When to go into hospital labour

Labor: When to Go to the Hospital

Your body starts preparing for labor in advance — as much as a month before you actually give birth. It can be tough to know when it’s happening for sure. We’ll help you spot the difference between a dress rehearsal and the real deal.

Learn to recognize the signs of labor

When to come to the hospital

Timing is different for every pregnancy. At your third trimester prenatal appointments, we’ll talk about how to know when it’s time, what to do, and where to go, but ideally you’ll come to the hospital when you’re in active labor.

It’s common to think the first signs of contractions are your cue to come to the hospital, but that’s usually not the case. Early labor can last for days. All we can do at this stage is wait for signs that your body is ready to deliver, so a lot of people come in too soon and wind up going home again. Getting from point A to point B isn’t fun during any stage of labor, so call us before you come so we can help you avoid multiple trips. Counting your contractions can help you figure out when it’s really time to go.

Real labor vs. false labor

You might have Braxton Hicks contractions — also called false labor — as your due date approaches. They’re basically warm-ups for childbirth, when your uterus expands and contracts, but you’re not in labor.

What’s the difference?

People call these types of contractions false labor because they can trick you into thinking it’s time when it’s really not. Spot the difference with these signs of Braxton Hicks contractions:

There’s no pattern.

They don’t last longer than an hour.

If you move around, they go away.

They aren’t painful.

If you’re still not sure, just call your care team. That’s what we’re here for.

Induced labor

Sometimes there are signs that it’s time to deliver your baby before labor starts on its own. If that happens, your care team might step in and get things going by inducing labor.

Learn why and how we induce labor

Counting labor contractions

A contraction is a tightening of the uterus that feels like cramping or pressure. You should feel it over your entire uterus and possibly into your back. As labor progresses, your contractions become more frequent and regular, so timing them is a good way to figure out when it’s time to head to the hospital.

Timing is everything. Here’s how it works:

Start timing your contractions once you feel a few in a row.

Time the length of each contraction. If the tightness lasts for 30 seconds or longer, they’re labor contractions.

Count the time between contractions from the start of one to the start of the next.

If this is your first baby, come to the hospital when your contractions:

Come every 3 to 5 minutes over an hour-long period

Last at least 45 to 60 seconds

If you’ve given birth before, come to the hospital when your contractions:

Come every 5 to 7 minutes

Last at least 45 to 60 seconds

Speeding up the process

If your contractions are still far apart and you want things to go faster, try walking around. It can help your baby move into your pelvis. The pressure that gravity puts on your cervix can also help things move along. You can also try these labor and birth positions to ease discomfort and possibly speed things up a bit.

Planning ahead

The first thing to do is call us to let the care team know you’re on your way. Save the number of Kaiser Permanente's dedicated Labor Line to your phone now so you have it when you need it.

After you call your care team, get going! Grab your hospital bag, head to the hospital, and get ready to meet your new baby.

Signs that labour has begun

Know the signs

There are several signs that labour might be starting, including:

contractions or tightenings
a "show", when the plug of mucus from your cervix (entrance to your womb, or uterus) comes away
backache
an urge to go to the toilet, which is caused by your baby's head pressing on your bowel
your waters breaking

The early (latent) stage of labour can take some time.

Urgent advice: Call your midwife or maternity unit if:

your waters break
you have vaginal bleeding
your baby is moving less than usual
you're less than 37 weeks pregnant and think you might be in labour

These signs mean you need to see a midwife or doctor.

Latent phase of labour

The start of labour is called the latent phase. This is when your cervix becomes soft and thin, and starts opening for your baby to be born. This can take hours or sometimes days.

You'll probably be advised to stay at home during this time. If you go to the hospital or maternity unit, they may suggest you go back home.

Find out more about the stages of labour and what you can do at home during the latent phase.

Call your midwife if you're unsure or worried about anything.

What do contractions feel like

When you have a contraction, your womb tightens and then relaxes. For some people, contractions may feel like extreme period pains.

You may have had contractions during your pregnancy, particularly towards the end. These tightenings are called Braxton Hicks contractions and are usually painless.

Your contractions tend to become longer, stronger and more frequent as your labour progresses. During a contraction, the muscles tighten and the pain increases. If you put your hand on your abdomen, you'll feel it getting harder; when the muscles relax, the pain fades and you will feel the hardness ease.

The contractions are pushing your baby down and opening the entrance to your womb (the cervix), ready for your baby to go through.

Your midwife will probably advise you to stay at home until your contractions become frequent.

Call your midwife or maternity unit for guidance when your contractions are in a regular pattern and:

last at least 60 seconds
come every 5 minutes or
you think you are in labour

Read more information on when to go to hospital

Backache often comes on in labour

You may get backache or a heavy, aching feeling.

A "show" can signal the start of labour

During pregnancy, there's a plug of mucus in your cervix. This mucus comes away just before labour starts, or when in early labour, and it may pass out of your vagina. This sticky, jelly-like pink mucus is called a show.

It may come away in 1 blob or in several pieces. It's pink because it contains a small amount of blood.

If you're losing more blood, it may be a sign something is wrong, so phone your hospital or midwife straight away.

A show indicates that the cervix is starting to open. Labour may quickly follow or may take a few days. Sometimes there is no show.

What happens when my waters break

It's likely your waters will break during labour, but it can also happen before labour starts.

Your baby develops and grows inside a bag of fluid called the amniotic sac. When it's time for your baby to be born, the sac usually breaks and the amniotic fluid drains out through your vagina. This is your waters breaking. Sometimes when you're in labour, a midwife or doctor may offer to break your waters.

If your waters break naturally, you may feel a slow trickle or a sudden gush of water you cannot control. To prepare for this, you could keep a sanitary towel (but not a tampon) handy if you're going out, and put a protective sheet on your bed.

Amniotic fluid is clear and pale. Sometimes it's difficult to tell amniotic fluid from urine. When your waters break, the water may be a little bloodstained to begin with.

Tell your midwife immediately if:

the waters are smelly or coloured
you're losing blood

This could mean you and your baby need urgent attention.

If your waters break before labour starts, call your midwife. Use a sanitary pad (not a tampon) so your midwife can check the colour of the waters.

If labour does not start after your waters break

It's usual to go into labour within 24 hours of the waters breaking. You'll be offered an induction if you do not because, without amniotic fluid, there's an increased risk of infection for your baby.

Until your induction, or if you choose to wait for labour to start naturally, tell your midwife immediately if:

your baby moves less than usual
there's any change in the colour or smell of any fluid coming from your vagina

You should take your temperature every 4 hours when you're awake, and tell your midwife if it's raised. A raised temperature is usually above 37.5C, but you may need to call before this – check with your midwife.

There's no evidence that having a bath or shower after your waters have broken increases your risk of infection, but having sex might.

How to cope when labour begins

At the beginning of labour, you can:

walk or move about, if you feel like it
drink fluids – you may find sports (isotonic) drinks help keep your energy levels up
have a snack, if you feel like it
try any relaxation and breathing exercises you've learned to deal with contractions as they get stronger and more painful – your birth partner can help by doing these with you
have your birth partner rub your back – this can help relieve pain
take paracetamol according to the instructions on the packet – paracetamol is safe to take in labour
have a warm bath

Find out what happens during labour and birth, and what you can do for pain relief in the early stages of labour.

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Video: How will I know I am in labour?

In this video, a midwife describes the signs that mean labour may be starting.

Media last reviewed: 1 November 2022
Media review due: 1 November 2025

Community content from HealthUnlocked

how to leave, essence, terms, documents, rules for registration, payments and exit from the decree

Maternity leave is usually called maternity leave. And sometimes - and leave to care for a child up to one and a half or three years.

Diana Shigapova

lawyer

According to the law, these are two different holidays - they will need different documents. Deadlines, rules for registration and benefits for them also differ.

We have already written how to calculate maternity payments and how to get out of maternity leave. In this article, we will analyze how to properly go on maternity leave. Maternity leave I will abbreviate as BiR, and for childcare - UzR.

Registration rules

The laws do not contain step-by-step instructions on how to apply for leave in BiR and UzR, but various regulations state who can go on maternity leave and when, how the allowance is assigned and what documents will be needed.

The right to leave in BiR, and then in UzR, is guaranteed by the labor code.

Art. 255, 256 of the Labor Code of the Russian Federation

How a sick leave is issued for B&R

Only a pregnant woman can go on vacation for B&R: it is issued on the basis of a sick leave. It is issued at the 30th week of pregnancy, and if a woman is expecting twins or more, at the 28th week.

Both a woman who has given birth and a father, grandmother, grandfather or other relative who cares for the baby can go on leave in UZR.

/prava-uchebnik/

Course: how to protect your rights at work

List of required documents for maternity leave

First, the doctor draws up sick leave. In 2022, there are no paper certificates of incapacity for work - everything is issued electronically.

Immediately after filling out and signing, the doctor sends an electronic sick leave to the FSS. And the woman is given a paper coupon in her hands, which contains all the necessary details: sick leave number, who issued it, the period of incapacity for work.

An accountant at the place of work, having entered the FSS website, fills out his part of the sick leave - the length of service and the average daily earnings of the employee - and calculates the amount of the benefit.

What to do? 07/15/19

How can an individual entrepreneur receive maternity payments?

If a woman works for several employers and worked for them for the previous two years, she must report the number of the electronic certificate of incapacity for work for each place of work.

clause 19 of the Regulations on the procedure for calculating benefits

Application for maternity leave. Since 2022, an unclaimed procedure for the payment of benefits, including benefits for pregnancy and childbirth, has been in force in Russia. Sick leave is generated electronically, and money is accrued automatically, but at work a woman may be asked to write an application for leave in B&R and provide an electronic sick leave number - it will be written on a coupon from a medical organization.

Certificate of income from employment for the previous 2 years will be required if the woman has worked for this employer for less than three years. This document is needed to calculate benefits.

Part 5 13 of the Law "On Compulsory Social Insurance"

Decree order. The employer can use the unified T-6 form or develop his own order form.

Duration of vacation

Vacation in BiR and vacation in UzR last a strictly defined number of days.

Maternity. How many days a woman stays on sick leave in BiR depends on how the birth went and how many children she had.

Length of leave in BiR

How was the birth	Number of days before delivery	Number of days after birth
No complications	70	70
With complications	70	86
Two or more children were born	84	110
Two or more children were born, but multiple pregnancy was determined at birth	70	124
Early: 22nd to 30th week of pregnancy	-	156
Early: 22nd to 28th week of pregnancy, two or more babies born	-	194

Delivery passed without complications

Number of days before delivery

Number of days after delivery

with 7 complications

0048

days before genera

days after birth

Born two or more children

Number of days before generation

days after giving birth

9000 110

9000 were born two or more children, but multiple pregnancy was determined at delivery

Number of days before delivery

Number of days after delivery

124

Early: 22nd to 30th week of pregnancy

Days to delivery

Days after delivery

156

pregnancy, two or more children were born

Number of days before delivery

Number of days after delivery

194

What is considered a complicated birth is listed in the special instructions. This is, for example, a caesarean section or childbirth, during which a woman lost a lot of blood.

The instructions also spell out how doctors should extend the period of sick leave in the postpartum period of a woman if childbirth suddenly becomes complicated.

/list/v-dekrete-slozhno/

4 difficult situations that may arise during the decree

Caring for a child up to 1.5 or 3 years old. The UZR period can be up to a maximum of 3 years of age. A woman can go to work at any time. Often this happens 1.5 years after childbirth, when the child care benefit period ends.

From which date does the vacation count. The calculation of leave for BiR is determined by the obstetrician-gynecologist. The general rule for everyone is that B&R leave should start from the 30th week of pregnancy, and if the pregnancy is multiple, from the 28th week.

The doctor issues a certificate of incapacity for work, regardless of whether the woman is going to go on vacation in BiR or not.

Parental leave begins immediately after the end of the B&R leave - usually on the 71st day after the birth of the child.

/guide/iz-dekreta/

How to get out of the decree

When to return to work

A woman must return to work on the next working day after the child turns 3 years old.

Is it possible to leave the decree ahead of schedule. The law does not provide for the possibility to return to work before the B&R leave ends. For example, 30 days after birth. If the employer meets the employee halfway, then the FSS, who overpaid maternity leave, will require the employer to return the overpayment. The employer will have to return the overpaid allowance to the FSS from his own pocket - the woman will not be able to keep it.

Letter of Rostrud dated May 24, 2013 No. 1755-ТЗ

You can return to work at any time from leave in UzR, without waiting for the baby to be three years old. At the same time, the mother retains the right to return to vacation again if she wants.

Is it possible to work during maternity leave. A woman can apply for a part-time job and work while on vacation in UzR. To do this, you need to write a statement to the employer with a request to establish part-time work with the desired schedule.

Art. 93 Labor Code of the Russian Federation

During a vacation in BiR, this will not work.

Extension of leave under the law

There are situations when the child is 3 years old, but the woman cannot return to work. For example, a child was not given a place in a kindergarten, and there is no one to leave him with.

Is it possible to extend maternity leave after 3 years of maternity leave. There are two options:

Take basic or additional leave, which is due, for example, to workers in hazardous and hazardous industries. These holidays can be issued if the employee did not have time to take them off before going on maternity leave.
Take a leave without pay for a period agreed with the employer. This leave can be issued only with the consent of the employer - he is not obliged to provide it.

What to do? 11/09/18

Need to go from maternity leave to maternity leave. How to arrange it?

Unfortunately, there are no other options.

What to do if the employer refuses to grant maternity leave

It is up to the woman to decide whether to go on maternity leave or not - the employer has no right to refuse to grant maternity leave.

If the employer "forgets" to take maternity leave, you need to complain about it to the labor inspectorate. You can learn how to defend your rights in this and other situations in the course "How to protect your rights at work".

/prava/dekret/

Rights of employees in the decree

Registration of leave for relatives

According to the law, it is possible to issue leave in UzR not only for mother, but also for another relative.

For the husband. Two people cannot be on leave in UZR, so the mother needs to give up her right to leave.

If a woman applied for maternity leave at the Pension Fund of the Russian Federation, then a certificate of non-use of leave in UZR must be issued there.

If the mother went to work, then she needs to issue a certificate of non-use of leave in UZR in the accounting department at the place of work.

The father of the child at his place of work writes an application for leave and attaches to it a certificate received from his wife, as well as a birth certificate of the child.

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How can a man go on maternity leave

Grandmother can also be issued leave in UZR - for this, both the mother and the father of the child must prepare certificates of non-use of the leave. If the grandmother works, such certificates can be requested by her employer to be sure that the grandmother is really entitled to take leave in UzR. For the FSS, such certificates are not needed.

In this case, the following should be taken into account:

Grandmother must be officially employed. If she does not work, then it will be possible to issue a vacation in UzR only in special cases: the parents of a grandson or granddaughter are missing, deprived of parental rights, or are in prison.
In order for the grandmother to accompany the child to the clinic for an appointment with a pediatrician or for examination by specialists, parents must give the medical institution written consent to the medical intervention in advance.
If a child needs to be vaccinated, hospitalized, or needs surgery, the grandmother cannot give consent. In order for the grandmother to sign the informed voluntary consent, the parents must issue a notarized power of attorney for her.

Benefits received during maternity leave

We have already talked about all payments and benefits in detail.

Who pays maternity leave. From 2021, the FSS pays maternity benefits, but documents are still submitted through the employer. If a woman has been working for the last 3 years with the same employers, then the allowance is assigned for each place of work.

Art. 13 of the law "On Compulsory Social Insurance"

The FSS of the expectant mother should be contacted if:

The employer has ceased operations.
The employer has no money.
The employer does not know where he is, and the fact of non-payment of benefits was established by the court.
The employer is in one of the stages of bankruptcy.
A woman is an individual entrepreneur, a lawyer or a notary and voluntarily pays insurance premiums for herself.

Who pays child care allowance. The allowance for UZR is paid by the FSS in the same manner as the allowance for BiR.

How to calculate the B&R allowance. Maternity payments in 2022 are calculated according to the following formula:

Income for 2020 and 2021 / (730 days - the number of days that a woman was on sick leave or on vacation according to BiR or UzR) × Number of sick days.

/guide/skolko-dekretniye/

How to calculate maternity payments

If the salary is low or there was no income, the calculation of benefits is based on the minimum wage. The calculation formula is as follows:

minimum wage × 24 months / 730 days × Number of sick days.

From June 1, 2022, the minimum wage is 15,279R. Therefore, the minimum benefit for B&R will be:

70,324.80 R for 140 days;
78,361.92 R for 156 days;
97,450.08 R for 194 days.

So what? 06/01/22

Since June 1, 2022, the minimum wage has increased to 15,279 R: what payments will it affect

social insurance.

Benefit amounts in 2022

How to calculate allowance for UZR. The child care allowance is calculated according to the following formula:

P = SDZ × 30.4 × 40%,

where P is the allowance,
SDZ is the average daily earnings, which is calculated in the same way as for vacation in BiR.

So what? 06/12/20

Child care benefits have doubled. Who will be paid more?

If a woman 2 years before going on maternity leave earned less than the minimum wage or did not earn at all, she will be paid the amount of the allowance established by the state - 7677.81 R per month.

How the allowance is paid. The allowance is assigned within 10 days from the date of submission of the necessary documents. At the same time, the initial payment of the monthly allowance is made. Then the FSS pays the benefit from the 1st to the 15th day of the month following the month for which it is due.

Art. 15 of the Law "On Compulsory Social Insurance"

How is the allowance for unemployed women issued. If a woman is unemployed, she is not entitled to B&R benefits. Child care allowance for unemployed women is assigned and paid by the PFR.

Taking maternity leave from maternity leave

It is impossible to be on leave in BiR and UzR at the same time. Therefore, a woman can go from vacation in UzR to leave in BiR, and then on a new vacation in UzR.

Document the transition from one vacation to another by order in a free form. The woman will be paid the B&R allowance again, and then they will pay the UZR allowance.

Annual paid leave before Decree is granted at the request of a woman. At the same time, it does not matter how long she has worked for the employer - she has the right to leave, even if the work experience is less than six months.

Art. 122 of the Labor Code of the Russian Federation

Annual leave after Decree should also be given, but only if the woman has not used it before.

Dismissal on maternity leave

A pregnant woman or mother who is on leave in UZR cannot be dismissed for any reason at the initiative of the employer, except for the liquidation of the company or the termination of the activity of the individual entrepreneur. A woman can only quit of her own free will and for other reasons, for example: by agreement of the parties or in connection with a refusal to work in new conditions.

Art. 261 of the Labor Code of the Russian Federation

You can also dismiss an employee who is on vacation in UZR if the term of the employment contract has expired.

In the event of the expiration of a fixed-term employment contract during the pregnancy of a woman, the employer is obliged, upon her written application and upon providing a medical certificate confirming the state of pregnancy, to extend the validity of the employment contract until the end of pregnancy, and if she is granted maternity leave in the prescribed manner — until the end of such leave.

An exception is the situation when the main worker leaves. In this case, the fixed-term contract can be terminated before the end of pregnancy if it is not possible to transfer the woman to another job.

What to remember about maternity leave

Only a working woman can go on maternity leave.
Both the mother and any other relative who cares for the child can go on parental leave.
Benefit for B&R and UZR is assigned at the place of work. If the employer is bankrupt, he has no money or the company has closed, and also if the woman is an individual entrepreneur and pays voluntary contributions, you need to apply to the FSS for benefits.
If a woman is unemployed, she is only entitled to allowance for UZR. You need to issue it in the client service of the PFR at the place of residence.

VIII. The procedure for issuing a sick leave certificate for pregnancy and childbirth \ ConsultantPlus

VIII. The procedure for issuing a certificate of incapacity for work

for pregnancy and childbirth <18>

--------------------------------

< 18> Features of the payment of benefits for pregnancy and childbirth and the duration of maternity leave are established by Article 10 of the Federal Law of December 24, 2006 N 255-FZ.

46. A sick leave certificate for pregnancy and childbirth is issued by an obstetrician-gynecologist, in his absence - by a general practitioner (family doctor), and in the absence of a doctor - by a paramedic. The issuance of a certificate of incapacity for work for pregnancy and childbirth is carried out at 30 weeks of pregnancy at a time for 140 calendar days (70 calendar days before childbirth and 70 calendar days after childbirth).

In case of multiple pregnancies, a certificate of incapacity for work for pregnancy and childbirth is issued at 28 weeks of pregnancy at a time for a duration of 194 calendar days (84 calendar days before delivery and 110 calendar days after delivery).

If a woman, when applying to a medical organization, refuses to receive a certificate of incapacity for work due to pregnancy and childbirth for the period of maternity leave, her refusal is recorded in the medical documentation. When a woman reapplies before childbirth for a certificate of incapacity for work for pregnancy and childbirth for registration of maternity leave, a certificate of incapacity for work is issued for 140 calendar days (for 194 calendar days - in case of multiple pregnancy) from the period established by the first or second paragraphs of this paragraph.

(as amended by the Order of the Ministry of Health and Social Development of Russia dated January 24, 2012 N 31n)

(see the text in the previous edition)

54 calendar days by the medical organization where the birth took place.

48. In case of complicated childbirth, a certificate of incapacity for work due to pregnancy and childbirth is issued for an additional 16 calendar days by the medical organization where the childbirth took place.

49. In case of childbirth that occurred between 22 and 30 weeks of pregnancy, a certificate of incapacity for work due to pregnancy and childbirth is issued by the medical organization where the birth took place, for a period of 156 calendar days.

(as amended by the Order of the Ministry of Health and Social Development of Russia dated January 24, 2012 N 31n)

(see the text in the previous edition)

for the entire period of incapacity for work, but for a period of at least three days.

(clause 50 as amended by the Order of the Ministry of Health and Social Development of Russia dated January 24, 2012 N 31n)

(see the text in the previous edition)

NPP (in the area of residence with the right to resettlement), as well as women living in settlements exposed to radiation contamination as a result of the accident at the Mayak production association and the discharge of radioactive waste into the Techa River, a certificate of incapacity for work for pregnancy and childbirth for prenatal leave is issued for a duration of 90 calendar days <19>.

--------------------------------

<19> with Article 18 of the Law of the Russian Federation of May 15, 1991 N 1244-1 "On the social protection of citizens exposed to radiation as a result of the Chernobyl disaster" and Article 1 of the Federal Law of November 26, 1998 N 175-FZ "On the social protection of citizens of the Russian Federation exposed to radiation due to the accident at 1957 at the Mayak production association and discharges of radioactive waste into the Techa River" (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 1998, N 48, Art. 5850; 2000, N 33, Art. 3348; 2004, N 35, Art. 3607; 2008 , No. 30 (Part II), Article 3616; 2011, No. 1, Article 26)

a child under the age of 3 years, a certificate of incapacity for work for pregnancy and childbirth is issued on a general basis.0003

53. A woman who has adopted a child under the age of 3 months is issued a certificate of incapacity for work from the date of adoption for a period of up to 70 calendar days (if two or more children are adopted simultaneously - for 110 calendar days) from the date of the child's birth.

54. During the procedure of in vitro fertilization, a certificate of incapacity for work is issued to a woman by a medical organization in accordance with a license for medical activities, including work (services) in obstetrics and gynecology and examination of temporary disability, for the entire period of treatment (stimulation of superovulation, ovarian puncture and embryo transfer ) before determining the result of the procedure and travel to the place of the medical organization and back.

In cases where the medical organization that performed in vitro fertilization procedures does not have a license to perform work (services) for the examination of temporary disability, a disability certificate is issued to a woman by a medical organization at her place of registration at the place of residence (at the place of stay, temporary residence) for on the basis of an extract (certificate) from an outpatient card issued by a medical organization that performed in vitro fertilization procedures.