A: First-time moms tend to have longer labors than women who have delivered a baby before. In general, I tell patients to call when their contractions are less than five minutes apart, lasting 30 seconds or longer for at least an hour. The contractions should be uncomfortable enough to take away one's breath. Using this set of guidelines, you will usually enter the hospital when you're 2 to 5 centimeters dilated. You are fortunate to live close to the hospital, allowing you to choose to wait at home longer, depending on your labor plan. If you are going to deliver without an epidural, you might want to stay home even longer. If you have medical or obstetrical complications, the obstetrician might want you to come to the hospital earlier. However, you should speak with your physician about his or her policy in this regard.

I doubt that you will deliver the baby at home. First-time moms typically labor between 10 and 20 hours, probably enough time for you to walk to the hospital and back home several times.

My recommendation for experienced mothers is quite different. They should call when their contractions are between five and seven minutes apart, depending on how far they live from the hospital and their delivery history. They can fool themselves—and me, too. Over the past 20 years I have had second-time moms and beyond deliver at home.

It is very helpful to take a test drive to the hospital. Take into account the traffic, the time of day you are driving, where you are going to park and the location of the labor and delivery wing. Preparation will ease your anxiety when the big day arrives.