What to Do When You're Sent Home From the Hospital Not in Labor

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You may have heard about false labor either from friends and family or in your childbirth class. The term false labor is a bit of a misnomer because that would indicate to many people that the sensations you are having, if you are experiencing false labor, are not painful nor productive. They can be both, and yet, you're still not in labor.

Being pregnant, particularly at the end of pregnancy, can really weigh on you (no pun intended).

During the last few weeks of pregnancy there are signs and symptoms that pop up that are really uncomfortable and make life a lot harder to cope with in some respects. One of the worst things is when these symptoms are mistaken as labor.

What Happens If You Go to the Hospital Not in Labor?

You might wonder what happens if you show up at the hospital or birth center and say you're in labor, only to be sent home. The good news is that no one laughs at you or thinks you've lost your mind. This happens all the time to lots of families. It is also not something that only happens to first-time mothers.

Typically when you arrive at your place of birth you will be met by a nurse who will help you through the process of getting settled at the hospital or birth center. Part of this process is to see where you are in labor, if it is labor at all. This may mean a period of monitoring. This usually includes monitoring the baby's heart rate, your contraction pattern, the intensity of your contractions, and how your cervix is responding to these contractions.

In many hospitals, this process is completed in the triage area. This is a separate area in most hospitals with beds separated by curtains or in very small rooms near the labor and delivery floor. You will usually have a brief period of fetal monitoring and be asked some questions. Then you will have your cervix checked.

You may be admitted if your cervix is dilated past six centimeters, or if your water is broken, or you have special circumstances determined by your doctor or midwife.

Why Is It a Problem to Go to the Hospital Too Soon?

We often think that if you get to the hospital you will have your baby sooner. This is not always the case. It is also not the case that simply waiting for labor to pick up while at the hospital is the best idea for most pregnant people, particularly for those experiencing a low-risk pregnancy.

Research shows us that when someone is admitted to the hospital, in very early labor, they can actually wind up with more risk and more intervention than if they had simply gone home to wait for labor to pick up naturally. A great example of this is when you show up to the hospital in early labor. Your choices are to go home and wait or to stay at the hospital and use Pitocin, or break your water artificially to speed labor up. These last two things can increase the potential for complications in your labor and to your baby.

Being in Early Labor Versus False Labor

The dynamic of early labor versus false labor does play into the equation, too. While a joint statement from medical organizations like the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal Fetal Medicine (SMFM) says that active labor should not be defined until the cervix is at least six centimeters dilated to avoid potential added risks to the parent and baby, some hospitals are still not following this guideline.

Using these guidelines has been shown as a safe and effective way to decrease the primary, or first time, cesarean birth rate.

If you were not having contractions that changed your cervix in about an hour, this would be a case of false labor—your cervix is not changing and you are not in labor. If your cervix was changing, but you were not yet six centimeters dilated, this is known as early labor. Early labor is best managed from the comfort of your own home.

What Happens When You Leave the Hospital

When you leave the hospital you will be given instructions on what to look for in order to know when to return.

It is important to realize that many parents come in and are sent back home to wait for a while before coming back to finally have their babies. This can be emotionally draining and even slightly embarrassing. This is one of the reasons that many families choose to wait to alert their relatives that they are going to the hospital until after they've been admitted.

You may also be given medication to help you sleep or to calm your symptoms down. You may also be given instructions about over the counter medications that you can take to help you rest as well. If you are not told how to manage the symptoms, be sure to ask for advice.

Ways to Minimize Trips to the Hospital

No one wants you to have to be sent home from the hospital not in labor or in very early labor. There are some things that you can do to ensure that once you make the decision to go to the hospital or place of birth, you will be staying until the birth of your baby.

1. Hire a Doula: A doula is a person who is trained to support you and your family in the months leading up to a birth, the early labor and labor, and the early postpartum period. This includes helping you determine if you are in real labor or false labor. This might even include having a doula come to your house and time some contractions with you. They can also help direct you as to when you might want to call your practitioner or return to the hospital.

2. Take a Childbirth Class: A childbirth class is a great way to learn what is really labor and what is simply the end of pregnancy. This includes learning to tell when you are merely having contractions, or are having labor contractions. A good childbirth class will also be able to help you know what hospital policies are in your area, so that you can be prepared with that information as it comes time for your baby to be born. You will also learn a variety of coping measures that will help you stay comfortable both at the end of your pregnancy and in labor. This helps you stay home longer in early labor and Lamaze International Childbirth classes have been shown to help you avoid elective induction of labor, such as in the case of arriving at the hospital before labor has started.

3. Time Contractions: Timing contractions sounds fairly easy to do, but there is a trick to it that is best taught in person. An app for timing contractions is fine, but it doesn't replace a human being able to help you measure the intensity of contractions. There is a nuance to contractions that is about much more than timing.

Symptoms on Late Pregnancy That Can Mimic Labor

Some of these pregnancy symptoms are expected. You might find that you feel a lot of back pain and experience backaches more frequently in the last weeks of pregnancy. This is often caused by a combination of the increased weight you are carrying and poor posture. Treating this with improved posture and massage is useful. There are also some benefits to massage and specific exercises, like the pelvic tilts.

Braxton-Hicks Contractions can also cause you to think that you are in labor. These contractions are real contractions. The difference between these practice contractions is that they do not change the cervix. That changing cervix is the definition of labor.

When to Return to Your Place of Birth

At some point, you will need to actually return to your place of birth. The best way to determine when it is time is when your labor symptoms have increased, your contractions are stronger, longer, and closer together, or you have met some other criteria set by your doctor or midwife. You will want to monitor for signs such as:

  • Fluid leaking from your vagina
  • Vaginal bleeding
  • Decreased fetal movements
  • Fever
  • Contractions that get increasingly stronger, longer, and closer together
  • Other signs your practitioner asked you to look for in your body

When you see these signs return to the hospital or place of birth. This can be a few hours after you've left the hospital before, or it can be days or weeks. Truthfully, no one can tell you exactly when it will happen.

You might also consider asking to come in to see your doctor or midwife for a quick check during office hours to help delay going to the hospital and sitting in triage until you know you're in labor. Many practitioners offer this service if they are open and have staff.

Once at the hospital again, you will go through the triage process once again. If it is determined that you are in labor, you will be admitted in labor and proceed to have your baby. Remember, labor is a process and one that moves through the stages at slightly varying paces and ways for every single person. It can even vary pregnancy to pregnancy with the same person. Everyone on your team wants what's best for you and your baby, so work together and don't stress out!

Sources:

Main, E. K., Moore, D., Barrell, B., Schimmel, L. D., Altman, R. J., Abrahams, C., et al. (2006). Is there a useful cesarean birth measure? Assessment of the nulliparous term singleton vertex cesarean birth rate as a tool for obstetric quality improvement. American Journal of Obstetrics & Gynecology, 194, 1644 - 1652.

Mikolajczyk, R., Zhang, J., Chan, L., & Grewal, J. (2008). Early versus late admission to labor/delivery, labor progress and risk of caesarean section in nulliparous women. Am J Obstet Gynecol, 199(6 Suppl A), S49.

Safe prevention of the primary cesarean delivery. Obstetric Care Consensus No. 1. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;123:693–711.

Simpson, K., G. Newman, and O. Chirino, Patients’ perspectives on the role of prepared childbirth education in decision making regarding elective labor induction. J Perinat Educ, 2010. 19(3): p. 21-32.

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