Unassisted Birth

LynaT · February 2013

Because of my current insurance I'm planning on delivering in a hospital (not my first choice, I would love to be in a birth center but at least I have a midwife) but the problem is the hospital is an hour away. In my family women have ridiculously fast births. My grandmother (maternal) had 3 kids, labor and deliver start to finish 15-30minutes. MINUTES! My mom only had 2 kids, myself and my brother. Start to finish 1 hour. Normally this wouldn't be an issue since most women get some type of warning that labor is about to start. In my family this isn't the case. No warning whatsoever. My mom said the day I was born she felt fine. Nothing out of the ordinary, no braxton hicks nothing. She felt like she had to go to the bathroom and then her water broke, an hour later I arrived. I wasn't even delivered by a doctor. My aunt was the same way, water broke she had an hour before my cousin arrived. My sister, same thing. So given my family history of lightening fast births I don't think I'll make it to the hospital since it's an hour away without traffic, using a short cut lol There's really no way to cut that hour and that's only if the stars align properly and everyone stays home. So basically I'm most likely going to have an unassisted (no midwife, no doctor, no nurse) home birth. I'm not worried about the pain since it'll be over so fast lol My main concern is being prepared to do this safely for both myself and my child. So any tips or references on how to home birth without assistance would be wonderful. Also, for those moms who have had home births assisted or unassisted, what do you do as far as birth certificate and a check up for yourself and the baby? Would I just wait until the next day (if all is well) and have the baby checked out? Do I call someone after it's here (if 911 doesn't respond fast enough which they might not)? That's my main concern is what to do after the fact. My original plan was to have a midwife and a birth center which obviously would mean I would have trained professionals with me. The plan I'm forced into because of insurance means I'll theoretically have a midwife in a hospital. Since this is my first I don't know what is and is not normal as far as how I will feel afterward and how the baby is doing. Any advice and help would be greatly appreciated. I have a few months before this little one is supposed to arrive and plan on addressing the same question at my next appointment in 3 weeks but I'd love to hear from other moms who have actually had unassisted births or birthed at home.

wifeofadam · February 2013

If you think you can't make it to the hospital, would an ambulance be able to get to you sooner? I would make sure you get the EMTs to you to help. Then they can transfer you to the hospital after the birth (or during) to get everyone checked out. One of the benefits of having a trained midwife for a HB is that they can assess the baby for signs of distress after the birth. I don't think you're qualified to do that.

As far as the birth certificate and all of that, once you transfer to the hospital they will handle it for you.

If you're planning to do it all alone without transferring to the hospital, you'll need to get all of the paperwork and do it yourself.

Also, I would highly recommend at least hiring a doula who has been present at several births and trained in baby catching, just in case if you're going to try to drive to the hospital on your own.

edited for clarification

Temp76535187505890 · February 2013

intheflowers:
Unassisted birth, especially in a FTM, is not something I consider safe. You might be better served by the mothering.com forums, they have a board specific to uc.

she's not planning an unassisted birth, rather she is preparing for the possibility should she not make it to the hospital in time based on family history.

OP: have you discussed these concerns with your midwife? I would think s/he would be able to give you resources and/or information on the subject.

nosoup4u · February 2013

+adamwife+:
If you're planning to do it all alone without transferring to the hospital, you'll need to get all of the paperwork and do it yourself. Also, I would highly recommend at least hiring a doula who has been present at several births and trained in baby catching, just in case.

That would mean her doula would be a MW at her birth.

OP, have you talked to your provider about your concerns of a fast birth? Women have been induced bc of a history of precipitous labors, that might be something to look into.

Have you looked around for HB MW in your area? Chances are, they could get to your house quicker than it would take to go to the hospital. I don't think unassisted birth is safe or advisable, quite frankly.

hollandmama · February 2013

nosoup4u:
+adamwife+:
If you're planning to do it all alone without transferring to the hospital, you'll need to get all of the paperwork and do it yourself. Also, I would highly recommend at least hiring a doula who has been present at several births and trained in baby catching, just in case.
That would mean her doula would be a MW at her birth.
OP, have you talked to your provider about your concerns of a fast birth? Women have been induced bc of a history of precipitous labors, that might be something to look into.
Have you looked around for HB MW in your area? Chances are, they could get to your house quicker than it would take to go to the hospital. I don't think unassisted birth is safe or advisable, quite frankly.

Exactly this. If I were you, I would look for a MW in my area who can assure you to be there as soon as you call her, I've seen videos of unassisted births and they are amazingly wonderful (I'd love to have one) but they were not FTM and knew how to check the baby after birth. I wouldn't risk it.

Does your insurance cover ambulance? Probably you'd get to the hospital in less than an hour.

superned · February 2013

You really need to talk to your provider. Just because you have a family history of precipitous labors does not necessarily mean you'll have one, but it's certainly something to prepare for, and your OB or MW is the best person to have that discussion with.

I'd definitely be sure and have cervical checks as soon as your provider will do them. I chose to have them, so I knew I was already dilated to 4cm when my first contraction hit with DS. My OB told me that I shouldn't waste any time getting to the hospital based on my 39w exam, so we made the decision to go right away. Thank goodness, because DS was born 78 minutes after my first contraction.

After having a precipitous labor myself, I will be taking any and all precautions to avoid UC if I ever have any more children. Is there anyone you could stay with who lives closer to the hospital, once you get to 37ish weeks?

wifeofadam · February 2013

nosoup4u:
+adamwife+:
If you're planning to do it all alone without transferring to the hospital, you'll need to get all of the paperwork and do it yourself. Also, I would highly recommend at least hiring a doula who has been present at several births and trained in baby catching, just in case.
That would mean her doula would be a MW at her birth.

No, not really.

My BFF is a doula and I've "hired" her in a doula capacity. My MWs live an hour and a half away. Since this is my fourth baby and I'm planning a homebirth, I want my BFF there as soon as possible just in case the baby comes before my MWs get here. I'm not hiring her as a MW, but since she has experience and training in catching babies, I feel safer with her there.

The doula could ride along in the car with the OP and be there in case she delivers on the side of the road. I'm not telling the OP to stay home and rely on the doula to deliver her baby. I'm telling her to plan to go to the hospital with her doula there for labor support and also as Plan B in case she never makes it to the hospital.

tokenhoser · February 2013

If this was me, I would start having cervical checks at 38 weeks and if I was significantly dilated, I would consent to being induced by having my water broken at the hospital. Births that fast are not going from 0 cm to 10 cm in 15 minutes; I would guess that these women are nearly 100% dilated when contractions start.

I don't think a HB midwife or other planned home support would be of any help in a labour this fast. That's neither here nor there, really.

AmyRI · February 2013

tokenhoser:
If this was me, I would start having cervical checks at 38 weeks and if I was significantly dilated, I would consent to being induced by having my water broken at the hospital. Births that fast are not going from 0 cm to 10 cm in 15 minutes; I would guess that these women are nearly 100% dilated when contractions start.
I don't think a HB midwife or other planned home support would be of any help in a labour this fast. That's neither here nor there, really.

I have to agree with this. Birth center, hospital, homebirth MW, doula... it doesn't matter. It's very likely that only EMTs will make it to the birth in time.

My plan would also be induction if the MW will consent. Otherwise, get a kit ready for birthing by yourself. Head to the hospital at first contraction and hope you make it, but be prepared if you don't and dial 911.

When I asked about precipitous labors, someone linked me to this Emergency Childbirth manual, and this website has a link to the PDF version.

https://www.theperfectbirth.com/Emergency-Childbirth--A-Manual.html

Celyn · February 2013

If you are concerned about precipitous labor, insist your DH be as knowledgeable as he can about what to do (don't rely on yourself to be the knowledgeable one, in case you can't do what you need to do). It's a good idea to take a neonatal resuscitation class (the methods are different than infant CPR) and get a homebirth kit to take with you on the way to the hospital, in case you're stopping on the side of the road.

In reply to the pp: Doulas are not supposed to catch babies. Hiring a doula who is trained to catch one would be then hiring a midwife (and while there are many midwives who work as doulas (and many student midwives who do too), when they do so, their contract is generally quite clear that they are working within the scope of a doula only... and often you still have to pay their midwife rate). While none of the doula certification agencies have a specific statement against attending UCs, they don't encourage it either. If something were to happen and she steps outside her scope to assist, the State can (and has) charge her with practicing medicine without a license.

OldGlory · February 2013

Celyn:
If you are concerned about precipitous labor, insist your DH be as knowledgeable as he can about what to do (don't rely on yourself to be the knowledgeable one, in case you can't do what you need to do). It's a good idea to take a neonatal resuscitation class (the methods are different than infant CPR) and get a homebirth kit to take with you on the way to the hospital, in case you're stopping on the side of the road.
In reply to the pp: Doulas are not supposed to catch babies. Hiring a doula who is trained to catch one would be then hiring a midwife (and while there are many midwives who work as doulas (and many student midwives who do too), when they do so, their contract is generally quite clear that they are working within the scope of a doula only... and often you still have to pay their midwife rate). While none of the doula certification agencies have a specific statement against attending UCs, they don't encourage it either. If something were to happen and she steps outside her scope to assist, the State can (and has) charge her with practicing medicine without a license.

In my contract with my doula, it specifically states that if the need arises for her to help with the delivery (driving, assisting with the birth, etc) it's all under Good Samaritan and that I agree to no sue for her assistance in that situation.

wifeofadam · February 2013

In reply to the pp: Doulas are not supposed to catch babies. Hiring a doula who is trained to catch one would be then hiring a midwife (and while there are many midwives who work as doulas (and many student midwives who do too), when they do so, their contract is generally quite clear that they are working within the scope of a doula only... and often you still have to pay their midwife rate). While none of the doula certification agencies have a specific statement against attending UCs, they don't encourage it either. If something were to happen and she steps outside her scope to assist, the State can (and has) charge her with practicing medicine without a license.

Just to clarify (again). I am NOT advocating hiring a doula for the purpose of catching the baby. I am advocating hiring her to be there with you on the drive to the hospital to serve as support and as someone there who has experience in birth just in case the baby comes early.

I am friends with two doulas. Both have had to catch babies before when their clients midwives didn't make it on time. One of them has had to catch the baby in the hospital when the nurse took too long to get into the room. I'm not saying that these women were hired in that role, but it was good that they were there, because they had experience and training in that. My BFF just finished her doula training last year and baby catching was part of it - she wasn't trained to catch babies as part of her normal duties, but baby catching was gone over in a "this could happen when you are doing your doula duties, so let's go over how to safely deliver a baby just in case" kind of thing.

I would never tell someone to hire a doula and to use them as a MW. I'm just saying that it would be nice to have SOMEONE there on the ride to the hospital just in case you need to deliver on the side of the road - preferably someone who has experience with birth.

ETA - I went back and reread my OP and I can see how people are thinking I am saying to hire a doula to be home with her. I wasn't very clear.

Celyn · February 2013

I've had to catch too. It comes with the territory. Heck, I've had to catch in a hospital when the OB wasn't paying attn, the bed was already broken down, and had I not, the baby would have hit the floor.

What's in a contract regarding lawsuit is a bit irrelevant. It's not the mom one worries about suing, because most likely she won't if the doula was acting as a GS and not merely doing things outside her scope for the sake of doing it. Other people/institutions can sue without mom's consent or approval - like her parents or the state. But that's highjacking this thread and not what the poster was asking about.

danuli8 · February 2013

I have no experience in this area, but two options come to mind:

1) Stay somewhere closer to the hospital (friends? family?) when you hit 38 weeks. Have someone ready to drop everything and get you to the hospital the instant contractions start (or just go straight to option #2).

2) Wherever you are when contractions start, call 911 immediately. The ambulance can get you to the hospital, and they can deliver and care for the baby on the way if necessary. I think that's your best option for not being totally alone when you give birth.

BLPL101 · February 2013

I just want to say that just because your family has fast births doesn't mean you will. I thought the same as you before I had DD. EVERYONE in my family has very fast births and the whole time I was pregnant my mother told me I will have a fast birth too. I, of course, thought I would too. My water broke and I had no contractions for over 24 hours and ended up having DD almost 45 hours after my water broke. Needless to say, I was shocked that I didn't have this fast birth that I imagined.

principessa81 · February 2013

BLPL101:
I just want to say that just because your family has fast births doesn't mean you will. I thought the same as you before I had DD. EVERYONE in my family has very fast births and the whole time I was pregnant my mother told me I will have a fast birth too. I, of course, thought I would too. My water broke and I had no contractions for over 24 hours and ended up having DD almost 45 hours after my water broke. Needless to say, I was shocked that I didn't have this fast birth that I imagined.

I agree with this! All the women in my family had fast labors and babies that typically came 1-2 days early, so naturally I thought the same thing would happen to me. Nope. Induced at 41w4d, 27-hour labor. I think it's good to be prepared in case of a insta-active labor and delivery, and I like some of the suggestions that the pp gave (especially hiring a doula, maybe staying with friends or family that live closer to the hospital), but I wouldn't automatically determine that you're going to have a crazy fast labor just because family members did.

JCWhitey · February 2013

My cousin's wife had her baby unattended in her bathroom but the EMTs arrived within seconds. My cousin was holding this baby not sure what to do when he saw their feet in the doorway. They got there pretty fast. So I'd just plan to call 9-1-1. They got the recording from the call as a baby gift a few days later and it's a great little keepsake, too!

That being said, while the labor and delivery went just fine at home, they liked being in the hospital to make sure all of the stuff comes after went OK. She didn't deliver the placenta until about 20 minutes are they arrived at the hospital and there was some issue with that. Although nothing seriously and they probably would have been just fine at home, better safe than sorry. Do you have the resources on hand to give yourself what you need if something goes wrong with the placenta? If not, get to the hospital or under the care of someone does as quickly as possible.

We live an hour from the hospital as well and while I don't expect my labor to be fast I don't want to be in a car for an hour during the most intense part of labor. I also don't want to get to the hospital/birth center (still deciding) too soon. So we're getting a hotel near the hospital where I can labor and still be close to the hospital. As a gift my parents are paying for the hotel for up to a week so that we can go whenever I feel I'm ready and even stay a day or two after if I don't want to make the drive back right away. We don't have traffic to deal with, but the road is having some major construction done to it over the summer and they are preparing residents for 45 minutes waits for TNT blastings. Not exactly what I call fun after just popping out a baby!

memo9 · February 2013

principessa81:
BLPL101:
I just want to say that just because your family has fast births doesn't mean you will. I thought the same as you before I had DD. EVERYONE in my family has very fast births and the whole time I was pregnant my mother told me I will have a fast birth too. I, of course, thought I would too. My water broke and I had no contractions for over 24 hours and ended up having DD almost 45 hours after my water broke. Needless to say, I was shocked that I didn't have this fast birth that I imagined.
I agree with this! All the women in my family had fast labors and babies that typically came 1-2 days early, so naturally I thought the same thing would happen to me. Nope. Induced at 41w4d, 27-hour labor. I think it's good to be prepared in case of a insta-active labor and delivery, and I like some of the suggestions that the pp gave (especially hiring a doula, maybe staying with friends or family that live closer to the hospital), but I wouldn't automatically determine that you're going to have a crazy fast labor just because family members did.

I would also like to echo this sentiment. My mother had a two hour labor and mine was 12.

briannabeebug · February 2013

MUD? LynaT has one post on the same day that she joined?

Sorry OP if it's not.

Also call me crazy, but an unassisted delivery (although not my ideal and I personally don't know if I'd be comfortable in your situation--if you do deliver as fast as the rest of the women in your family seem to) is not that crazy. I'm not medical professional and have only studied the birth process as a doula and a parent (plus general interest!), but if these births are happening so fast--these babies have got to be super well positioned/no complications to make labor difficult/or slow it down. In order to be on the safe side I would study what happens after the birth to protect yourself (in case of hemorrhaging), and how to handle baby. Also of course if you did end up with an unassisted birth by accident you can always have the EMT's on speed dial--so at the start of your labor/contractions dial them and they should get there by time the baby is born as a safety net.

Pretty wild the women in your family have that trait!

kathleen02 · February 2013

The real and only fact is that you are not your grandmother, mother, aunt or your sister. I have the same family history and you know what? My labor lasted two days. Two DAYS. You may want to talk to your OB about this and your concerns about possibly not getting to the hospital on time but I wouldn't bet that this will happen to you because it happened to everyone else in your family.

evelyntaylor · February 2013

I think that the best thing you can do to prepare is to read up on neonatal resuscitation and other birth complications so you can have a good idea of what to expect in the event of an emergency before an ambulance shows up, which I think you should call the moment you think you're in labor/water breaks. Shoulder distocia, cord prolapse, maternal hemorrhaging, etc are all things you should research and be prepared for. I'd also talk to you midwife about having a small at home kit just in case that has sterile items in it for both you and baby to cut the cord, clean, etc.

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