labor

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.

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Eating, Drinking in Labor and IV

Not allowing food or drink in normal labor because of risk of rare aspiration in case you need general anesthesia isn’t evidence based care, but based on outdated hospital policy and is harmful. People in labor need and want to stay well nourished and hydrated if given the choice, instead of being then connected to an IV for at least the fluids. You are running your marathon in labor. The uterus like any muscle requires nutrients to meet its energy needs. According to research from sports medicine, it is well known that for example eating carbohydrates during exercise improves performance, reduces fatigue, and prevents ketosis. Power bars and nutrient dense snacks and hydrating fluids are given out to runners along their journey. No athlete or coach would advise performing while fasting.

When supported to labor normally and naturally, risk of emergency cesarean needing general anesthesia is very low in the healthy population. This policy of fasting before surgery began in the 1940s when general anesthesia was not as safe as today and dangerous aspiration of stomach contents was more common. These days anesthesia and airway management are much more sophisticated and improved, most cesareans don’t use general anesthetics, fasting in labor doesn't guarantee an empty stomach anyway and could lead to harmful acidic stomach juices if aspirated, and aspiration causing severe lung disease & death is extremely rare today in healthy people. Free standing birth centers and homebirth midwives do not have this no intake by mouth ’NPO’ policy.

But if you are healthy and birthing in the hospital, you can absolutely allow yourself the food and drink you need. It's your body, your birth and they don’t have authority over you. Best to discuss your preferences with your provider beforehand, in pregnancy, for if they don't support you, they may not support your other plans and you might want to change providers to those who practice evidence based care & are more in alignment with your philosophies. If you choose to stay with a provider and setting that does not allow food and drink, next option is to sneak it in, and ingest them in privacy (which might mean when you are in the bathroom).

Got to stay well nourished and hydrated in labor like running your marathon.

Best labor foods are basically - whatever you want that’s nourishing and easily tolerated! Mamas tend to prefer more bland foods but not always. But you do need lots of extra quality fuel in your tank for your journey. Some favorites include organic eggs, whole grain toast and dairy or nut butter, whole grain crackers and cheese, whole grain cereal or oatmeal and dairy or nut milk, maple syrup/honey, power and granola bars, nuts and dried fruit, trail mix, dark chocolate, frozen fruit bars, fruit that’s not messy to eat.

Best drinks include water, fruit juices, herbal tea with honey, bone or miso soup broth, coconut water, smoothies, organic Gatorade, homemade labor-aid - recipe in my Natural Birth Secrets book 2nd edition.

Many who labor in hospitals that don’t allow food and drink, need IV to prevent dehydration which can cause complications needing more interventions….unless you are sneaking enough food and drinking plenty orally. If you’re pregnancy and labor are healthy are proceeding naturally, IV fluids aren’t at all necessary and may cause harm. Even the American College of Obstetricians & Gynecologists, the American Society of Anesthesiologists and of course the World Health Organization all recommend encouraging oral fluids instead of IV.  Why is this not happening?  Routine IV can over hydrate and decrease newborn weight and blood sugar and cause maternal swelling - even in the breasts which impairs breastfeeding, can be uncomfortable, get inflamed, infiltrated or cause infection. IV restricts needed movement in labor, undermines mama’s confidence and sense of feeling empowered and healthy. I’ve posted before on the harmful practices of restricting needing nourishment and hydration. As long as you are keeping well hydrated by drinking, you can absolutely feel no qualms about declining that routine IV.

There is also no evidence to support the IV access called saline lock for low risk laboring mamas because in case of postpartum hemorrhage. The risk of that in this population is low, & needing treatment beyond natural remedies & medications without IV even lower. An excellent practitioner can start an IV in that rare emergency.

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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.