Ships from our DE warehouse – no customs, 1–2 daysFree shipping from EUR 50Easy returnsSupport 7 days a week
EN · EUR
0
LIINI Logo_Sticky
0
Pregnancy & birth

Contractions and Water Breaking: When Should You Go to the Hospital?

Signs of labor, an overview of types of contractions, guidelines for going to the hospital, and what to do if your water breaks. Includes warning signs that require you to call immediately.

By the LIINI editorial teamUpdated 10 min read20 sources

Wehen & Blasensprung
Contents

In short

Call your hospital, birthing center, or midwife before you head out. With your first child, labor is usually underway when contractions come regularly every 5 minutes for about an hour; with subsequent children, it’s already underway when contractions are about 10 minutes apart. If your water breaks, always let them know—even if you aren’t having contractions. You must call immediately if you experience bleeding like a period, if your amniotic fluid is green or bloody, if you have a fever, if you have persistent abdominal pain, if your baby is moving less, or if contractions start before 37+0 weeks. If you see or feel the umbilical cord, or if your baby is already coming out, dial the emergency number 144 (112 in Germany).

A tugging sensation in your belly, wet underwear, a hard belly in the evening: Toward the end of your pregnancy, every little twinge makes you wonder if labor is starting. Here you’ll learn how to recognize the signs of labor, which contractions are harmless, and when you should go to the hospital or birthing center if you’re having contractions or your water breaks.

Attention

Call the hospital, birthing center, or your midwife immediately—even in the middle of the night—if you’re bleeding as heavily as during a period, if your amniotic fluid is noticeably green, brown, or bloody, if your baby is moving less than usual, if you have a fever, persistent abdominal pain, unexplained headaches, or vision problems, or if labor begins before 37+0 weeks. If you see or feel the umbilical cord in your vagina or if your baby is already coming out, call emergency services immediately: 144 in Switzerland and Austria, 112 in Germany.

Signs of Labor: How It Begins

According to the NHS and OB-GYNs online, typical signs include:

  • Mucus plug: The mucus that has been sealing the cervix comes out. It is thick, gel-like, and often pink because it contains a small amount of blood.
  • Light bleeding: A little spotting may signal the start of labor. If you’re bleeding as heavily as during a period or more, call immediately.
  • Contractions: Your abdomen hardens at regular intervals; the breaks between contractions become shorter and the contractions stronger.
  • Water breaking: Amniotic fluid flows out in a gush or drop by drop.
  • Back pain: A heavy, pulling sensation in your lower back.
  • Urge to have a bowel movement: Your baby is pressing on your bowels.

According to the Aarau Cantonal Hospital and the NHS, it can take many hours or even days before labor really gets underway. Experts refer to this early stage as the latent phase.

Types of Contractions: From Practice Contractions to Dilatation Contractions

Not every contraction means that labor has begun. Here’s an overview based on information from familienplanung.de, Frauenärzte im Netz, and the University Hospital of Zurich:

Type of ContractionsWhenWhat it feels likeWhat to Do
Practice contractionsEspecially in the last few weeks, often in the evening for 2 to 3 hoursYour belly becomes hard and round, with a slight pulling sensation in your lower abdomen; rest intermittentlyRest; if they occur regularly before 37+0: call immediately
Descending contractionsstarting around the end of the 36th weekTend to be short and not very painful; your baby is dropping lower into the pelvisNothing—this is normal
Pre-labor contractionsin the last few days before birthIrregular and brief, a dull, pulling sensation like menstrual cramps; they subside in a warm bathStay home, rest, take a bath
Early labor contractionsLabor has begunRegular, initially about every 5 to 20 minutes, lasting about a minute, cramp-like; you can no longer distract yourselfNote the intervals; call according to the rule of thumb
Pushing contractionsCervix fully dilatedThe strongest contractions, intense urge to pushIf you’re still at home: Call 144 (DE: 112)
AfterpainsIn the days following the birthThe uterus contracts back to its normal size; this is often more intense while breastfeedingare part of the postpartum period
Practice contractions or labour contractions? Practice contractions: irregular and fairly short, a dull ache like period pain, ease off in a warm bath, may stop when you walk or rest. Labour contractions: regular and closer and closer together, last about a minute, stay no matter what you do, and you can no longer distract yourself. How to measure the interval: from the start of one contraction to the start of the next.Practice or real contractions?How to tell the differencePractice: no rush yetcome irregularly, fairly shortdull ache, like period painease off in a warm bathmay stop again when you walkLabour: time to callregular and closer togetherlast about a minutepersist whatever you dodistraction no longer worksMeasuring the intervalIntervalLengthFrom the start of oneto the start of the next

Time the interval from the start of one contraction to the start of the next, as explained by the Mayo Clinic. Write down the start time and duration, either on paper or using an app. Real contractions continue whether you’re standing, sitting, or lying down. Practice contractions, on the other hand, may stop if you walk, rest, or change positions.

To learn what to expect after childbirth—including afterpains and the postpartum period—read the guide “Postpartum Care: Midwife and Health Insurance.”

When to Go to the Hospital? The Rules of Thumb

Always call first before you set out. That’s what the cantonal hospitals in Aarau and Winterthur, for example, ask you to do. The midwives in the delivery room are available around the clock and will tell you whether you should come in yet.

Labour: when to go to hospital? Call first, then go. Green – stay at home for now: contractions are irregular and ease off in a warm bath; rest, drink, get your bag ready. Amber – call and set off: with your first baby, regular contractions every 5 minutes for about an hour; with later babies, about every 10 minutes; or your waters break, even without contractions; call the hospital, birth centre or midwife. Red – call immediately: bleeding like a period or heavier, green, brown or bloody waters, baby moving less than usual, fever, constant abdominal pain, unexplained headaches or vision problems, contractions before 37+0. Umbilical cord visible or baby already coming: call the emergency number 144 immediately in Switzerland and Austria, 112 in the EU.Labour: when to go to hospital?Always call first, then goGreen: stay at home for nowContractions are irregularand ease off in a warm bath.→ Rest, drink, get your bag readyAmber: call and set offFirst baby: regular, every5 minutes, for about an hourLater babies: about every 10 minutesWaters break, even without labour→ Hospital, birth centre or midwifeRed: call at onceBleeding like a period or moreWaters green, brown, bloodyBaby moving less than usualFever, constant abdominal painHeadaches, vision problemsLabour before 37+0→ Hospital or midwife at onceUmbilical cord visible?Baby already coming?Call 144 (CH, AT) · 112 (EU)Better to call once too often.
  • First child: According to familienplanung.de, it’s time when contractions occur regularly every 5 minutes for about an hour and last about a minute. The Aarau Cantonal Hospital defines regular contractions as occurring every 5 minutes, while the University Hospital of Zurich and the Hirslanden Clinic define regular contractions as those occurring every 5 minutes that require you to breathe through them.
  • Subsequent children: Call the hospital as soon as contractions occur regularly about every 10 minutes (Aarau Cantonal Hospital, familienplanung.de, midwife advice from swissmom and the Swiss Midwives Association).
  • Water breaking: Always call, even if you aren’t having contractions. This is usually followed by an examination in the delivery room (University Hospital of Zurich, Lucerne Cantonal Hospital, Hirslanden Clinic).
  • Unusual contractions: If a contraction lasts longer than 2 minutes or if you have 6 or more contractions in 10 minutes, call immediately, according to the NHS.
  • Uncertainty: If you’re afraid or feel unwell, call—even if the rule of thumb hasn’t been met yet. The Aarau Cantonal Hospital and the Lucerne Cantonal Hospital expressly encourage you to do so.

Have the following information ready when you call, as recommended by swissmom: your week of pregnancy, your baby’s position, and—if your water has broken—what the amniotic fluid looks like. Also mention how long you’ve been having contractions, how far apart they are, and how long it will take you to get to the hospital. You can find your current week in the guide “Calculate Your Due Date.”

First child or subsequent child?

According to gynecologists online, the dilation phase usually lasts 10 to 12 hours for a first child and 6 to 8 hours for subsequent children. That’s why the longer interval between contractions applies to subsequent children. If your last birth went very quickly or if you live far from the hospital, talk to your midwife in advance about when you should head out.

Water breaking: What should you do?

When your water breaks, the amniotic sac ruptures and amniotic fluid flows out, either in a gush or just a few drops at a time. According to the NHS, amniotic fluid is clear and pale, sometimes slightly bloody at first, and not always easy to distinguish from urine. Therefore, contact your healthcare provider as soon as you suspect this has happened. Contractions usually start soon after: According to the German professional associations for obstetrics and midwifery (DGGG and DGHWi), about 60% of women go into labor within 24 hours after their water breaks at or after 37+0 weeks.

  1. Note the time. Write down when your water broke.
  2. Check the color and smell: If the amniotic fluid is noticeably green, brown, or bloody, or if it has an unpleasant odor, call immediately.
  3. Usea pad instead of a tampon: Put on a pad or an absorbent liner—never a tampon.
  4. Call Contact the hospital, birthing center, or your midwife, even if you aren’t having contractions yet.
  5. Discuss next steps: Depending on the situation, you’ll either go in for a checkup right away or, as agreed, wait at home for contractions to start. The DGGG and DGHWi recommend taking your temperature every 4 hours while you’re awake.

If labor doesn’t start on its own, the NHS and DGGG recommend that you be offered induction after 24 hours, because the risk of infection for your baby increases slightly when the amniotic fluid is gone. You can read about how this works in the guide on labor induction.

Do I have to go to the hospital while lying down? Not if there are no specific risks: According to the DGGG and DGHWi, pregnant women should not be advised to lie down after their water breaks. The situation may be different if your baby isn’t in a head-down position—that is, if it’s in a breech or transverse position—or if your water breaks before 37 weeks. In those cases, according to the British professional association RCOG, the risk of umbilical cord prolapse is higher. Ask your midwife or doctor in advance what you should do in your specific situation.

Can I take a bath afterward? According to the DGGG, DGHWi, and NHS, bathing and showering do not increase the risk of infection after your water breaks. Some hospitals still advise against bathing. Ask your hospital for their recommendation.

Warning Signs: When to Call Immediately, When to Dial 144

Contact the hospital, birthing center, or your midwife immediately—at any time of day—if you experience:

  • Bleeding as heavy as a period or heavier (Aarau Cantonal Hospital, Hirslanden Clinic)
  • Amniotic fluid that is noticeably green, brown, or bloody, or has an unpleasant odor (DGGG and DGHWi, Johannesstift Diakonie)
  • Fewer fetal movements than usual (Lucerne Cantonal Hospital, Aarau Cantonal Hospital, NHS)
  • Fever—even as low as 37.5 °C after your water breaks (DGGG and DGHWi)
  • Persistent abdominal pain (Winterthur Cantonal Hospital)
  • unexplained headaches, vision problems, nausea, or general malaise (Winterthur Cantonal Hospital)
  • Vomiting and diarrhea, if you can no longer drink anything and feel weak (Aarau Cantonal Hospital)

Attention

If you see or feel the umbilical cord in your vagina after your water breaks, call 144 immediately (Germany: 112). According to the RCOG, get down on your knees, rest your elbows and hands on the floor, and lean forward, or lie on your side with pillows under your hips. Do not touch the umbilical cord. You should also call emergency services if your baby is already on the way and you feel a strong urge to push (NHS).

Preterm Labor Before 37+0

According to the University Hospital of Zurich, a baby is considered premature if it is born before 37 full weeks of gestation. In Switzerland, this affects about 7 out of every 100 newborns. According to the University Hospital of Zurich (USZ), warning signs include contractions that last longer than an hour, occur every 5 to 10 minutes, and last more than 30 seconds each, as well as your water breaking or bleeding. In that case, the USZ advises you to notify your midwife or doctor and go to the hospital. The NHS recommends calling immediately if you suspect labor is starting before 37 weeks.

What you can do at home

In the early stages, your home is often the best place, writes swissmom in a midwife tip in collaboration with the Swiss Midwives Association. According to the NHS and familienplanung.de, these things can help:

  • Take a warm bath or shower: False labor contractions often subside in a warm bath, while real contractions continue. If your water breaks, check with the hospital first.
  • Stay active: Stay upright and move around a little during the day; take a few steps.
  • Eat and drink: Eat and drink something to keep your strength up.
  • Relax: Breathing exercises and a massage from your support person can help.

Tip

Pack your hospital bag well in advance and figure out beforehand who will drive you and who will take care of your older children. The “Packing Your Hospital Bag” checklist shows you what to pack.

Frequently Asked Questions

How can I tell if these are real contractions?

Real contractions come at regular intervals, become more frequent and stronger, and last about a minute. They continue whether you’re walking, sitting, or lying down, and don’t subside in a warm bath. Braxton Hicks contractions are irregular, brief, and often become weaker in the bath.

When should I go to the hospital for labor?

For your first child, usually when contractions come regularly every 5 minutes for about an hour. For subsequent children, as soon as they’re coming regularly about every 10 minutes. Always call first; your midwife will tell you whether you should come in.

What should I do if my water breaks but I’m not having contractions?

Write down the time, check the color of the amniotic fluid, put on a pad, and call the hospital or your midwife. This is usually followed by a checkup. At the appointment, about 60% of women go into labor within 24 hours; otherwise, you’ll be offered induction.

Do I have to go to the hospital lying down after my water breaks?

Not if you have no risk factors, according to the German professional associations DGGG and DGHWi. If your baby isn’t in a head-down position or if you’re less than 37 weeks pregnant, an umbilical cord prolapse is more likely. In that case, discuss with your midwife or doctor beforehand what you should do if your water breaks.

How can I tell if it’s amniotic fluid or urine?

It’s not always easy to tell, and according to the Winterthur Cantonal Hospital, many women wonder about this. Amniotic fluid is clear and light in color and often gushes out, though it can also just trickle. Call right away if you suspect it’s amniotic fluid—the hospital will help you figure it out.

How long do pre-labor contractions last?

According to familienplanung.de, pre-labor contractions can last a few hours and then subside. The early phase before actual labor can last many hours to days, according to the Aarau Cantonal Hospital and the NHS. If the contractions become regular and stronger, call the hospital.

Sources

  1. Shortly Before Delivery, Lucerne Cantonal Hospital
  2. Before the Birth: Hospital Admission, the Right Time, Aarau Cantonal Hospital
  3. Handout: Childbirth Preparation Class (PDF), Winterthur Cantonal Hospital
  4. Before Birth: Prenatal Care, University Hospital of Zurich
  5. Premature Birth, University Hospital of Zurich
  6. Frequently Asked Questions About Childbirth, Hirslanden Clinic
  7. Midwife’s Tip: Labor Begins, swissmom in collaboration with the Swiss Midwives Association
  8. Going to the Hospital When Labor Starts, swissmom
  9. What Do Contractions Feel Like?, familienplanung.de, Federal Institute for Public Health
  10. Practice contractions (glossary), familienplanung.de, Federal Institute for Public Health
  11. Preliminary Contractions (Encyclopedia), familienplanung.de, Federal Institute for Public Health
  12. Stages of Labor, Gynecologists Online, Professional Association of Gynecologists
  13. Managing Premature Rupture of the Membranes at the Due Date (as of July 2024, PDF), DGGG and German Society for Midwifery Science (S3 Guideline), published by the Lower Saxony Midwives Association
  14. Rupture of the membranes, Johannesstift Diakonie, 2025
  15. Signs that labor has begun, NHS
  16. The Stages of Labor and Birth, NHS
  17. Umbilical Cord Prolapse in Late Pregnancy (August 2025), Royal College of Obstetricians and Gynecologists (RCOG)
  18. Signs of labor: Know what to expect, Mayo Clinic
  19. Emergencies in Switzerland, ch.ch
  20. Emergency numbers, gesundheit.gv.at, Austria’s Public Health Portal
0