Go to hospital now — do not wait to be told
- Vaginal bleeding of any amount, bright red or with clots.
- Waters breaking, especially if the fluid is green, brown, blood-stained or foul-smelling, or if you are under 37 weeks.
- Reduced or absent fetal movement. Lie on your left side, eat something, count for two hours; fewer than ten movements means go in.
- Severe, constant abdominal pain that does not come in waves, particularly with a hard, tender abdomen.
- Severe headache with blurred vision, flashing lights or upper abdominal pain — possible pre-eclampsia.
- A cord you can see or feel at the vaginal opening. Get on your hands and knees with your hips raised and call an ambulance.
- Fever above 38°C, or shivering with a foul-smelling discharge.
- An urge to push, or contractions two minutes apart.
- Regular contractions before 37 weeks.
- Fainting, chest pain, or difficulty breathing at rest.
Call and describe — they will tell you when to come
- Contractions five minutes apart, lasting a minute, for a full hour (or your own threshold if your doctor gave you one).
- Waters possibly broken but you are unsure — a steady trickle you cannot control is different from discharge.
- Loss of the mucus plug with pink or brown streaking, if you are unsure.
- Vomiting repeatedly, or unable to keep fluids down.
- Pain that feels unmanageable and you want to discuss options.
- Anything that simply feels wrong to you. This is a legitimate reason to call and every good obstetric team knows it.
Usually safe to stay home and keep timing
- Irregular contractions that ease with rest, hydration or a change of position.
- Mild period-like cramping and low backache without a pattern.
- Clear mucus discharge without bleeding.
- Loose stools or nausea in early labour — common and normal.
- A burst of energy or restlessness.
What to say when you call
Have this ready so the conversation is fast and useful:
- Your name, your obstetrician's name, and how many weeks you are.
- How many babies you have had before, and how those labours went.
- Contraction frequency and duration, with the last hour's log.
- Whether your waters have broken, and the colour of the fluid.
- Any bleeding, and roughly how much.
- When you last felt the baby move, and whether it feels normal.
- Your blood group and Rh status, and any pregnancy complications — gestational diabetes, high blood pressure, low-lying placenta, previous caesarean.
- How long it will take you to reach the hospital.
Prepare this at 36 weeks, not on the day
Ask your obstetrician: what number do I call at night and on holidays? At what point do you want me to come in? What if I am in early labour and you are not on duty? Which entrance do I use after hours? Write the answers down, put them on the fridge and send them to whoever is driving you. Save the hospital labour room number in your phone, not just the clinic reception.
One principle
You will not be a nuisance. Obstetric teams would far rather assess you and send you home than have you talk yourself out of a call. If you are weighing it up at 3 am, that itself is reason enough to phone.