Preparing for giving birth without medical assistance

[Maevish]

I'm due in three weeks. Because of where I live there is a reasonable chance I'll end up giving birth on the way to hospital, which is 2.5 hours away. There are lots of mobile phone black spots on the way so we may not be able to get medical advice via phone either.

I'm packing hospital bag and have included lots of towels, clips and badass scissors for cord.

We will also Google shoulder dystocia and positions that can help.
What else should we take/learn about?

It's my second baby, no complications, and me and my husband are competent and not panickers. My midwife won't really say much about which possible complications we could prepare for. I know it's likely to be fine, but I'd prefer to be prepared and not need it than to be unlucky and wish I'd prepared. If we are literally all on our own and there's a problem, I want to at least try to save the baby (or me!) even though we might not do it right.

BTW there are no other options here, like I can't have a home birth or anything.

Are there no NHS midwives providing home birth assistance? Surely this is the safest options in your scenario, assuming you can't stay closer to a birthing centre or hospital in the run up to your due date.

I find it shocking that there is no NHS provision. However, if there really isn't, could you try and find an independent midwife who could come to you? Or failing that, a doula, who is not medically qualified but who does have experience of supporting women to give birth, at least.

You don’t need to cut the cord, just leave baby attached. Far less risky than cutting with non sterile scissors. Just make sure baby is kept warm, have hats ready. Otherwise skin to skin with towels and blankets over you both does the best job.

I really would just plan a home birth though in the hope that at least if you end up doing it alone it’s in your own house with telephone signal rather than by the side of a windy dark lane.

Having given birth unassisted (Baby came entirely too fast at home) I would seriously be looking at getting closer to the hospital for the final weeks or at the absolute first signs of labour getting in the car and going straight there. My second baby came fast - about three hours after I woke up having frequent contractions having had a few in the evening before. He also came earlier than my first at 37+2.

I'm also not sure about cutting the cord yourselves - the paramedics cut ours when they arrived but I'd hate to do anything that could introduce infection when you can leave it on until you get medical assistance.

This is a good point. Many of my friends had really quick second births and had to have immediate intervention to do PPH. Common with quick births.

I completely understand that you don't want induction / section and that the baby could come earlier anyway but, to me, the safety of the baby would be more important than my ideal birth plan, simply because the lowest risk to my baby would win out. I'm not criticising you at all for what you ideally want but, for me, the weighing up of my birth options would be very different if there's a high chance that one option would lead to me giving birth at the side of the road. I couldn't live with myself if something went wrong and I could have made a different choice.

I do think it's much safer to stay at home and get midwife and/or paramedics to come to you. Giving birth en route would be my worst nightmare!

My second child was born at home - had planned a home birth but still hadn't quite decided whether I might go to the birthing centre after all - in the end it all happened too fast for me to go anywhere. Midwife arrived less than 10 mins before baby was born. It was stressful and I was relieved when she got there. Baby was already born when second midwife arrived.

Yes, it's still not that uncommon really. I'd hate to be far from a hospital if that happened. I gave birth away from hospital and I'm glad I'm still here to tell the tale. Home birth is fine but I wouldn't be planning it hours away from a hospital.

I have had three (due to fast labour) unassisted births but in all these situations someone was available within an hour or so to come to me and cut the cord etc. And I stayed at home because we planned for home births (because we knew we wouldn’t be able to get to hospital in time).
Your situation though op , would fill me with enormous anxiety. Why can’t you have a home birth exactly?

In these scenarios I wonder if you could get a prescription for the injection they give you to reduce risk of PPH, and keep it in the fridge at home or something?! I was given the injection by the midwife at home, they must have it in their kit. (Can't remember what it is but they give it just after baby is born to help get placenta out asap.)

Could you go and stay in a hotel nearer the hospital?
This is very rare but I had a cord prolapse with DS1 and he was born in hospital and had to be resuscitated If I was out of hospital I was told he wouldn't have made it
I'm sorry but I just wouldn't risk it if you're so remote

I would be doing everything in my power to be nearer to a hospital in your shoes op. I'm sure millions of women give birth alone safely each year but millions also don't and for me it's just not worth the risk.

2.5 hours would be a really short labour, was your fourth quite quick or are you just trying to be prepared in case?
I think in your shoes I’d be focussing on mapping the mobile black spots and trying not to stop there, plus phoning the hospital ahead to give warning that you are on your way.

No one got a satellite phone you can borrow?

I'm in a similar area. I basically did the same as you, giving birth in a layby rarely happens but not never! It's just how it is in rural areas.

Women here are triaged by a local midwife and they are pretty experienced at knowing how these things go. If they don't think you will last the journey they will accompany you in an ambulance to the hospital. Or deliver at home if it's going really fast and transfer you afterwards if need be.

Quite frankly, that sounds terrifying, I'd take myself and toddler and stay in an Air B&B, Premier Inn or Travelodge type place for two weeks. If your Labour started you'd be near civilisation, DD would be looked after until DH arrived. Do you have any family you and DD can go stay with and DH meet you afterwards.

Having had a child already means birth is likely to happen faster, and although in yesteryear women in remote places managed they also had skills that have long since been lost and ofcourse tragedies happened often.

Don’t encourage someone to knowingly undertake an unassisted / free birth. The option of a planned induction / caesarean is far far safer!

I’d also say this. It’s great that you both feel confident and practical , but you have to take yourself out of the equation a bit, as you will be otherwise engaged! It wouldn’t really matter if you were a midwife/ doctor/ paediatrician with 30 yrs experience, as you’ll be busy and may not be able to access your best skill set in the heat of the moment😅. This is not to be patronising , you have given birth and you know yourself but from my experience, a couple of times I was quite good mentally, one time my mind was totally elsewhere (as if I was on a drug high) because of pain, and logical practical thinking in that moment is pretty impossible.

What happened in your first birth? Any particular events that indicate risks you need to look out for second time around?

Unless you’re prone to giving birth very quickly I would just leave home as soon as things start and present to hospital. Surely they’re not going to send you home when it’s a five hour round trip…

The main planning would be what to do with the toddler as I wouldn't want to be in labour, possibly giving birth in a car on a 2.5 hour drive with a 2 year old with me.

In all seriousness I'd ask locals what they did (is there a local FB page you could ask if you don't know anyone?) Is home birth an option?

I had a fast first birth. I live an hour from the hospital and where I am home births aren't common. When I was pregnant with my second it was winter and the consultant said it would be a good idea to schedule an induction.
I considered it but in the end went into labour naturally at home. It was even quicker than the first time and the drive to the hospital was incredibly stressful and quite scary. I was having very strong intense contractions while my poor DH was trying to drive safely.
I gave birth within a couple of minutes of getting to the delivery room. If j had a two and a half hour drive we would not have made it to the hospital.
In your situation I would strongly consider induction. Now you have childcare to arrange I really think it would be the best option.

Don’t think the medical professionals involved in her care probably have a better idea of the situation & what the safest plans are than random posters on the internet?

I echo the person who has mentioned post partum haemorrhage. I have suffered this and it gets bad quickly.

Lots of videos here https://globalhealthmedia.org/our-projects/childbirth-series/

Having read your most recent post I would seriously think about a planned section perhaps at 39 weeks where you have a firm date to arrange care for your DC
Circumstances alter cases and in my view the safety of your baby is paramount and dare I say it more of a priority than inconvenience to you( no offence intended)

If you could have an induction at 38 weeks then it’s unlikely that your baby would come before then? Was your first baby early?

I understand not wanting an induction, I wouldn’t have been keen on one either. But if it’s an option I don’t see how it’s not preferable to giving birth with no medical assistance and potentially by the side of the road.