It’s been nine long months, and you are more than ready not to be pregnant anymore. When should you head for the hospital?

It’s one of the most burning questions an expectant mom has. Go too soon, and you might be sent home. Wait too late, and you could be delivering your baby in the front se – … well, let’s not think about that.

Once you reach between 32 and 35 weeks of pregnancy, it’s a good idea to pack an overnight bag (don’t forget your insurance card and nursing bra!) and have it ready to go when you’re ready to go.

But how will you know when that time comes?

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Timing is everything. Just as you’ve been doing throughout your pregnancy, you’ll be counting.

If your contractions (they’ll feel like bad period cramps and/or a bad backache in the lower back) are pretty mild and coming more than five minutes – and up to 20 minutes – apart), consider yourself officially in labor. But, it’s early labor – which can last for a few hours or (we’re sorry to say) a few days – but the big event will be here soon.

During early labor, contractions aren’t necessarily happening at regular intervals. They’re probably lasting 30 to 45 seconds each. If you aren’t already at home when contractions start, it’s a good idea to head home.

Now’s the time to get out your kick-counting notebook. You’ve got more counting to do. Jot down when each contraction starts, its duration and how much of a lull you have between contractions. Or use a contraction counter app. Forbes recommends several.

Call the midwife (or your doctor). Once contractions start, it’s OK to call your doctor or midwife. They won’t mind. But if you’re contractions aren’t lasting for a full minute yet, they may tell you to stay home for a bit longer.

When your contractions start coming with greater frequency and lasting longer (and when they become more painful) is when your OB-GYN or midwife will want to hear from you.

Also call your doctor if your water breaks or you’re having significant vaginal bleeding. Water breaking isn’t necessarily a sign that full-on labor is imminent, but do let your doctor know. If you think your water has broken but aren’t sure (it’s not always obvious), call your doctor.

Your doctor or midwife will ask you some questions over the phone to determine if it’s time to come to the maternity ward. Several factors will play into the decision, including how dilated your cervix was at your most recent exam, the position of the fetus and what, if any, complications or risk factors you have.

Maternity 2024 High Performing emblem

Six Novant Health medical centers have received the coveted U.S. News and World Report High-Performing Hospitals designation for maternity care: Novant Health Forsyth Medical Center, Novant Health Thomasville Medical Center, Novant Health Huntersville Medical Center, Novant Health Matthews Medical Center, Novant Health Presbyterian Medical Center and Novant Health New Hanover Regional Medical Center. They are among just 17 hospitals in North Carolina to receive this distinction.

But, how will you really know? When your contractions start coming more frequently (every five minutes or fewer), when they remain consistently forceful (rather than ebbing and flowing as they do in early labor) for an hour or more, when they begin to last longer – up to a minute – and when your lower back really hurts, it’s time to grab your bag and go.

Another (unfortunate) potential sign? Diarrhea. We’re sorry; it’s not like you don’t already have enough going on.

Don’t forget! You may need to factor in traffic when thinking about your ride to the hospital. If it’s rush hour when those contractions start coming faster, err on the side of caution and leave early.

You did pack your phone charger, right? Soon enough, you’re going to have plenty of happy calls to make.

This is the moment you’ve been dreaming of and planning for. It’s not every day you get to be part of a miracle, but your baby’s birthday is exactly that.