Labor as long as possible at home means 5-1-1 rule?

[Anonymous]

Please help me understand this - I read a lot of mothers saying here that if you want minimum interventions and in the abscence of any issues, you should labor at home as long as possible. At the child birthing class, I was told that you can wait at home until the 5-1-1 (contractions 5 min apart, 1 min long and continue for more than 1hr). So are these two the same?
My doc says both baby and I are in good condition and I am hoping no issues will crop up. Assuming the best case scenario, meaning I would not get any complications, when do I go into the hospital for delivery if I want minimum interventions?
FWIW, I am not against any interventions as long as that is what is need to get a healthy baby.
Thanks.

[Anonymous]

Great question, PP. I am wondering the same thing. I imagine that women can be having contractions at 5-1-1 and be dilated to varying degrees.

I was having contractions at about that rate and then got to the hospital and was 3 cm dilated...still didn't give birth until 12 hours later...

Looking forward to responses. I would hate to wait too long at home despite wanting to avoid interventions!

[Anonymous]

Midwife told me she didn't want me At the hospital until my contractions were 2 mins apart and coming on top of each other.

[Anonymous]

hi! my daughter was born in a birth center with midwives, so i can really only speak to the protocol for that place - you should definitely clarify with your care provider what they mean by follow the 5-1-1 rule.

in my case, what they wanted was for us to call them when contractions were a minute long every 5 minutes for at least an hour. we called when those criteria had been met. trained birth professionals have ways to assessing your labor's progress without cervical checks - they can assess the intensity of your contractions by your ability to carry on a conversation through them, for example. in my case, my midwife determined that my labor was still fairly early and suggested that we remain at home, try to have a nap, take a walk, etc. and see what happened.

when we ended up coming in, i was 5cm dilated and looking back, those contractions felt TOTALLY different than the ones in early labor. she didn't come for another 12 hours or so, but the purpose of the 5-1-1 rule is to prevent women coming to the hospital or whatever in VERY early labor. the reason they tell you to labor at home as long as you can if you don't want interventions is that hospitals sometimes start a clock on you when you walk in the door and if you run out their clock, they encourage you to have various interventions and augmentations that you might not necessarily need or be interested in having. not every hospital does this, of course, but it does happen.

[Anonymous]

For the first baby, I labored at home until my contractions were about 5 minutes apart and one minute long. But when I got to the hospital, found that I wasn't dilated at all. I was so disappointed!

This time around we're having the support of a doula, who will be at the house with us during that early labor time and help make the right decision about when to go to the hospital.

[Anonymous]

Anonymous wrote:Midwife told me she didn't want me At the hospital until my contractions were 2 mins apart and coming on top of each other.

I think this sounds like a good rule of thumb. I'm thinking 5-1-1 must be super early for most every woman. I actually kept waiting awhile past 2 minutes apart (had a doula at home with me who thought I had a while longer to go), but then suddenly the baby turned her position and she was on her way out, and I had a super fast pushing phase. We almost had an unplanned home birth. But, you'll know when you're in serious active labor -- it's not comfortable!

[Anonymous]

Your understanding of the 5-1-1 rule is correct, but not always applicable.

As a rule first-time mothers have a longer labor, lasting sometimes several days if nature is left to take its course. (My mother was the exception and had her first child in 2 hours start to finish!)

I had a natural birth with the MCA midwives at Shady Grove, and labored at home for as long as possible - problem was, my contractions were never regular, so they were hard to time! Until my water broke (just a trickle, really) while I was packing my bag, and I had such an intense contraction I could only moan through it, never mind talk! I told DH "we have to go NOW". So we dropped off DC1 at the neighbors', and drove 30 minutes to the hospital. I arrived 8 cm dilated and DC1 was born 2 hours later.

FWIW, my contractions were never "painful", just breathtakingly intense, and it felt good to low like a cow The pushing phase was quite tiring for me (eat before you go to the hospital!) and stung a lot at crowning. It helps to be very focused on your body's signals - block out the nurses' encouragements if they are not in sync with what your body is telling you. Visualize your baby unfolding out!

[Anonymous]

Having had two labors that didn't fit any kind of mathematical model I had read or heard anywhere, I think the 5-1-1 rule is kinda BS. And I agree with other posters that it could be way too early for a lot of women. In my first labor if I had followed the 5-1-1 rule I would have ended up at the hospital when I was barely dilated, since my labor started and stopped a few times. If your intention is to go med-free, I would stay home until your labor is very, very intense. If you are interested in maybe getting an epidural but don't want a lot of other interventions, I would stay home until you get to the point where you start wanting the epidural. Of course these are subjective things that vary from woman to woman, but in general I think judging by intensity rather than timing of contractions would have done a better job at getting me to the hospital at the right time.

[Anonymous]

Another post to agree that 5-1-1 as you described would have been pretty early for me. I labored at home for 12 hours, and all but the last two of those were pretty easy, including at least one hour of 5-1-1.

By the time I got to the hospital, the contractions were coming every two minutes or so, practically on top of each other. And they were far more intense -- I was at the point where I couldn't talk at all during contractions -- had to focus elsewhere/inward to get through them.

It turned out I was 6 cm dilated by the time I was upstairs in a room and checked by a doctor. Three hours later, I was at 8 cm and MORE than ready for an epidural, which finally came at that point. I'm sure others would have just gone for the natural birth at that point, but I was ready for some rest and relief.

Anyway, I'm so glad I waited as long as I did to go to the hospital. BUT my labor stalled a bit at 6 cm, while other poeple I know had things speed up at that point, which would have made it a closer call. I agree with the advice to judge by the intensity of the contractions as much as by the frequency/duration. It sounds silly to say, "You'll know," but I think that's actually true.

Good luck!

[Anonymous]

Like one of the PP's, I never had regular contractions until they were 2 minutes apart and on top of each other my first go around. I expected something regular and there just was no pattern. We called the OB while things were sort of all over the place, but on average they were around 5-6 minutes apart, and told him what was going on and he said, "well, come in, we'll check you." By the time I got out of my tub and into the car, my contractions were on top of each other and my daughter was born 45 minutes after I got to the hospital. I really wish someone had told me that it was possible to never have regular contractions until the end like that, but on a first baby, everyone just assumes you'll take forever. And usually, they're right, but if not, well, at least you'll know.

[Anonymous]

At 38 weeks I was 4 cm dialated (with child #1). My dr told me to ignore the contractions 5 min apart "rule" and to come as soon as I had any contractions. For me, this was the right approach. I went from no signs of labor to intense contractions 2 min apart in less than 20 minutes.

For DC #2, my water broke at home and once again I had no other signs of labor (no contractions). In this case, my daughter was in my arms 40 minutes later.

[Anonymous]

I had no signs of contractions until my water broke and even then I had no pain. If my husband had not been such a nervous nelly about getting to the hospital our first kid would have been born at home. I wanted to labor at home, eat something, take a shower and relax and he was anxious about waiting so we took the 10 minute drive. I walked into the hospital in no pain and almost at 10cm.

I had the natural birth I had never planned on!

[Anonymous]

I had a very good friend whose baby was born at home unintentionally because she was following the 5-1-1 but the contractions were never regular so she didn't go to the hospital. She, too, was trying to labor at home as long as possible in order to avoid interventions. Anyway, by the time she called her doula, the doula heard her on the phone and realized she did not have time to get to the hospital. I do think she had a really fast labor but just wanted to throw it out there not to be too bound by the 5-1-1 rule and to trust your gut. Here baby was fine and everything worked out in the end but she was totally shocked to have a baby at home!

[Anonymous]

Great answers above. I never had the 5-1-1 pattern either, glad I'm not the only one! I'll just add that just because your water breaks does not mean you need to go to the hospital right then. Check with your provider; advice on this varies widely. My water broke around 3 p.m., while I was in early labor, and I wasn't in active labor until hours later. Going to the hospital at that point didn't make sense. The baby was born around 11 that night.

[Anonymous]

i agree 5-1-1 can be very early. i think paying attention to your behavior may make more sense than trying to use a formula.

i love this post about the potential pitfalls of using contraction timing as a way to assess where a woman is at in labor:
http://motherwitdoula.blogspot.com/2010/01/throw-your-clocks-out-window.html

if you read "The Birth Partner" by Penny Simkin there is tons of great information in there about behavioral signposts that women exhibit at various points in labor, which can be really useful in helping determine when to go to one's birthplace.

We had a doula for my first daughter's birth and she was incredibly helpful in terms of figuring out when to go to the hospital. She could tell by my behavior that things were gearing up, and I was about 6cm when I got to the hospital. Without her, I think I would have gone much earlier.

Until you've gotten through an entire labor, you have no frame of reference -- the early contractions can seem very difficult, because you haven't gotten to the end yet and don't have harder ones to compare it to, so it's easy to think you are very far along when you aren't, and that can be very disappointing once you get to the hospital.