The rule your provider gave you
The 5-1-1 rule, one number at a time
Three numbers, and the third one is the one that gets dropped. What each of them measures, how each of them gets measured wrong, and the honest part: no primary source we can verify uses the words 5-1-1 at all.
What is the 5-1-1 rule?
The 5-1-1 rule is the shape many providers give as the signal to call: contractions arriving every 5 minutes or less, each one lasting 1 minute or more, and that pattern holding for 1 full hour. Not one of the three. Not two of the three. All three at the same time, inside the same hour.
The hour is the part that gets dropped, and dropping it changes the answer. Four contractions five minutes apart is not 5-1-1, because 5-1-1 also asks for the hour, and four contractions is about fifteen minutes of pattern. The rule is not a scoreboard of good contractions, it is a description of an hour that behaved a certain way. Whatever your own provider told you wins over this page.
The first number: how often, and it is start to start
The 5 is the gap between contractions, and the most common way to get it wrong is to measure the wrong two moments. The interval is counted start to start, from the moment one contraction begins to the moment the next one begins. The contraction sits inside the interval, not next to it.
Count from the end of one to the start of the next and every gap comes out longer by exactly the length of a contraction. ACOG describes true labor contractions as lasting about 60 or 90 seconds each, so a real four minute pattern reports itself as five. That is one mistake, made once, repeated on every row of your log.
If you are counting by hand on paper, write down the clock time each contraction starts and nothing else. The gaps between those times are the number your provider is going to ask you for.
The other half of this number is regularity. ACOG describes true labor contractions as coming at regular intervals and getting closer together over time. Gaps of four minutes, then eleven, then six average out near five without meaning what five is supposed to mean.
The second number: how long one contraction lasts
The 1 in the middle is the length of one contraction, from the moment it starts to tighten to the moment it fades. One minute or more. This number is not arbitrary: ACOG puts true labor contractions at about 60 or 90 seconds each, and MedlinePlus lists contractions lasting 60 to 90 seconds as a reason to contact your provider right away.
The ways this one goes wrong are human rather than mathematical. A contraction that is still running has no length yet, so counting it as finished pulls the average down. A double tap produces a contraction of zero seconds, which is not a short contraction, it is a mistake. And timing by feel runs long: something that hurts feels like ninety seconds when the clock says fifty.
This number also separates practice from the real thing better than the gap does. The NHS describes Braxton Hicks as contractions that generally do not last that long, do not happen very frequently and do not build up. They can come five minutes apart for a stretch. What they tend not to do is get longer.
The third number: for one full hour
The last 1 is not a contraction at all. It is a duration of the pattern itself. The first two numbers have to be true together, without falling apart, for sixty minutes. That is what turns a stretch of strong contractions into something worth reporting.
It is also the number nobody wants, because an hour at three in the morning with contractions is a long hour. That is exactly why it is in the rule, and it is the one part of 5-1-1 that a primary source really does back up. MedlinePlus lists regular, painful contractions every 5 to 10 minutes for 60 minutes as a reason to contact your provider right away. The hour is in the source, not in the marketing.
It is not counted on a wall clock either. It is the last hour of timing, ending at the last thing you timed. A session that met the rule and then went quiet for forty minutes is not still meeting it, it is a pattern that stopped. ACOG points the same way with its own test: if rest and hydration make the contractions go away, they are not true labor contractions.
The honest part: nobody official says 5-1-1
Here is the part that is worth opening for yourself. We checked the primary sources this site cites, on 24 August 2026, and none of them uses the expression 5-1-1. Not ACOG, not the NHS, not MedlinePlus. They are all linked at the bottom of this page, and you can search them yourself.
The two that come closest come close from different directions. MedlinePlus says to contact your provider right away for regular, painful contractions every 5 to 10 minutes for 60 minutes, which has the five and the hour, but as a range and with no separate duration criterion. The NHS says to call your midwife or maternity unit for guidance if you are having regular contractions coming every 5 minutes or more often, which has the five and no hour at all.
So 5-1-1 is real, but it is a bedside rule of thumb that providers hand out at appointments, not a published standard with a citation behind it. That is not a scandal. It is how a lot of good clinical advice works: memorable, roughly right, and shaped for the person in the room.
It has one consequence at two in the morning. If 5-1-1 is not a published standard, then no website is the authority on it, and that includes this one. The version that counts is the one your provider wrote on your paperwork or said to you at your last appointment. If theirs is 4-1-1, or call us when they are regular and you cannot talk through one, then theirs is the rule. A page on the internet does not know your history, your distance to the hospital, or how your last labor went.
Why some people are given 4-1-1 instead
4-1-1 is the same shape with a tighter gap: contractions every four minutes or less, a minute or more each, for an hour. Providers move the numbers for reasons that have nothing to do with the arithmetic and everything to do with you.
- How far you are from the hospital. Ninety minutes of driving turns a comfortable margin into a tight one, so the line that triggers the call moves earlier.
- Whether you have given birth before. ACOG puts a first labor at typically 12 to 18 hours and a later one at 8 to 10, so a second baby tends to give less warning than a first.
- Anything in this pregnancy that means less waiting around. A previous fast labor, a planned cesarean, something being watched. A rule from the internet knows none of it.
- Where you are planning to give birth. A hospital across town, a birth center and a home birth with a midwife all put the line in a different place.
Some providers give no number pattern at all. If yours said to call when the contractions are regular and you cannot talk through one, that is your rule. Time them anyway, because you will still be asked how long they last and how far apart they start.
What the popular timers ask for before they say go
On 24 August 2026 we downloaded the browser contraction timers that rank for this search and read the JavaScript they serve to your phone. We were looking for one thing: whether the third number is in the code at all.
| Tool | What its own code requires before it says go | Contractions | The hour |
|---|---|---|---|
| yourduedate.com | Average gap under 5 minutes and average length over 60 seconds | 4, about fifteen minutes of pattern | Not checked |
| mycontractiontimer.com | Average gap under 200 seconds, then a message in capitals telling you to call now | 3, about seven minutes of pattern | Not checked |
| Wavesong, in your browser | All three parts of the rule you picked, met at once, averaged over the full window, with the pattern still running | As many as the hour takes | Measured and shown |
The families it happens to do notice. From a two star review in this vertical, about a timer that sent one of them in early: "it also told us within 3 interactions it was time to go to the hospital, which was untrue, since the last number in a 411 or 511 contraction timing is for one hour". Being sent in on three contractions is how you end up in triage at 2 a.m. and driven home again.
Wavesong is not a medical device and does not give medical advice. This page explains what a rule your provider may have given you is asking for. It never says that you are in labor.
Call your provider or your maternity unit now, whatever any rule says, if your water breaks, if you are bleeding heavily, if you have constant severe pain with no relief between contractions, if your baby is moving less than usual, or if you are under 37 weeks and think you might be in labor. The first four are on ACOG's own list of reasons to go in, and ACOG defines preterm labor as labor that starts before 37 weeks of pregnancy and says it needs medical attention right away. Not one of them waits for an hour.
Time the hour instead of guessing at it
The timer on this site measures all three parts of 5-1-1 or 4-1-1 separately and puts the real number next to each one, including how long the pattern has actually been running. One tap starts a contraction, one tap ends it. Everything is worked out in your browser, with no account and nothing uploaded.
The app is not on the App Store yet. The price is on the home page and in pricing.md, and there is no trial because the browser timer is free and runs the same model.
Where this comes from
- MedlinePlus, Am I in labor?. Contact your provider right away for regular, painful contractions every 5 to 10 minutes for 60 minutes, or contractions lasting 60 to 90 seconds. The closest a primary source gets to the shape people call 5-1-1, and it does not use those words.
- NHS, Signs that labour has begun. Call your midwife or maternity unit for guidance if you think you are in labour or you are having regular contractions coming every 5 minutes or more often. Braxton Hicks generally do not last that long, do not happen very frequently and do not build up.
- ACOG, How to Tell When Labor Begins. True labor contractions come at regular intervals, get closer together over time, and each lasts about 60 or 90 seconds. If rest and hydration make them go away, they are not true labor contractions. A first labor typically lasts 12 to 18 hours, a later one 8 to 10.
- ACOG, Preterm Labor and Birth. Preterm labor is labor that starts before 37 weeks of pregnancy, and it needs medical attention right away. For about 3 in 10 women, preterm labor stops on its own.
Questions about the 5-1-1 rule
Does the hour start over if the contractions space out for a bit?
In practice, yes. The rule asks for the pattern to hold, so what counts is the last hour of timing, not the best hour you have had all night. If the gaps stretch to nine minutes for a while, that stretch is inside the window and it drags the average with it.
It is also why a timer should stop saying the rule is met once nothing new has been timed for a while. A pattern that met the rule and then faded is a pattern that faded.
Do I count from the end of one contraction to the start of the next?
No. Start to start, from the beginning of one contraction to the beginning of the next. Counting end to start makes every gap longer by the length of a contraction, which with minute long contractions turns a real four minute pattern into a reported five.
How many contractions is 5-1-1, roughly?
If they are truly five minutes apart for a full hour, about twelve. There is no fixed count in the rule, because the rule is written in minutes rather than in contractions. That is the whole point of the third number, and it is why a tool that fires after three or four of them is answering a different question.
My provider gave me 4-1-1. Which one do I follow?
Theirs. 5-1-1 is a rule of thumb that providers give, not a published standard, so there is no higher authority to appeal to. If you were given something else entirely, use the two raw numbers, how long each contraction lasts and how far apart they start, because those are what you will be asked to read out either way.
Can I hit 5-1-1 with Braxton Hicks?
You can get close on the gap, which is why frequency on its own settles nothing. What the NHS describes Braxton Hicks as not doing is lasting long, coming very frequently and building up, and a full hour of minute long contractions is a lot to ask of practice contractions. ACOG's test is simpler: if rest and hydration make the contractions go away, they are not true labor contractions.
If I am under 37 weeks, does 5-1-1 still apply?
No. ACOG defines preterm labor as labor that starts before 37 weeks of pregnancy, and says that preterm labor needs medical attention right away. There is no hour anywhere in that. The same goes at any point if your water breaks, if you are bleeding, or if your baby is moving less than usual, which are on ACOG's list of reasons to go in.
Keep reading
- Time your contractions. The free timer, with all three parts of the rule measured and shown.
- Braxton Hicks or labor: how to tell them apart while it is happening. The test ACOG gives, and what a timer can and cannot settle.
- When to go to the hospital in labor: the call, the drive and the timing. Going too early and going too late are different mistakes.
- Contraction timer app: what to look for before you install one at 38 weeks. Ads, paywalls and pattern alerts, measured across the vertical.
Last checked 2026-08-24