Taking the Fear Out of Birth: Not Getting to the Hospital

My friend Kylie of Family Birth Support and I (Amy of AKFW Childbirth Services) have started a new column in one of our local papers called "Taking the Fear Out of Birth."  Since this particular paper is not online, I will also be posting our articles here to share with the the internet community.

The first article in this series is on "Not Getting to the Hospital."  Enjoy!

Taking the fear out of birth: Not getting to the hospital.

By Amy Wehner, childbirth educator (www.akfw.net)

It’s an exciting movie scenario isn’t it?  A very pregnant woman in labor rushing out of a public place or in a car wondering if she will make it to the hospital?  Turns out, many women (and men) are afraid of this; they just won’t make it to the hospital in time to have the baby.  Fortunately, this isn’t the worst scenario for childbirth, and the likelihood of it happening is pretty low.  In the US in 2009, only 0.9 percent of births (about 40,000) happened outside of the hospital, this includes planned and unplanned births. Of those, only 6% (2,400) didn’t occur at home or in a birth center or hospital[1], which means you have about a 1/2000 of finding yourself in an emergency situation.

However, since it is preferable to have your baby with a trained medical professional near by, let’s talk about what you should do to lower your risk of an emergency childbirth and what to do if it does happen.

First, prepare for situations like this by taking a childbirth education class.  Look for a class that teaches both you and your partner about normal, healthy pregnancy and labor and how to deal with the unexpected.  Practicing labor can help you both to talk about what you would do if the unexpected arises.  Understanding what normal labor looks like will help you judge better when it is time to get to the hospital.

Second, having an additional birth professional, like a doula, can give you extra peace of mind in an emergency.  A doula supports you through the entire labor and is available to you before you go to the hospital.  She helps support your partner in many ways so that he can attend to your needs.  She can also call 911 and help coach you through emergency labor.

Third, it’s unlikely you won’t know you are in labor in advance (more likely with your second or third child, but still not great).  The biggest problem here would be your distance from the hospital.  To plan for this, you can compensate by leaving a little earlier than recommended.  The most common recommendation for leaving for your birthing facility is the 4-1-1 rule, contractions 4 minutes apart, lasting for 1 minute for the duration of1 hour.  You can adjust this as needed to give you time to get to the hospital.  One caveat: if you are like me, your contractions may not be regular, varying in length and time.  In this case, call your doctor, earlier rather than later, to get their recommendation.

Now, if you do find yourself an emergency birth situation, here’s what to do [2]:

1.     Don’t Panic. Childbirth is completely normal and natural.

2.     Call 911 from the nearest available phone.

3.     Stop, in a safe place and prepare.  Find any blankets, sheets or t-shirts you can, place under mom and over baby when born.  Stay where you are and wait for the ambulance.

4.     Let nature be your guide, do not give mother any medications, or alter her state or the baby’s at any time.  Let baby and afterbirth come naturally without assistance.

5.     Catch! Dads, that’s it! Don’t pull, tug or turn the baby to help. Place your hands under the head and allow the baby to fall into your hands gently.  Be prepared for it to be a little slippery at first!

6.     Put baby skin-to-skin with mommy immediately. Have her try to breastfeed, which helps pass the placenta and reduces risk of hemorrhage.  It’s also the best way to keep baby warm. Put baby directly in contact with mom’s skin and cover both.

7.     Do NOT cut, tug, or pull the umbilical cord.  Let the placenta come naturally and gather it and umbilical cord in blanket with baby.

8.     Finally, cheer up!  If this does happen to you, now you know what to do and you will have had a great natural birth and a fun story to tell for years.

For more information contact Amy Wehner at amywehner30@gmail.com, or Kylie Saari at familybirthsupport@hotmail.com.

Next time: Taking the Fear Out of Birth: Loss of Privacy/Modesty

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[1] MacDorman, M., Matthews, T.J., Declerq, E. (2012). Home births in the United States, 1990-2009. NCHS Data Brief, (84), Center for Disease Control and Prevention. http://www.cdc.gov/nchs/data/databriefs/db84.pdf

[2] Adapted for non-medical professionals from the Federation of American Scientists bulletin, Emergency Childbirth. http://www.fas.org/irp/doddir/milmed/childbirth.pdf

Article Reference:

Wehner, A. (June 26, 2013). Taking the fear out of birth: Not getting to the hospital. The Fairmont PhotoPress, 50(7), 4.