What's the procedure if you can't make it to the hospital in time?

[KitKat1985]

Hi. I'm probably panicking but would be interested in people's thoughts on this were (I will also speak to my community midwife at my 34 week appointment, as she was in a rush at my 28 week one due to running late). My first labour with DD was fairly quick (6 hours from first twinge to baby). I'm due DD2 in late November and am currently 30 weeks. My midwife has already said that my first baby would have probably been quicker as well if it hadn't been for the fact that my waters never broke (they were literally broken about 2 minutes before DD was born as she was nearly born en-caul). My first labour was very similar to my Mum with her first, and her second labour (first twinge to baby) was 50 minutes! For this reason I'm a little bit mindful that there's a possibility that my second labour could be very quick. My midwife has already advised leaving for the hospital early in labour, but even then I need to get childcare for DD before I can go anywhere, and that's likely to take 40 minutes minimum as no-one lives that locally to us. Then it's a 20 minute hospital journey. So, my question is if it becomes glaringly apparent that I'm unlikely to make it to hospital in time for the birth, what do I do? I presume stay at home rather than try to travel anywhere (giving birth by the side of the road doesn't sound great), but who do I call? Would midwives come out to an unplanned homebirth? Or would I just ring 999 and get an ambulance to attend?

I had an unplanned home birth in similar circa paramedics delivered and mw then came to check me over. I planned a homebirth for dc3.

It was my best labor and birth!

As above usually paramedics followed by a midwife.

Is there any reason you're not considering a home birth as a part of your planned care? My last labour was under 2.5 hrs and if I should get pregnant again whilst I would prefer hospital I think I would have a very frank discussion with a midwife about the pros & cons of a home birth. It would take a lot of the 'what if' out of the equation.

Possibly get childcare to meet DH/DD1 at the hospital could save time (assuming family childcare).

Thank you for your replies.

Well overall I'm thinking it would be safer if I could make it to the hospital, and I know the idea of a home-birth makes DH very anxious (although I have considered a home birth). I've found the community midwives really reluctant to want to talk about labour plans before the third trimester, and as I say at my last appointment the midwife was clearly rushing to catch up so I didn't feel comfortable asking then. I will speak to her next time though about the best option in the circumstances. I'm hoping that in reality labour will be a least a couple of hours so it won't be as panicked as I'm fearing, but given my family history it seems sensible to be at least a bit prepared for what to do in the circumstances that making the hospital seems unlikely.

Oh and I agree that if absolutely necessary DD would have to come to the hospital with us and family meet us there to look after her (can't imagine anything more enjoyable than trying to labour whilst trying to get DD to stop shoving raisins up her nose during the car journey.... )

I planned for a home birth with no3, as it happens she was induced so I was in hospital anyway. Luckily, as she managed a speedy 45min from first contraction to delivery... I was given a bag to keep in the house and some drugs that had to be kept in the fridge. This was all done on the premise that I wanted a hospital birth but that no2 had been 1hr40 from waters breaking to delivery. I suspect had I gone into labour without being induced, she would have been born wherever i happened to be at the time with an ambulance.

We aren't having a no4

Watching with interest as my first labour was also six hours from first twinge to birth and I was also told that it could have been quicker (DD was back-to-back which is supposed to slow things down).

It's all hypothetical for me at the moment as I'm not pregnant, but DH have discussed it and think that probably we'll ask a relative (my mum/his mum/my cousin - not sure yet) to stay with us from 39 weeks to solve the childcare issue. I'm guessing that isn't an option for you though, or you'd already have considered that.

If things really are moving fast though and you find yourself alone with DC1 and in labour, surely you'd just have to call an ambulance? There's no way I could have driven myself to hospital in my first labour, my contractions were intense and two minutes apart right from the off.

It's further complicated for me because I also haemorrhaged very badly after DD was born and was told I will be high risk for any future pregnancies and should always deliver in hospital, so can't even plan for a home birth!

This is the exact reason I'm planning a home birth this time!!
My first labour with DD lasted 3hrs from first twinge, my family live an hour and a half away, and the hospital is a 20 min drive and that's without traffic.
If you would be open to the idea of home birth, could you not throw some facts and statistics at your DH about how with second/subsequent, low risk pregnancies, you are statistically as safe at home as you would be in a hospital
My DH wasn't overly keen on the idea at first, but he's done his research and is now very much on board with home birthing

My last baby was five hours from first twinge to being out so interesting to see different experiences

My hospital is 30-60 min drive depending on traffic

I think I'm literally just gonna start getting DC sorted and get there asap once contractions start

Last time I arrived at hospital three hours in and already at 8cm.

Someone told me that in your circumstances midwives recommend booking a home birth as that means you have the box of stuff at home and you are in the system for midwives to come to your house. If your labour starts slowly you can head to hospital without any bother but if you have a very quick labour then the midwives can probably get to you in time.

If you're not booked in for a home birth then you're likely to have to have paramedics instead.

Oh and I'm due in four weeks! I'll let you know if I make it

Yeah my contractions became very intense very quickly too redshoes. There's no way I'd consider trying to drive myself anywhere.

Unfortunately we don't really have any relatives who could stay with us. My lovely Mum has offered to come over asap as soon as labour starts but she's a carer for my Dad and wouldn't be able to be away from her home for any extended period of time.

I rang the labour ward, told them I didn't think I'd be able to make it in as contractions were so close together. They sent paramedics and ambulance out, I did (just) make it in (blue lights and sirens) but was only in labour about 50 mins start to finish . Paramedic sat in back of ambulance with me on way in and constantly reassured me that he was trained to deliver if need be. I couldn't really care less at that point, I was too busy screaming for drugs

Afreshstart - oh yes, please do keep us updated.

Hufflepuffin - that's really interesting thanks. I'll speak to my midwife and see if I can keep some 'just in case' medical supplies at home.

A friend had DC3 at home (unplanned) after quick labours with the first 2.
DC3 was delivered by her DH who was being given instructions over the phone by the emergency services. Very quickly after DC3 arrived, so did an ambulance followed by a midwife.
They went to hospital to be checked over and were all OK.
Don't think they are having another....

So, call 999 and follow their instructions / advice if necessary

I had an unplanned and unattended hb with no2. He arrived just before the paramedic did. All the mw I spoke to after advised us to have a planned hb if we had another, so I would give it serious consideration if I were you, but yes we just dialled 999, they sorted paramedics and a mw to attend as well. Good luck!

Ds1 was 2 hrs from 1st contraction, waters went about 30 mins before 1st contraction. All very straight forward with gas & air pain relief and no tearing.

Ds2 I planned a home birth. I'm not sure what midwives are meant to deliver, but I didn't have anything.

In the event I had a bba.
Waters went around 11.35pm, I rang the hospital to get them to sent midwife out.
First contraction around 11.45pm, at which point midwife rang back and I told H she had better hurry.
After 2 or 3 contractions I got off the bed so H could put some plastic sheet on it, thought I better just check nothing was happening, reached down and delivered his head. Then the rest of him. H didn't do anything.
Not quite sure what time he was born, but H called 999 after and his phone showed that as 11.55pm.

kitkat it's a shock isn't it? I was completely unprepared, they'd made such a big deal in antenatal classes about how our first labour was likely to be long and we shouldn't come into hospital too early! And how we might be able to sleep in between contractions...

I was induced last time but had a fast labour of 5.5 hours followed by a post partum haemmorage.

I'm 28 weeks today and I'm also pretty worried about a faster labour this time around. I can't have a home birth because of pph and I'll have to organise childcare for DD.

I had a debrief and the supervisor of midwives told me not to hang around before getting to the hospital. She told me to ring an ambulance if I needed to.

The hardest thing is not knowing when labour will start, particularly when you already have a child that you'll need to arrange childcare at short notice. I'm sure it'll all work out though. Best of luck!

Redshoes - yep. Was told repeatedly at NCT classes that first labours are normally 12-24 hours and not to rush anywhere. And the maternity assessment unit insisting on telling me my contractions were just 'early stage twinges' as I had only been a labour for a few hours and to 'try and rest' and avoid coming in if possible.... We only just made the delivery suite with a few minutes to spare in the end and I never even got time for any gas and air.

Chasingsquirrels Wow. That is quick!

Bilabye I agree. I wish baby would give us some advance notice of when they were planning to arrive. Would make things so much easier!

OP you need to discuss it with your MW. Booking a hb is by far the best option as you can transfer to hospital if you want to and there is time. Surely DH would rather that you birthed at home with a mw than on you're own in the worst case scenario?

I'm due DC3 very soon and have the same worries. First labour was 6 hours, second labour 2 hours 50 - both from first twinge to baby. Hospital is 20 mins away and we will need to wait on in laws to come round for childcare.
I don't really want a HB but I'm panicking now - I have a MW appt on Thurs tho and wondering if it's too late to book one just in case?!

When are you due msfiremansam? Can't hurt to ask your mw for her opinion atleast!