Midwives and doctors providing antenatal care for healthy women at health centers — including the after-hours medical service (tel. 1770) — handle general pregnancy-related questions and issues, and refer women to the maternity departments at Landspítali if needed.

Midwives and doctors at Landspítali and Akureyri Hospital who provide antenatal care for women in high-risk groups refer patients to other maternity departments as appropriate.

However, if you believe that labor has started, your waters have broken, or you are experiencing heavy vaginal bleeding — more than about 1–2 tablespoons (15–30 ml) — you should contact the maternity ward if your pregnancy has reached more than 22 weeks (see also answers regarding water breaking and vaginal bleeding).

In the last weeks of pregnancy, many women experience what are known as Braxton Hicks contractions. These are irregular uterine contractions that can feel like mild period cramps. They are more common in the evenings and at night and may last for several hours before subsiding.

The beginning of labor — sometimes called the latent phase — can feel similar to these early contractions. However, true labor contractions do not fade away with time; instead, they gradually become stronger, longer, and more regular as labor progresses.

The active stage of labor is marked by regular, strong contractions coming every 2–5 minutes.

You can safely stay at home as long as you feel comfortable, but many women feel the need to see a midwife as

this stage progresses.

We recommend calling the maternity ward before leaving home, or if you’re unsure whether it’s time to come in.

If you have a uterine scar from a previous cesarean section, high blood pressure, diabetes, GBS in the birth canal, or other risk factors, you should come to the maternity ward as soon as active labor begins.

• A car seat for the trip home — make sure you’ve learned how to secure it in the car

• Clothes, diapers, and wipes for the baby

• A robe, comfortable clothes, and slippers for you and your partner or support person

• Toiletries such as a toothbrush, toothpaste, and lip balm

• Music or anything else that helps you relax

• A camera or phone

• Snacks (light refreshments are available for women in labor)

• Cash, card, or phone for vending machines

• Money or card for parking meters in paid parking areas

At the start of labor, before arriving at the hospital, it’s good to try non-medical methods such as taking a bath or shower, getting a massage, or using warm or cold compresses.

If you need additional pain relief early in labor, we recommend contacting the maternity ward.

The maternity ward provides care for all women — both those with healthy pregnancies and those with risk factors or health issues.

According to the Directorate of Health’s guidelines on choosing a place of birth, women with risk factors or medical conditions are advised to give birth where specialized healthcare services are available — such as at the maternity ward.

Healthy women without risk factors may consider other options, such as giving birth at the hospitals in Akranes, Selfoss, or Keflavík, or with the assistance of midwives at a birth center or during a home birth.

Most labors begin with contractions, but in about 10% of cases, labor starts when the amniotic sac ruptures and the water begins to leak. This can happen as either a large gush or smaller trickles.

Because many women experience increased discharge or even mild urine leakage late in pregnancy, it can sometimes be hard to tell if the fluid is amniotic fluid when only a small amount is released.

Amniotic fluid usually has a sweet odor, which helps distinguish it from discharge or urine.

A key sign of amniotic fluid leakage is that it often continues to leak intermittently until the baby is born — for example, when you or the baby move.

If the leak is only a small, single gush, the fluid smells like urine or discharge, and you don’t need a pad to absorb it, it’s unlikely that your water has broken.

During pregnancy, a thick mucus forms in the cervix — this is called the mucus plug.

It can come loose in the last days or weeks of pregnancy as the cervix begins to soften, shorten, and sometimes open. Some women notice this as a thick vaginal discharge that may be clear or tinged with blood.

Noticing the mucus plug does not necessarily mean that labor is about to start — it may still be several days or even weeks before labor begins.

If you experience heavy vaginal bleeding — more than about 1–2 tablespoons (15–30 ml) — you should contact the maternity ward if your pregnancy is beyond 22 weeks.

At earlier stages of pregnancy, you should instead contact:

• The antenatal outpatient clinic during office hours (tel. 543 3253) if heavy bleeding occurs between weeks 12–21.

• The maternity and postnatal ward outside office hours (tel. 543 3220) if heavy bleeding occurs between weeks 12–21.

• The women’s emergency department (tel. 543 3266) if you are less than 12 weeks pregnant.

Light spotting or blood-stained discharge is much more common during pregnancy. This can appear as red, pink, or brown stains in your underwear or on toilet paper. Such minor bleeding can occur after sexual intercourse or due to constipation.

You should discuss any bleeding with your midwife or doctor at your antenatal care visits.

Light bleeding can also occur at the beginning of labor.

A normal pregnancy can last anywhere from 37 to 42 weeks.

The estimated due date, based on your last menstrual period or an ultrasound, is set at 40 weeks — meaning labor can naturally start up to three weeks before or two weeks after that date.

It’s generally considered safest for labor to begin on its own, and induction is not recommended for healthy women without risk factors until the pregnancy is approaching or has reached 42 weeks.

If you choose to wait or decline induction, close monitoring of both your health and the baby’s wellbeing is recommended.

For women with certain risk factors, doctors will assess the situation individually to determine whether and when induction of labor is advisable.

The family stays in the delivery ward for about two hours after the baby is born.

The placenta is delivered, and the perineal area is examined to see if stitches are needed.

The baby is usually placed on the breast, weighed, measured, and examined by a midwife, and the parents are offered a vitamin K injection for the baby.

Efforts are made not to separate mother and baby during this important and sensitive period of adjustment.

After this time, the family is usually transferred to the maternity ward, where they stay for 4–72 hours, depending on circumstances.

Once the baby has been examined by a pediatrician, most families are discharged to midwifery home care, where a midwife visits the family during the first few days after birth.

If the birth has gone smoothly, it is possible to be discharged directly from the delivery ward to midwifery home care. In that case, it is recommended that the family stays on the ward for four hours and that the baby is examined by a pediatrician before going home.