When Do I Go to the Hospital During Labour?
The 5-1-1 rule, real vs false labour, and the situations where you need to go immediately - with Singapore hospital helplines.
The 5-1-1 Rule for First-Time Mums
For first-time mums (primigravidas), the 5-1-1 rule is the standard guideline used by most obstetricians and midwives in Singapore. It helps you judge when labour is active enough to head to the hospital.
5
Minutes Apart
Contractions come every 5 minutes
1
Minute Long
Each contraction lasts at least 1 minute
1
Hour Duration
This pattern has been going for at least 1 hour
If This Is Not Your First Baby
Second and subsequent labours are typically faster. Your gynae or midwife may advise you to go in at 10-minute intervals or even earlier, especially if your previous labour was quick. When in doubt, call the hospital labour ward and describe your contractions.
How to Time Your Contractions
Use a free contraction timer app (Contraction Timer & Counter on iOS or Android) or simply note the time each contraction starts. The interval is measured from the start of one contraction to the start of the next - not from the end of one to the start of the next.
Ask your partner to help time them so you can focus on breathing through each one.
Braxton Hicks vs Real Labour Contractions
Braxton Hicks contractions (also called "practice contractions") start as early as the second trimester and become more common in the third trimester. They are your uterus toning up for labour. Many first-time mums find it hard to tell them apart from real labour.
| Feature | Braxton Hicks | Real Labour |
|---|---|---|
| Pattern | Irregular - no pattern | Regular, getting closer together |
| Duration | Under 30 seconds | 30-90 seconds, lasting longer over time |
| Intensity | Mild, does not intensify | Gets stronger and more painful over time |
| Location | Usually just in front of abdomen | Starts in back, wraps around to front |
| Walking response | Often eases when you walk or change position | Continues or intensifies with activity |
| Discharge | No change in discharge | May see bloody show (pink mucus plug) or clear fluid |
Stage-by-Stage Labour Signs
Early Labour (Latent Phase) - Stay Home
Contractions 5-20 minutes apart, lasting 30-45 seconds. Cervix dilates from 0 to 6cm. This can last many hours for first-time mums. You can still talk through contractions.
What to do: Rest, eat light meals, time contractions, have a warm shower, watch a movie. Stay home until 5-1-1 is met.
Active Labour - Go to Hospital
Contractions every 3-5 minutes, lasting 45-60 seconds. Cervix dilates from 6 to 10cm. Contractions are intense and you cannot talk through them easily.
What to do: Head to the hospital. Call ahead. Bring your hospital bag. Call your support person.
Transition - Almost There
Contractions every 2-3 minutes, lasting 60-90 seconds. Very intense. Urge to push may begin. You should be at the hospital by now.
If you are not at the hospital yet, call 995 (SCDF ambulance) immediately.
When to Go to Hospital Immediately (Do Not Wait)
Regardless of contraction pattern or how many weeks pregnant you are, go to the hospital immediately if you experience any of these:
Waters break (rupture of membranes) - any gush or steady trickle of clear or yellow fluid, even without contractions
Heavy vaginal bleeding - bright red blood, heavier than a normal period
Reduced or absent baby movements - if baby is not moving as much as usual from 28 weeks onward
Severe headache, visual disturbances, or swelling - could indicate preeclampsia
Contractions before 37 weeks - regular contractions in preterm pregnancy need urgent assessment
Singapore Labour Ward Helplines - Call Before You Go
KKH Labour Ward
6294-4050
24 hours, 7 days
NUH Labour Ward
6779-5555
24 hours, 7 days
TMC Labour Ward
6251-5566
24 hours, 7 days
Emergency Ambulance
995
SCDF - for emergencies only