The 5-1-1 rule: when to go to the hospital
"How do I know when it's time?" The most common answer providers give is the 5-1-1 rule — a simple pattern that signals labor is established enough to head in or call.
Are your contractions at 5-1-1 yet?
Tap once when a contraction starts and once when it ends. This checker watches the last hour for you and says where you are against the rule. It works offline and your log never leaves this browser.
Always call your midwife, doctor, or maternity unit if your waters break, you see bleeding, the baby moves less than usual, or something simply feels wrong. Do not wait for a 5-1-1 pattern.
What 5-1-1 means
- 5, five minutes apart: contractions start every 5 minutes or closer, measured start-to-start.
- 1, lasting one minute: each contraction lasts about 60 seconds, from the moment it builds until it fully fades.
- 1, for one hour: that pattern holds consistently for a full hour, not just for two or three contractions.
When all three line up, active labor is likely underway. For most low-risk, first-time pregnancies that is the standard cue to call your provider or head to the hospital or birth center.
You will see it written several ways: 5-1-1, 511, 5 1 1, sometimes 5:1:1. They all describe the same three numbers in the same order: how far apart, how long, for how long.
The number people get wrong is the first one
"Five minutes apart" is measured from the start of one contraction to the start of the next, not from the end of one to the beginning of the next. Because a contraction lasts about a minute, timing the rest between them instead makes a 6-minute pattern look like a 5-minute one, and makes labor look further along than it is.
If you are not certain which gap you have been measuring, our guide on how to time contractions walks through it in detail. Timing the wrong gap is by far the most common reason a 5-1-1 reading turns out to be wrong.
5-1-1, 4-1-1, 3-1-1: which one applies to you
5-1-1 is the most widely quoted version, but it is a convention rather than a law. Providers pick the threshold that fits how fast they expect your labor to move and how long it takes you to reach them.
| Pattern | Means | Typically used for |
|---|---|---|
| 5-1-1 | 5 minutes apart, 1 minute long, for 1 hour | The default for most low-risk first pregnancies |
| 4-1-1 | 4 minutes apart, 1 minute long, for 1 hour | Often given when you live close to the hospital, or when a provider wants labor a little more established before you come in |
| 3-1-1 | 3 minutes apart, 1 minute long, for 1 hour | Sometimes used for very short journeys, or by a birth center that prefers a later arrival |
A tighter number can mean either "come later" or "come sooner" depending on who is giving it, which is exactly why the instruction from your own midwife or doctor overrides anything you read here. Second and subsequent babies often move faster, and many providers ask those parents to leave earlier than 5-1-1 rather than later.
If you have come across 5-5-1, 551, 555 or 1-5-1, these are almost always 5-1-1 with the digits remembered in the wrong order. The three patterns in the table above are the ones in common clinical use.
What 5-1-1 does not tell you
The rule is a timing threshold, not a diagnosis. It says nothing about how dilated you are, and reaching it does not guarantee you will be admitted. Some people arrive at a textbook 5-1-1 and are sent home to labor longer; others are asked to come in at a looser pattern because of something else in their history.
It also has nothing to say about pain. Contractions that hurt a great deal but stay irregular, or that ease off when you move, rest or drink water, are usually Braxton Hicks however intense they feel. True labor contractions get longer, stronger and closer together as time passes.
When to call before you reach 5-1-1
- Your provider's instructions win. If they asked for 4-1-1, an earlier call because you are group B strep positive, or a call as soon as anything starts because you live far away, follow that instead.
- A fast previous labor. Do not wait for a perfect pattern, go earlier.
- Your waters break, with or without contractions.
- Any bleeding, or fluid that is green, brown or foul-smelling.
- The baby is moving less than usual.
- You are under 37 weeks and contractions are becoming regular. Preterm labor is assessed differently.
- Something simply feels wrong. That is a reason to call on its own, and you never need a pattern to justify it.
What to say when you call
Whoever picks up will ask you the same three things the rule describes, so have them ready:
- How far apart the contractions are, start to start.
- How long each one lasts.
- How long the pattern has held. The answer they need is the last hour, not the whole day.
They will also ask how many weeks you are, whether your waters have broken, whether you have had any bleeding, and whether the baby is moving normally. A written log answers the first three instantly and takes the guesswork out of the rest.
Why the pattern is hard to spot by hand
Recognizing 5-1-1 means timing every contraction accurately for an hour, while you are having them. A note scribbled here, a contraction missed there, and you genuinely cannot tell whether you have crossed the threshold. Averages hide the problem rather than solving it: three contractions 4 minutes apart and one 9 minutes apart average to something that looks like 5 minutes but is not a 5-1-1 pattern at all. That is exactly what a contraction timer with pattern detection is for.
Lunera PRO watches for 5-1-1 so you don't have to
While you time contractions with one tap, Lunera PRO's 5-1-1 pattern detection continuously checks your session against the rule — contractions 5 minutes apart, lasting 1 minute, for 1 hour — and alerts you the moment the pattern is met.
- No mental math between contractions — the app tracks intervals and durations precisely
- The alert is your cue to call your doctor or midwife, exactly as they advised
- Generate a PDF report of the whole session (timings, averages, 5-1-1 status) to share when you call
- Works with the Live Activity on your lock screen and Dynamic Island
Quick answers
What is the 5-1-1 rule?
5-1-1 describes contractions that come 5 minutes apart measured start to start, each lasting about 1 minute, sustained for 1 full hour. For most low-risk first pregnancies it is the point at which providers ask you to call or come in. It is also written 511 or 5 1 1.
Is 5-1-1 measured from the end of one contraction to the start of the next?
No, and this is the most common mistake. All three numbers are measured start to start: from the moment one contraction begins to the moment the next one begins. Timing the rest in between instead will make your contractions look closer together than they are.
What is the difference between the 5-1-1 and 4-1-1 rules?
Only the first number, which is how far apart the contractions are: 4-1-1 means every 4 minutes rather than every 5. Providers choose the threshold that fits how quickly they expect your labor to progress and how far you have to travel. Some also use 3-1-1. Follow the one you were given.
Is the 5-1-1 rule the same for second babies?
Often not. Second labors tend to move faster, so many providers suggest leaving earlier, for example at a 4-1-1 pattern. Ask your provider what they want you to do.
What if my contractions are 5 minutes apart but only 40 seconds long?
You have not met the full pattern yet, because duration counts too. Keep timing; contractions typically lengthen as labor progresses. Call your provider if you are unsure or anything feels wrong.
Does reaching 5-1-1 mean I will be admitted?
Not necessarily. The rule is a timing threshold, not a diagnosis, and it says nothing about how dilated you are. Some people arrive at a textbook 5-1-1 and are sent home to labor longer, while others are asked to come in earlier for reasons in their own history.
Can I be in labor without ever reaching 5-1-1?
Yes. Labor does not always follow a tidy pattern, and a fast labor can go from irregular contractions to birth without ever holding 5-1-1 for an hour. The rule is a guideline for when to make the call, not a requirement labor has to meet.
How long should I keep timing before I call?
Long enough to see whether the pattern holds, which is where the third number comes from: about an hour of consistent contractions. If anything else is happening, such as your waters breaking, bleeding, or reduced movement, call straight away without waiting for the hour.
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This guide is for informational and educational purposes only and is not medical advice. Lunera is not a medical device. Always consult your doctor, midwife, or healthcare provider with any questions about your pregnancy or labor.