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 an 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 fewer 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 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 though the basic steps of a home birth, so if possible, put them on speaker phone. And unlock your door so the EMTs can enter easily, as you my 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!
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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 partner 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 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 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 baby’s out
Wow, you’ve got a beautiful new baby! As soon as you’ve delivered your little one, 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 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 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.
After baby is born, avoid tugging on the umbilical cord. Your uterus should expel the placenta on its own in anywhere from five to 30 minutes or more, but it's safest not to try to force it. If the placenta delivers itself, don't cut the cord (more on this below) and wait for help to arrive.
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.
What to include in an emergency birth kit
If you live in an area prone to natural disasters, the nearest hospital is quite a distance away or you’re at risk for preterm labor, put together an emergency birth kit — it could come in handy in the slim chance you go into labor and can’t make it to a hospital. Your kit should include clean towels, sterile gloves, sheets, clean scissors, sanitary pads, diapers, water and instructions for infant-rescue breathing. Remember, in all likelihood you won’t have to use any part of your emergency plan — but you will be happy to have it if you do need it.
Other ways to be prepared for the unexpected? Give your doctor’s contact information to a few select people in case something happens and you aren’t able to make a call yourself (also, print out a copy of the information and hang it on the fridge or another prominent place in your home).
Bottom line: Do your best to stay calm if you find yourself in this situation, call 911 and trust your body while you wait for help to arrive. Your body and baby can do a lot more on their own than you might think!
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