Admission Procedures and Early Labour Checks

What happens when you arrive at hospital in labour

When labour starts, whether your waters break or contractions begin, things can feel quite sudden. If you have planned a hospital birth, you may be advised to go in for an initial assessment. This helps staff work out how your labour is progressing and whether you need to stay or can go home for a while longer.

Before you leave for hospital, ensure you have your maternity notes with you. In many areas, these are now digital and accessed through an app or online portal, so check that your details are up to date. If you still have paper notes, many people keep them in their hospital bag from around 36 weeks so they are ready to grab when the time comes.

It is worth calling the maternity unit before setting off. The midwife on the phone can ask about your contractions, whether your waters have broken, and how you are feeling. For first-time parents, many NHS trusts suggest coming in when contractions are regular, roughly five minutes apart, and lasting about 60 seconds each. This call also lets the unit know to expect you.

Your birth partner can usually accompany you to the hospital, though policies on visitors can vary between trusts. It is worth checking with your maternity unit beforehand so you know what to expect when you arrive.

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The initial midwife assessment

When you arrive, you will usually be taken to a triage or assessment room rather than straight to a delivery suite. Do not be surprised if the midwife who sees you is not someone you have met before. Whoever is on duty will carry out the checks, and your community midwife may not be working at that time.

The midwife will ask you a number of questions to build a picture of what has been happening. Expect to be asked about:

• When your contractions started and how often they are coming
• Whether your waters have broken and what the fluid looked like
• Any bleeding or unusual symptoms
• Your baby's movements
• Your birth preferences and any concerns you have

They will also check your blood pressure, pulse and temperature. A urine sample may be taken to check for protein or signs of infection.

In most cases, the midwife will then carry out an abdominal examination to feel the position of your baby. They may also offer a vaginal examination to see how dilated your cervix is. You can ask questions about any check before it happens, and you can decline if you prefer.

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Monitoring your baby

Part of the early assessment involves checking how your baby is coping. This is usually done using a handheld Doppler device or a cardiotocograph, often called a CTG. The CTG uses sensors placed on your bump to record your baby's heart rate and any contractions you are having.

If everything looks straightforward, this monitoring may only take 20 to 30 minutes. In some situations, such as if there are concerns about your baby's movements or your pregnancy has been higher risk, you may need longer or more frequent monitoring.

The results help the midwife decide whether you are in established labour or still in the early stages. Early labour can last many hours, and it is often the case that you may be advised to return home if your cervix is not yet dilated to around four centimetres. The decision will also depend on how your contractions are progressing and your overall health. Being sent home is not a sign that anything is wrong. Staying mobile and comfortable at home can actually help labour progress.

What happens next

If you are in established labour, you will be moved to a delivery room or birth centre, depending on your hospital and your preferences. The midwife looking after you will discuss pain relief options and go through your birth plan with you. Your birth partner can usually stay with you throughout.

If you are sent home, you will be given clear advice on when to return. This usually includes guidance on timing your contractions, watching for changes in your waters, and knowing what signs need urgent attention, such as heavy bleeding or reduced baby movements.

Every labour is different, and the early checks are there to make sure you and your baby are well while working out the right time for you to be admitted. If you have any worries at any point, you can always call the maternity unit for advice. The NHS website has further information on the stages of labour and what to expect during birth.

The Next Step

Now that you have read through the advice above, you might want to put it into practice. Our Due Date Calculator lets you calculate your estimated due date and get week-by-week pregnancy guidance. Try it now →