Natural Birth

Precipitous labor #1, preemie, and a doula. Help!

Hi ladies.  I'm hoping to get your thoughts on my situation. I have a lot of different factors to consider, so bear with me.

My son was born at 26w3d. I drove myself to the hospital at about 9p, and he was born at 11:38. I never had any painful contractions, and I dilated from 4cm (when I showed up at the hospital) to fully dilated within about an hour and a half. He was born with just 3 or 4 pushes.  I'd hired a doula for his birth, but I didn't end up using her at all due to the delivery situation (my son was actually born out of town, too). While my birth wasn't completely intervention free (had to have an episiotomy due to my son being so premature), I managed to go pain med free. It was kind of NBD. Crowning hurt, but nothing else did, really.

Now, I'm pregnant again, due in June. I'll be high risk this time and will likely have a cerclage. I'll have P17 shots, frequent monitoring, etc. While I'd like to have as few interventions as possible, that obviously isn't possible given my history. The best guess as to why I delivered so early (and with so little pain) is that I have incompetent cervix.  That means I should completely expect another precipitous labor with baby #2.

My question is: What the heck should I do for a birth plan? I think we're going to have to bring my son with us when we go to the hospital, since we'll have to go there with the first contraction, pretty much. Do I even bother hiring a doula? My OB has mentioned induction (not pushing it - just mentioning it as a possibility so I can be sure I'm, you know, AT THE HOSPITAL when baby #2 arrives). I'm not comfortable with a home birth, and frankly, I'd be nervous that a midwife wouldn't be able to make it to my house in time. The hospital is close - probably 15 minutes, and the one where I'd like to deliver has both labor tubs and a level 3 NICU.

Any help, advice, or encouragement is much appreciated. 

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Re: Precipitous labor #1, preemie, and a doula. Help!

  • My sister just had her 2nd in just under an hr. Since she was low risk she was able to use the birth center part of the hospital. She just went as soon as she had a labor contraction and the nurses told her to let them know if she felt the urge to push and they would skip the regular check-in stuff. She made it to the room, but just stayed on the gurney. She and her husband had a neighbor who could stay with their DS1 while the regular sitter came. My family seems to have a pretty strong pattern when it comes to birth so I am also planning, just in case, for a short labor. DH knows some basic doula type things, my OB knows not to doddle if we call saying we are on the way, and we will do as much as we can to alert the nurses of the medical support (IV adrenal medicine and a different IV) that I need for my specific high risk issues. I will probably do a wee bit of reading on delivering babies in the car, but I have heard that pretty much all car births are because people with long labors want to stay home too long. 
    Married to E on June 5, 2010
    Gave birth to baby boy, I, on March 25, 2012
    Gave birth to baby girl, A, on May 20, 2013
    Baby #3 due April 29, 2015

    Recovering from mitochondrial dysfunction and Addison's/possibly very severe adrenal burn out using food, medicine, and a large amount of garden therapy.
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  • Some thoughts:

    You might specify on your birth plan about not wanting to be offered pain meds (if that is your wish).  You might arrive at the hospital in transition and forget that the intensity means you are almost done, and if offered something then might be inclined to take them up on it even though you could do without it.

    You'll want to include post-birth stuff that's important to you: no premature cord-cutting, skin-to-skin, any instructions about eye ointment / vitamin K shot / hep B shot (e.g., skipping or delaying for some time period), waiting to weigh the baby until you'd had a chance to nurse, etc. 

    If it were me I would probably not hire a doula, but you could (and just call her immediately at the first twinge).  I am a big proponent of doulas, but my last birth was after less than 4 hours of labor and everyone (midwives, doula) got there after the birth, so I've thought I probably wouldn't hire one again for any future births.  

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  • Thanks for the ideas ladies.  I'm also thinking that a doula might be pointless, given the likelihood of another quick birth. The weird thing about it is that, while I've already been through a birth, my husband has not (he wasn't there when my son was born). I wonder if HE would need the extra support.  Something to think about, I guess.

    Appreciate the ideas! 

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