Is there anyone knows what are the signs for a pregnant women to come to the hospital

nurse12b · Jul 28, 2010

steady contractions 10-15 min apart for at least an hr. Or water breaks.

DayDreamin ER CRNP · Jul 28, 2010

hi , all the friends !
is there anyone can help me out , who knows what are the signs for a pregnant women to come to the hospital before they are going to labor ?
thanks !

I can think of a dozen reasons for a pregnant woman to go the hospital before going into labor, however, we are not permitted to give any medical advice on this board.

If you have questions about labor it is best to seek the advice of your physician.

redessa · Jul 28, 2010

I got sent home from the hospital with my 1st when my contractions were still in the 10 min range. They told me to come back when they were 3-5 min apart. They never got that close together. I almost didn't make back it in time!!! (Literally, 5 kids and not once did my contractions ever make it closer than 6 min apart until I was to the point of delivering.)

But yeah, there's a lot of reasons to seek medical attention when you're not even in labor yet.

cnmbfa · Jul 28, 2010

I am a nurse midwife and have attended over 1000 births. I can tell you that if someone can talk when having contractions, it's too soon to go in. Until your cervix starts to make good change at 2-3 cm and is 100% effaced (thinned out), there is little the staff can do for you other than have you walk to try to simulate labor. They will probably just send you home, which is very demorlaizing for most women. Save the trip. The exceptions are women having a 5th or greater baby, women with a known history of fast labors, and women who live 50 miles from the hospital. Otherwise, stay home, keep busy to keep your mind off how long this seems to be taking (normal first labor is 16 hours + pushing). Rock in a chair, slow dance, eat light, drink fluids, take a very long warm bath, try to nap if possible. Breathe, and realize that it is truly dumb to fight against doing waht your body needs to do: open up to let the baby come out. Work with it, rather than against your contractions. Tell yourself this is what you were meant to do. You are far, far stronger and more capable than you think.

You will know when it's time to go in because you'll be serious, inwardly focused, and not able to answer questions during contractions. Call your doctor or midwife and give them a heads up. Call if your water breaks--they may vary in what they want you to do (go right in or wait until the AM). Call ASAP if you are more than 2 week early. Call if the baby is moving a lot less than usual. Bloody show when you wipe is normal, but bleeding as much as a mid period is not. Do not go in for mucousy discharge; it could be two more days until onset of the real deal. Do go in stat (or call 911) if you are feeling rectal pressure.

Most babies take a while and give us plenty of time to get there. Active labor is usually really obvious as well; absoltuley no one has ever slept through having a baby.

cnmbfa · Jul 28, 2010

In addition to labor, here are some things that deserve a trip (but CALL FIRST and talk to the provider, not an office assistant!)

1. Suspcted ruptured membranes

2. Bright red bleeding, even if painless

3. Any blow to abdomen or sides, fall on back, butt, side or abdomen

4. T > 100.6F

5. ANY pain above the umbilicus, especially with worsening heartburn, nausea, or loss of appetite.

6. Very tender or rigid abdomen between contractions

7. Smelly, itchy, or purulent lady partsl discharge

8. If after drinking something sweet and cold, you lie down on left side and baby doesn't them move 5-10 times in the next hour.

9. ANY headache that is not relieved after 30 minutes of rest & Tylenol

10. ANY visual changes

11. Swollen face or hands

12. Gradually worsening itchy skin WITHOUT a rash

13. Worsening dysuria and frequency.

14. Worsening dyspnea at rest.

15. Chest pain with palpitations.

16. Warm, swollen, tender calf.

17. Recurrent syncope.

roser13, ASN, RN · Jul 28, 2010

I'm constantly surprised by the numbers of people who are willing (even eager) to give medical advice on a public forum. I don't know if it's a matter of a desire to demonstrate one's knowledge or what, but the potential for causing harm by (effectively) discouraging posters to seek personalized medical care seems extremely high.

cnmbfa · Jul 28, 2010

Maybe because I am an APRN/CNM with tons of experience I see it differently. I saw it as a chance to possibly educate, ease someone's fears, or save them an unecessary trip to the hospital. I also was thinking of the hundreds of people here taking NCLEX soon, and summed up 5 or 6 chapters worth of key points from an OB text in a list. If you want to see that as showing off, so be it.

roser13, ASN, RN · Jul 28, 2010

"Maybe because I am an APRN/CNM with tons of experience.......save them an unecessary trip to the hospital. "

Well, there you go. I believe that is the function of someone's personal healthcare providers. But then, I'm admittedly not an Advanced Practice anything.

MsAng · Jul 28, 2010

I am a nurse midwife and have attended over 1000 births. I can tell you that if someone can talk when having contractions, it's too soon to go in. Until your cervix starts to make good change at 2-3 cm and is 100% effaced (thinned out), there is little the staff can do for you other than have you walk to try to simulate labor. They will probably just send you home, which is very demorlaizing for most women. Save the trip. The exceptions are women having a 5th or greater baby, women with a known history of fast labors, and women who live 50 miles from the hospital. Otherwise, stay home, keep busy to keep your mind off how long this seems to be taking (normal first labor is 16 hours + pushing). Rock in a chair, slow dance, eat light, drink fluids, take a very long warm bath, try to nap if possible. Breathe, and realize that it is truly dumb to fight against doing waht your body needs to do: open up to let the baby come out. Work with it, rather than against your contractions. Tell yourself this is what you were meant to do. You are far, far stronger and more capable than you think.
You will know when it's time to go in because you'll be serious, inwardly focused, and not able to answer questions during contractions. Call your doctor or midwife and give them a heads up. Call if your water breaks--they may vary in what they want you to do (go right in or wait until the AM). Call ASAP if you are more than 2 week early. Call if the baby is moving a lot less than usual. Bloody show when you wipe is normal, but bleeding as much as a mid period is not. Do not go in for mucousy discharge; it could be two more days until onset of the real deal. Do go in stat (or call 911) if you are feeling rectal pressure.
Most babies take a while and give us plenty of time to get there. Active labor is usually really obvious as well; absoltuley no one has ever slept through having a baby.

I respectfully disagree with some of your post. I for one could talk during my contractions. When I called my provider about my contractions, he doubted my need to come to the hospital. But I went anyway. I was 5 cm and gave birth 2 hours later.

My point is, be careful when you generalize like this. Everyone is well aware that every situation can be different. I have to say that I am in agreement that this is not a place to give medical advice.

cnmbfa · Jul 28, 2010

I forgot to say that what you called me "giving medical advice" is much the same as what her childbirth instructor would say about recognizing the onset of labor and coping with early labor if she called her, or what she would find if she Googled danger signs in pregnancy.

I am much less concerned about crossing some line re: giving medical advice, because the supposed rule against that is one of the silly traditions that hold nurses back. If you look up the ANA's definition of nursing, or if you review the state laws that define our scope of practice, it is clear that health education is a nursing role. We cannot give patients the information they need to make good decisions about their health if we constantly fear that something we say is practicing medicine.

Nurses get asked about and answer health-related questions all the time, like when your neighbor calls at 10PM to ask if she should take her child to the ER for a 100.6F temp and a rash. What's wrong with saying not yet, and then telling her the same things she would find if she looked it up on mayoclinic.com? Isn't it better that we can put it in context, and can find out more about the situation?" For example, if her child had CF or a weak immune system, I would tell her to go in promptly. I can also reassure her if things seem minor and give her some emotional support to help cope with her worry over her child. I can and would also say "If he seems listless, or the fever goes up to ____, or if he vomits more than ___ times, or you cannot get him to drink at least _____ amount overnight, call your doctor or NP, no matter what time it is." Can Web MD do that?

This whole issue reminds me of the articles I have read on the "Doctor-Nurse game". That the dancing around that goes on when a nurse calls a doctor with a concern about a patient, but doesn't come out and say directly that he or she is worried and why, and would like ___________, or thinks a stat CBC should be done, or that someone should come and evaluate the patient. Most of this occurs because the nurse had it beaten into her head that he or she cannot diagnose, or that he or she needs to be ultra deferential to the doctor's egos. Or, the nurse simply doesn't want to go beyond just doing the basics or having to think more and take responsibility for him or herself.

We now know that this kind of beating around the bush causes communication breakdowns, and that patients are hurt by it. That's why more and more places are using SBAR and want their nurses to say what they think clearly and directly.

I think nursing is harmed by a need to pretend we know less than we actually do. I know a lot, based on almost 30 years of OB experience, and will not hide that away. Why should I? I do not give out unsolicited advise, but when asked a question, will answer it.

roser13, ASN, RN · Jul 28, 2010

"I think nursing is harmed by a need to pretend we know less than we actually do. I know a lot, based on almost 30 years of OB experience, and will not hide that away. Why should I? I do not give out unsolicited advise, but when asked a question, will answer it."

Wow. You have generalized this question into well beyond the scope of the initial post. We all believe that you "know alot." No one's arguing that. I have no idea how this thread transitioned into nursing being "harmed" by a need to pretend to know less than we actually do.

When I'm at work, I do not hide my knowledge - that's why I'm there. However, I never succumb to the need to show how much I know just because I can.

This is a public forum that is dedicated to the avoidance of even giving the appearance of medical advice, and I won't be surprised if this thread gets closed or deleted.