How to Track Contractions and When to Call the Hospital

Tracking contractions sounds straightforward until you are actually in the middle of it at 2 am, trying to remember when the last one started while timing the current one. Getting it right matters — the data you collect over an hour or two is exactly what the hospital or midwife will ask about when you call.

This guide covers what contractions feel like, how they differ from Braxton Hicks, precisely what to measure, what the different timing guidelines mean, and when to stop tracking and call immediately.

Fact-Checked & Transparent: This article is fact-checked against current CDC, WHO, ACOG, and NHS guidelines. All health information is based on authoritative medical sources. Last verified: June 2026.

⚠️ MEDICAL DISCLAIMER

This article is educational information only. It is NOT a substitute for professional medical advice, diagnosis, or treatment.

Always consult your pediatrician or healthcare provider before making any medical decisions for your baby or child. Every baby is unique, and professional medical guidance is essential.

In case of emergency, call 911 or your local emergency number.

What Contractions Feel Like — and How They Differ from Braxton Hicks

True labour contractions and Braxton Hicks contractions can feel similar early on, which is one of the reasons false alarms to maternity units are so common. Understanding the difference saves unnecessary trips and helps you recognise the real thing when it starts.

Braxton Hicks contractions:

• Irregular — they do not follow a pattern
• Usually painless, or mildly uncomfortable but not painful
• Often felt as a tightening across the abdomen
• Tend to ease with a change of position, movement, or a warm bath
• Do not increase in intensity over time
• More common in the afternoon or evening and during physical activity
• More noticeable from around 28 weeks, though they can occur earlier

True labour contractions:

• Regular and progressively closer together
• Increase in intensity over time — they do not get easier
• Feel like a wave starting in the lower back, radiating around to the lower abdomen and sometimes down the thighs
• Continue regardless of position change, movement, or a bath
• Make it difficult to talk or concentrate during the peak
• Cause the uterus to become very firm when you place your hand on your abdomen

A useful rule of thumb: if a warm bath or a walk makes them stop, they were likely Braxton Hicks. If they continue and intensify regardless, they are more likely to be true labour.

What Exactly to Track

Many people record contractions incorrectly, which gives a misleading picture of labour progress. There are three measurements that matter:

1. Start Time

Note the exact time each contraction begins. This is not when you notice it is getting stronger — it is the first moment of tightening.

2. Duration

Measure from the start of the contraction to the moment it completely releases. Duration is recorded in seconds. Early labour contractions typically last 30–45 seconds. By active labour, most contractions last 60–90 seconds.

3. Interval (Frequency)

This is the most commonly misunderstood measurement. The interval is measured from the start of one contraction to the start of the next — not from the end of one contraction to the beginning of the next.

This distinction matters. If a contraction lasts 60 seconds and there are 4 minutes between the end of it and the start of the next one, the interval is 5 minutes (1 minute duration + 4 minutes gap) — not 4 minutes.

When you call the hospital, they will ask how far apart contractions are. They mean interval — the start-to-start measurement.

The 5-1-1 Rule

The 5-1-1 rule is commonly used in the United States and widely referenced in birth preparation resources:

• Contractions every 5 minutes apart (start to start)
• Lasting at least 1 minute each
• For at least 1 hour

This pattern suggests active labour is establishing and it is time to go to hospital or call your maternity unit.

NHS Guidance: What They Actually Say

NHS guidance is slightly different in emphasis. The NHS advises calling the maternity unit when contractions are regular and coming every 5 minutes — but the key word is regular. A single contraction 5 minutes after the previous one does not mean contractions are 5 minutes apart; you need to see a consistent pattern over time.

For first-time parents: NHS maternity guidance generally advises calling when contractions are regular, lasting around 60 seconds, and coming every 5 minutes for at least an hour. This aligns closely with the 5-1-1 rule.

For second or subsequent births: Call earlier. Second labours are typically significantly faster than first labours. NHS units advise calling when contractions are 3–4 minutes apart rather than waiting for 5 minutes. Do not apply first-birth timing guidance to subsequent pregnancies.

If you had a previous fast labour: Call as soon as contractions establish, regardless of the interval. Speak to your midwife in advance so you have a clear personalised plan.

What to Do During Early Labour at Home

Early labour — when the cervix is dilating from 0 to 6 cm — can last many hours, particularly for first-time parents. Arriving at hospital in early labour means a high likelihood of being assessed and sent home again, as this is the recommendation of NICE for uncomplicated pregnancies.

According to NICE guidelines, active labour is defined as beginning at 6 cm dilation. Before this threshold, early labour management at home is generally more comfortable and just as safe for low-risk pregnancies.

While at home in early labour:

• Rest if it is night-time. Sleep if you can — you will need energy later.
• Distract yourself. For many people, watching something absorbing, going for a short walk, or baking keeps early labour moving without fixating on every contraction.
• Use a warm bath or shower. It will not stop true labour but can significantly reduce discomfort.
• Apply a TENS machine. Most effective when started early, before contractions become very intense.
• Stay hydrated and eat light, easily digestible food. Labours can be long and energy-depleting.
• Ask your birth partner to track contractions if you are finding it hard to focus.
• Contact your maternity unit if you have any concerns, even in early labour. There is no threshold of urgency you need to reach before you are allowed to call.

Using Apps to Track Contractions

Several apps make tracking contractions significantly easier than pen and paper or mental arithmetic:

• Full Term (iOS) and Contraction Timer (Android) are widely used and simple — tap when a contraction starts, tap again when it ends.
• Bloomlife includes a wearable sensor option as well as app-based tracking.
• The Bump Contraction Timer and Ovia Pregnancy both include contraction tracking within broader pregnancy tracking apps.

The advantage of apps is that they automatically calculate duration and interval, show you a pattern over time, and produce a log you can describe (or even show) to the midwife when you call. Rather than trying to describe "they're coming about every five minutes, I think," you can give precise information.

Most apps let you export or display data from the last hour, which is exactly the window the hospital will be interested in.

Early Labour vs Active Labour

Understanding the clinical distinction between early and active labour helps you understand why timing guidelines exist and what the hospital is assessing.

The NICE definition of established labour is 6 cm or more of dilation. This is the threshold at which hospital admission and active management begin. Before this, even with regular contractions, a vaginal examination may show the cervix is at 3 or 4 cm, and you may be advised to return home.

This is not dismissal. Early labour in familiar, comfortable surroundings — with your own food, your own bath, and freedom to move — is genuinely better for progress than a hospital bed. Trust the guidance, and trust yourself to recognise when things are changing.

When to Go to Hospital Immediately

There are situations where you should go to hospital immediately, regardless of the contraction pattern. Do not wait to track for an hour. Do not call to ask first — or call on your way.

Go in immediately if you experience:

Waters breaking with green, brown, or blood-stained fluid. This can indicate meconium in the amniotic fluid, which requires prompt assessment of the baby's wellbeing.

Bleeding beyond a small amount of bloody show. A small amount of pink or blood-streaked mucus (a show) is normal in early labour. Bright red bleeding or a larger amount of blood requires immediate assessment.

Reduced or absent fetal movement. If you notice the baby is moving less than usual, or you cannot feel the baby moving at all, do not wait. Contact your maternity unit immediately. RCOG guidance is clear that reduced fetal movement should always be assessed promptly, regardless of whether you are in labour.

Cord prolapse. If you feel or see a loop of cord at the vaginal opening after your waters break, this is an emergency. Call 999 immediately.

Extreme pain that is constant and not coming in waves. Labour contractions build and release. Constant severe abdominal pain that does not ease may indicate placental abruption.

You feel faint, unwell, or are having difficulty breathing. These are not symptoms of uncomplicated labour.

Any feeling that something is wrong. Maternal instinct is not clinically measurable but is clinically respected. If something feels different or frightening in a way you cannot explain, call.

Frequently Asked Questions

How do I know if contractions are regular enough to call?

Track for at least 30–60 minutes and look for a consistent pattern. If the start-to-start interval is consistently around 5 minutes (or 3–4 minutes for a second birth), and each contraction lasts approximately a minute, that is the pattern to call about. One or two evenly spaced contractions do not establish a pattern.

What if my contractions stop after a few hours?

This is normal in early labour, particularly overnight. The pattern of contractions may pause and restart. If contractions were progressing and then completely stop for more than an hour, you can call your maternity unit to discuss. Otherwise, rest and let your body do what it needs to do.

Is it normal for contractions to feel different from one to the next?

In early labour, yes. Contractions can vary in intensity, particularly at the beginning. As active labour approaches, they become more consistent and predictable. If contractions are fluctuating widely in intensity and spacing over a long period, you are likely still in early labour.

My second baby is coming — when exactly should I call?

For second and subsequent births, NHS units generally advise calling when contractions are 3–4 minutes apart rather than 5 minutes. Do not wait for the same markers you used in a first labour. Some people have very fast second labours — discuss the specifics with your midwife at a late pregnancy appointment.

Can I track contractions on my own?

Yes. You do not need a birth partner to track contractions accurately. A phone with a stopwatch and a notes app is sufficient, or a contraction timing app makes it even simpler. If you have a birth partner, tracking together allows you to focus on managing the contractions while they handle the timing.

Should I eat something before going to hospital?

If you are in early labour at home and contractions are not yet too intense to eat, eating a light, easily digestible meal or snack is a reasonable idea. Labour is physically demanding and having some energy stores helps. Avoid large meals or anything high in fat, which take longer to digest and may worsen nausea.

Key Takeaways

• Track three things: start time, duration, and interval — measured from the start of one contraction to the start of the next.
• The 5-1-1 rule (every 5 minutes, lasting 1 minute, for 1 hour) aligns with NHS guidance for first births; for second births, call at 3–4 minutes apart.
• NICE defines established (active) labour as 6 cm dilation — before this, early labour at home is safe and often more comfortable than hospital.
• Contraction timing apps automatically calculate the pattern and give you a log to describe to the midwife when you call.
• Early labour at home: rest, stay hydrated, use a TENS machine, take a warm bath, and distract yourself until contractions establish a clear pattern.
• Go immediately — without tracking — if you have heavy bleeding, green or brown amniotic fluid, absent fetal movement, constant severe pain, or cord prolapse.

📋 SOURCES & FACT-CHECKING

This article is compiled and verified against these authoritative sources: - CDC (Centers for Disease Control & Prevention) - WHO (World Health Organization) - ACOG (American College of Obstetricians and Gynecologists) - NHS (National Health Service) - AAP (American Academy of Pediatrics)

Last verified: June 2026

Educational content only. Always consult your pediatrician for medical decisions.

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