What to Do When Baby Is Coming And You Can’t Get to Your Doctor or Midwife – Emergency Childbirth
With the winter storm coming to the Northeast, and all the other severe storms occurring, it sometimes happens that mom goes into labor, but can’t get to the hospital, or her midwife can’t get to her, in time for baby’s birth. This can also happen when mom has a fast labor, which is more common with second births. It is unusual, but there can be that nagging worry. Knowing how to prepare can help get rid of the worry.
So what can you do if you are due any day, and officials are warning everyone to stay off the roads? First, I’ll give tips on how to prepare for a storm if you *might* go into labor, then the steps involved in emergency birth in case mom were to find baby coming with no medical professionals around.
Please note: This information is meant ONLY for those unusual cases when mom is stuck giving birth without her attendant. It is my opinion that birth is safest with a qualified doctor or midwife present to act as lifeguard in case a problem were to arise.
If a Storm Is Coming and You’re 36 Weeks or Later
1) Relax. Chances are you will begin labor AFTER the storm has passed. Relaxing will lower your stress level, and help you be less likely to go into labor, too.
2) Get support. Make sure you will have someone staying with you during the storm just in case. Having someone you trust with you can help reduce stress, and is very helpful if labor does begin.
3) Plan ahead. If you think you might be in labor before the storm hits, or have a “hunch” you will give birth during the storm (especially if you are past 41 weeks), take a room at a hotel immediately next to your birth place. Most hospitals and birth centers have hotels a block or less away. This way, if you do get farther along in labor, getting to your birth place is much easier and safer. Again, have someone stay with you for support.
4) Prepare. Make sure you have supplies of food, water, clean towels, battery-powered lighting, blankets, a fully charged phone (preferably multiple phones, a back-up battery, or a hard line phone), and a hard copy of your birth attendant’s and birth place’s phone numbers. That way, you’re prepared in case you lose power, or are housebound for a few days.
What To Do In Case of Emergency Birth
These tips are mostly taken from “Emergency Childbirth,” by Gregory J White, MD, with a few updates from evidence-based research. These tips would come into play only when mom was already feeling an overwhelming need to push, and her support person knows getting to her birth place will not happen in time.
- Don’t Panic I could not resist the Hitchiker’s Guide to the Galaxy reference, and the idea is still the same. Stay calm. Birth is a normal occurrence, and most of the time it will go well.
- Call emergency services (911). While there is no guarantee that anyone will get to you before baby is born, calling 911 gets help on the way in case a problem were to come up, or for cutting the cord and helping deliver the placenta. Sometimes, your support person can get your doctor or another birth attendant on the phone to guide you through the birth. If so, listen to them and not these tips.
- Be in a safe place. If you are in a car, pull over to a safe location. If there is a storm, be in a safe part of the house.
- Go natural. Don’t take, or let anyone give you, medications or pain-relieving drugs. Instead, use comfort measures like massage, rocking, a shower, relaxation and deep breathing.
- Stay off the toilet once pushing. If you feel like you need to have a bowel movement, it is probably baby coming down. Once you have the urge to push, baby is down far enough to start moving through the birth canal. Get on a waterproof surface, preferably with a bit of padding underneath and some towels or newspaper on top to absorb wetness, but stay off the toilet until after birth.
- Wait to push. The best way to work with the pushing stage in an emergency childbirth is to wait until the urge is completely overwhelming at the beginning of the contraction and you can’t help pushing no matter how hard you try. Breathe with those early pushing contractions where the urge starts after the contraction does. Some women never get an overwhelming urge to push. It’s ok – baby will come out anyway.
- Use a comfortable position for birth. There are many positions in which to birth a baby, which are taught in most childbirth classes. The only thing a position must include is mom keeping her legs wide apart to open the pelvis.
- Take it easy. Instead of pushing while holding your breath, or counting, just go with what your body tells you. This includes backing off and going gently once baby starts to crown.
- “Catch” baby, or let baby be born gently onto towels or whatever soft, cleanable surface you have available. Make sure baby will have support when he is born, by holding hands under him like a catcher or keeping mom’s bottom close to the surface. Baby will usually come out on his own – just provide a nice place to land.
- Leave the cord alone. The umbilical cord will continue to pulse for a bit after baby is born, sometimes for as long as 45 minutes. Leave it alone. Don’t try to tie or cut the cord because of the risk of infection from unsterilized instruments. Baby can safely remain attached to mom until after the placenta comes out, and even for some time after that. Let a health professional deal with the cord.
- Put baby skin to skin. This keeps baby warm. Most of the time, the cord is long enough to bring baby up onto mom’s belly (or at least lower abdomen) and put a blanket over baby’s back and mom’s belly.
- Let the placenta come naturally. Again, leave the cord alone. No pulling or yanking, just leave the cord alone, and eventually mom will have additional contractions to push out the placenta. It may take an hour or longer for this to happen. Breastfeeding baby will help. Once the placenta does come down into the birth canal, just lift it up and place it in a bowl to keep near baby until a professional cuts the cord.
- Give mom some juice, and a light snack. Giving birth is hard work! Mom will need to replenish her blood sugar. Some juice within 15-20 minutes of birth, and a light snack within the first hour or so will help her recover.
- Breastfeed baby. Being born is hard work! Baby will be hungry soon after birth, too. Breastfeeding baby within the first hour or so will help bonding with mom, get baby immune factors, and stimulate contractions to release the placenta, in addition to giving baby a blood sugar boost. If the cord is short, wait until after the placenta has been born so baby can reach without pulling on the cord.
For more information, see “Emergency Childbirth, ” by Gregory J White, MD. Published by NAPSAC International, 1998.