Timing Contractions

If there’s one thing that families are most anxious about, worrying about whether or not they’re in labour is top of the list. The whole process can come across as wishy-washy or difficult to nail down in concrete terms and families often just want something, anything, to give them the answers they so dearly want, which is why timing contractions is often a very exciting prospect. It’s a measurable, scientific, fool-proof way to know what’s what -- except that it’s not.

You’ve probably heard of people who have random contractions and are in full-blown labour and those that have had steady, long contractions for day and nothing’s happened with their cervix at all -- timing contractions is one way that we can glean some information from the body but remember that it’s just one tool, one peek into what’s going on.

Here are the top three things I want you to know about timing contractions.

1. 4-1-1. Regardless whether the hospital tells you 5-1-1 or I tell you 3-1-2, you gotta know what these numbers mean if you’re timing your contractions at home. The first number is how far apart these contractions are -- so 4 minutes from the start of one contraction to the start of the next. It is not the time from the end of a contraction to the beginning of the next, but from when one starts to the time it takes the other to start. The first 1 in 4-1-1 stands for 1 minute long -- this means that the contraction needs to last at least one minute, so a MINIMUM of 60 seconds. So back to the 4 for a second, this means that a contraction starts, it lasts 60 seconds, then there’s a 3 minute break before the next contraction starts, and then it repeats again. The last 1 means that it’s been in this pattern for at least 1 hour. Often this 4-1-1 pattern means that the cervix might be starting to change and we’re beginning to enter active labour, so getting to 4-1-1 is just the beginning of “true” labour; the cervix could very well be 1-2-3cm and the hard work is just beginning at this point. This is why I often encourage families to stay home until 3-1-2 because labour begins to really pick up then and I can almost guarantee that change, and good change, is happening to the cervix. Other variations of “4-1” can be contractions that last 90 seconds and then a 2 minute break, contractions that last 75 seconds and then a 2 and a half minute break. It may not stay super consistent, so contractions can range between 60 and 120 seconds, 1 to 2 minutes, with breaks anywhere between 60 and 240 seconds, 1 and 4 minutes.
2. The second thing about all of this timing business is what happens if you’re timing contractions and they’re shorter than a minute or there’s more than 4 minutes from the beginning of one to the beginning of the next; you may not like this, but all the data you’ve collected essentially gets thrown at the window and you start back at minute 0. If contractions were 4-1-1 for 40 minutes and then there’s a 5 minute break or a short contraction, it means that the next 4-1 pattern is the beginning of the new hour countdown. Yes, I know, the outrage at only one contraction being off means the whole thing gets scrapped but when families don’t scrap it, they end up going to the hospital too early and these are the families who get sent home because they’ve gone in too early. So partners, you have to be honest about what’s happening and not fudge any of the timing numbers. Another piece of this is that if and when the contractions do get shorter or space out, take 30 minutes off timing. Give everyone a breather, get a snack, have some water, change positions, and then begin to time again. That moment can be so disappointing or enraging or frustrating so it’s very important to reground, recenter, refocus. Do not be afraid of taking this time off timing; often the timing itself is the reason why contractions begin to space out or shorten because adrenaline and cortisol begins to spike which means less oxytocin circulating so don’t be afraid of missing the cue when you need to go to the hospital or missing counting those contractions that will go towards the hour. I truly can’t say this enough but labour takes TIME so knowing you’ll be in active labour for 4, 5, 6, 7, 8, 9, 10 hours, don’t be afraid of giving up 30 minutes of timing because you’re essentially gaining time and gaining cervical change without the stress or worry about monitoring it.
3. The last thing about timing contractions is that no one at the hospital will want to see your app or your paper; they just want to know approximately how long the contractions have been lasting, how long it’s been going on for and when they started. When you get to the hospital the contractions most likely will have changed because of being in the car, the change of environment, etcetera so that’ll be what it’ll be. As soon as you decide to leave for the hospital, you can stop timing and you don’t need to time when you get to the hospital either. The hospital will do all the timing and monitoring for you, so all of your energies, both you and your birth partner, should be focused on coping, feeling safe, promoting the circulation of oxytocin.

So now that you know these three things, how do you actually time them? Well, you can download an app like the one or two I’ve included or below or you can do what I do which is just use the built-in stopwatch. Check out my screenshots/recordings below for an idea of what timing looks like and surely we can go over this again at one of our prenatals too.