Worried you'll go into labor when you're by yourself and can't get to a hospital? Although the odds are very slim, here's a step-by-step rundown of what you should do.
As you near your due date, you’re likely brimming with excitement — and, if you’re like many moms, also brimming with “what ifs.” Like: What if I go into labor when I’m home alone and can’t make it to the hospital? Although that scenario is common in soap operas, only about two in 1,000 women end up with unplanned home birth. But to lay your fears to rest (or in the case you are that rare mom who finds herself snowed in on D-day), heed these simple instructions for an emergency delivery by yourself at home:
1. Assess the situation
First things first: How do you know if the baby’s coming quickly and you won’t make it to the hospital? While every woman's labor is different, if you’re having strong, long, frequent contractions (generally occurring less than five minutes apart), and/or if your water has broken and you have a strong urge to push, you’re experiencing signs that delivery is imminent. First babies tend to take longer than subsequent ones — so if you’re having your second or third child, the odds are higher that you could end up giving birth at home.
2. Call 911
Sounds obvious, but in all the excitement (baby’s on the way!) you don’t want to forget to get those medical professionals en route; when you get them on the line ask them to call your practitioner too. Most dispatchers are also trained on how to talk you through the basic steps of home birth, so if possible, put them on speakerphone. And unlock your door so the EMTs can enter easily, as you may not be in any condition to usher them in by the time they arrive.
3. Stay calm and know this is natural
While an unplanned delivery at home may seem frightening, try your best to keep calm and remember: Your body knows how to do this! For starters, if you’re worried baby will get stuck or come out feet (or butt) first, understand that babies who arrive quickly typically don’t encounter these problems since they’re positioned in the ideal head down position – that’s why they’re raring to go! Also keep in mind that home births are surprisingly common in rural areas and even developed countries like the Netherlands, where about 13 percent of babies are born at home. In fact, one 2013 study out of the Netherlands found that planned home births were actually safer for low-risk mothers than hospital births, in part because women at home suffered fewer unnecessary medical interventions.
4. Make yourself as comfortable as possible
Wash your hands and your vaginal area with soap, or use wipes or hand sanitizer. Grab a bucket of warm water and at least four clean towels, which you can use to wipe your baby down and keep him warm. Though your first impulse might be to lie in the tub to avoid a messy cleanup, you won’t be comfortable there — or easily accessible to the EMTs. Instead, lay clean sheets, towels, or a waterproof covering such as a plastic bag or shower curtain over your bed or on a rug on the floor. The best position is whatever is most comfortable; however, if you're alone and need to lie down, try to prop yourself up with a bunch of pillows. In this position, you can also easily reach down with both hands and help ease your baby out.
If someone’s around to help you (i.e. you go into labor in a Walmart parking lot or are at home with your husband and can’t get to the hospital), most of the advice is the same — except for how you’re positioned. At home, sitting up on the edge of a bed with your feet on a chair is good, because someone is there to catch the baby and this simulates the position you’d be in at a hospital (that said, you should assume whatever position feels comfortable). You can also consider squatting or being on all fours if that feels right.
5. Resist the urge to push — until you can't
When having a baby unexpectedly it’s better not to bear down, since you could risk the baby coming out quickly and damaging your delicate tissue. Panting can help since this keeps you from holding your breath and adding to the internal pressure. If your baby starts to arrive despite this, try to ease him out gently by pushing each time you feel the urge. Once your baby's head becomes visible, gently press your hands against your perineum (the area between your vagina and anus) to keep the head from popping out too fast. Do not pull; just guide the baby out gradually. If you find the umbilical cord around your baby’s neck, hook a finger under it and slowly loosen it enough to ease it over his head. Once the head is out, gently push it slightly downward while pushing with the next urge. This should deliver the shoulders; the rest of the body should come easily after that.
6. What to do once the baby’s out
Wow, you’ve got a beautiful new baby! As soon as you’ve delivered your little one, towel him off and bring him up onto your belly or chest; skin-to-skin contact will keep him warm and calm, and wrap him with a clean towel. To help drain the amniotic fluid and stimulate first breaths, wipe baby's mouth and nose, and run your fingers from the corners of the eyes down the outsides of the baby's nostrils. Then vigorously rub the sides of the back on the rib cage up and down at about the pace and pressure of washing your hair, keeping the head lower than the feet until the baby starts breathing.
Today the majority of doctors don’t use an aspirator, as it's not necessary: Most babies will start to breathe on their own without any intervention or stimulation, with only 1 percent requiring advanced methods of resuscitation. In the rare case that your baby is among those who need help, clear out his mouth some more with a finger, then give two quick and extremely gentle puffs of air into the mouth and nose.
Once the baby is calmly breathing on his own, guide his mouth to your nipple to initiate breastfeeding. This will prompt your body to release more oxytocin, a hormone that will cause your uterus to contract further so it should expel the placenta on its own anywhere from five to 30 minutes or more. (Some women are surprised to find that labor doesn’t end after the baby comes out, so be prepared for some more strong contractions. They are totally normal.)
7. Don’t cut or tie the umbilical cord
Cutting the cord yourself in a sterile fashion may be difficult — by doing so you could expose your baby to infection. Plus at the time of birth, about 30 percent of your baby’s blood is still in the placenta, which can give him two to five minutes of oxygen (this can be lifesaving if he hasn’t started breathing on his own and the EMTs haven’t arrived yet). So with the cord attached, wrap the placenta in a clean towel elevated above the level of baby, if possible, and wait for the EMTs, who will cut it in a sterile fashion.
Bottom line: When in doubt, do nothing. Your body and baby can do a lot more on their own than you might think!
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