorized to give one to me.” And what do you think I did? I stole one right in front of him, he looked stunned but did nothing, I took mama up to the maternity unit breaking all kinds of hospital rules.

But really? What would have happened if that was just herself and partner, no advocate? They would have had an ER waiting room birth, in an atmosphere of neglect and then chaos.

As soon as we got into the room, the staff was undressing her and put her into a hospital gown. Some battles aren’t worth the fight, and she did not care at this point, what she was wearing or not wearing. As I am supporting her in the hospital room, she assumed hands and knees position on the bed and continued to push. I could see baby’s head with each push. Multiple people came in, to draw blood, get her admitted by asking all kinds of irrelevant questions - like how much weight she gained in pregnancy as she was pushing; several nurses were trying to get her to lay down to get a continuous fetal monitor strip and start IV. I said she declines both, and intermittent listening to baby’s heart rate was her preference and is sufficient. Mama anyway kept insisting she needed to be on her hands and knees and resumed that position. I then see baby’s head crowning (emerging from the vaginal opening), and prepare for birth.

I suddenly heard mama shrieking, begging for me to help and make the doctor get out of her butt hole. I could not believe what I then witnessed. An obstetrician was doing a rectal exam, obviously without her consent, she was resisting, and he started yelling at her. Mama continued to scream to get him out of her. He continued to yell at her saying he needs to check if she is fully dilated. For those of you who don’t know, if baby is crowning, there is no more cervix, so of course mama is fully dilated. And to check the cervix you need to do a vaginal exam. It’s not accessible through the rectum. Nurses rolled their eyes as he was in the wrong place and his exam was not needed anyway. Help! Don’t let him touch me she pleaded.
I said I was a midwife, her advocate, her midwife is on the way (just changing) to take over as it’s her case, I am not sure why he was in there anyway, what he was doing was abusive, and he would be reported. He left in a huff.

I looked mama in the eyes, said I was sorry for what was done but she is safe now, it’s good to be on her hands and knees. I reassured her that Baby’s heart rate was fine by Doppler, and reminded her to breathe. We breathed together as her baby gently slipped into midwife’s hands. She cried, and was so thankful…but part of the tears was how she was treated initially. I held her in her pain. Just practicing midwifery. THIS ABUSE HAS TO STOP. He was reported to no effect!

Mama and baby were wonderfully healthy, she was amazingly able to tune it all out with her eye pads and head phones, and actually loved her birth but joked her situation at the hospital was like a sit com. But…”Next time just staying at home” she said. She did not want to pursue any other action against the doctor.

Share this! We must improve maternity care. We must know what is going on with our bodies and what to expect, have an advocate or doula especially if its your first and you are planning a hospital birth, speak up and make the choices best for us.

To learn more what you can do whether you are planning to birth in the hospital, at a birthing center or home, to have the birth YOU want & will treasure forever, check out my signature comprehensive Love Your Birth online prep Guide to Pregnancy, Birth & Postpartum prep course and in adjunct my Natural Birth Secrets book 2nd edition, for deep dive into the hot topics and research.


Story told with permission.

Interview with renowned author Henci Goer

It was such an honor to speak with renowned pregnancy and birth author Henci Goer…We talk all things out-of-hospital home and birth center birthing as well as hospital birth. What is the evidence saying about the safety of each option, and how can you best navigate the world of having a baby these days….to birth YOUR way, have safer outcomes and feel wonderful about your experience.

Starting out as a Lamaze teacher and doula, Henci Goer’s life’s work soon became analyzing and synthesizing the obstetric research in order to give pregnant women and birth professionals access to what constitutes optimal care in childbirth.

 She is the author of four books: Labor Pain: What’s Your Best Strategy?, Optimal Care in Childbirth: The Case for a Physiologic Approach (co-author Amy Romano MSN, CNM), The Thinking Woman’s Guide to a Better Birth, and Obstetric Myths Versus Research Realities. In addition, she has written numerous blog posts and articles and given lectures around the world. 

In recognition of her work, she has received, among others, the American College of Nurse-Midwives Best Book of the Year Award, Lamaze International’s President’s Award, DONA International’s Klaus & Kennell Research Award, a Lifetime Achievement Award from BOLD Atlanta, and the Media Award from the American Association of Birth Centers. 

The “Take Charge of Your Birth Series,” short books on single topics to help women make informed choices and obtain optimal care for themselves and their babies, is a continuation of her work. Labor Pain: What’s Your Best Strategy? is the first book in the new series. It delivers up-to-date access to the best medical research plus practical strategies for developing your plan and putting it into action. Also available in audiobook.

Website: hencigoer.com

Facebook: https://www.facebook.com/takechargeofyourbirth

Instagram: @takechargeofyourbirth

Her Latest Book: Labor Pain: What’s Your Best Strategy? is available on Amazon in paperback, ebook, hardback, and audiobook versions.

If you are planning a pregnancy, expecting, wanting to prepare as best you can for birth and postpartum, get yourself my online Guides!

I’ve taken everything I’ve learned from over 27 years in my private practice and I’ve poured all of my love, passion, knowledge, and experience into creating something truly special for you… my new Pregnancy, Birth & Postpartum Guides. My transfer rate from home to hospital is 7% which means 93% of mamas are having beautiful natural homebirths, and I have not once had to transfer a mama for an epidural because she could not handle the sensations of normal labor. Not once. A huge part of that is how I help them prepare. I want that for you!

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Whether you’re an experienced or new parent, there are over 24 hours of videos, workbooks, and PDFs to answer all of your questions. Everything in my Guide is searchable; so you can just type or talk and it’ll bring you right to the exact moment in the video where I answer your question. Try it! Say "Labor Positions" and it'll bring you right to the moment I start talking about positions ideal for labor. It’ll blow your mind!

The key to a positive birth is feeling confident, strong, relaxed, and empowered during the entire process, regardless of the twists and turns it may take. I give my full heart and all I know in everything I do to support Moms like you!

have created THREE Guides with hours of searchable videos, workbooks and pdfs to lead you to the birth of your dreams! They are easy to use, mobile friendly, and transliterated and translated in Spanish, French, and any language you need! AND THAT IS HUGE! TAKE ADVANTAGE NOW, AND YOU HAVE LIFETIME ACCESS.

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For more in depth discussion and holistic modalities for common ailments through the entire journey of having a baby, check out my Natural Birth Secrets book 2nd edition, available in print, kindle and ebook.

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Getting Real With A Mama in My Practice Who Rocked Her VBAC

Part one and two of a an awesome video I was invited to do with Joni, a mama in my practice who had a homebirth birth after cesarean, that really brings together many things pregnancy, birth, and breathwork, holistic health and healing.

Learn how to rock your VBAC and have the birth of your dreams with these three different but crucial resources - so you can prepare like a boss!

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