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.

Oh wow I wasn't expecting sk many answers!

I can't have home birth because there aren't enough midwives at the moment (usual problem of pretty rural places - healthcare staff can't find/afford houses because of too many second homes etc).

First birth I went to Inverness once labour started. This is usually fine for a first because you are very unlikely to give birth so quickly that you birth roadside.

Second babies used to be born locally with midwives but we can't do that now because of no midwives!

Thanks for the idea of looking up freebirthing safety - I hadn't thought of that.

PPH is a concern. I am not at particular risk for that but obviously that doesn't rule it out.

I could stay at home until I guess we are near the second stage and then call an ambulance. They don't want me to do this deliberately though (although they are understanding if it happens so fast that's the only option).

My first baby was just over five hours. Very uncomplicated birth.

I am not TRYING to have a freebirth, for the poster who suggested that 😆 I just think it's sensible to have a think about possible issues in advance and do what we can to prep. I appreciate there are many things we can't do anything about, but it would be stupid to not even bother looking up what to do with the things we can do something about.

Can you pay for a private midwife? If there is a shortage of NHS ones

I really don’t think it’s worth the risk to be honest. Be induced if that’s the only option. Of course it will probably be fine! But there’s always the chance you’ll need intervention. I had a low risk pregnancy and my son ended up needing a lot of help to make it out! Episiotomy, forceps, that suction machine thingy (whatever it’s called!). His heartbeat dropped very low and if the doctor hadn’t have been there (or if I’d have been very far away) I don’t know what would have happened. If I’d have been 2.5 hours from hospital, it might not have gone so well. I was induced for another birth and it was absolutely fine. The feeling of security being in the hospital waiting for it to happen was such a relief and I found no it no more painful. I’d definitely go for the induction.

If your first birth was only five hours I'd be twitchy TBH

5 hours is pretty quick for a first birth… I would be getting in the car at the very first sign of a twinge.

In A&E they keep plastic sandwich bags in case any babies are born in the car park. Apparently they are very effective at keeping a baby warm!

Chances are you’ll be fine but there’s always a chance the baby could need emergency help.
my first birth was long but relatively plain sailing with no real medical intervention needed for my baby. My second required forceps in the emergency C-section theatre to get her out.
my 3rd was born in a birthing centre but needed emergency blue lighted ambulance to the Main hospital as she’d swallowed lots of meconium, on top of this she was critically ill and had an undiagnosed genetic condition so went back in to hospital for diagnosis and life saving treatment.

i think you just have to accept that where you live isn’t always appropriate for having a baby. My daughter has spent all 10 years of her life visiting the hospital for appointments for a condition that was undetectable during pregnancy. To say you can’t go to Inverness because of work is very naive. You might end up having no choice but to move. So I think you need to look for an air bnb closer to the hospital and keep your fingers crossed that baby will be born healthy and be able to live in a remote area.

Given that your first birth was only 5 hours, you need to plan for a home birth, because subsequent births are usually quicker, and by the time you're in labour it's too late to go anywhere (happened to me).

If you can afford it, see if you can find an independent midwife who can come to you. I t really think that's your best bet. With or without a midwife, stay at home and call an ambulance when you're in active labour. Do not feel guilty about this, it's not your fault there are no NHS midwives for home births.

You don't need scissors for the cord. Just leave it be

You can’t manage shoulder dystocia or PPH in a lay by.

There is no appropriate advice to give you. You need to be able to access care at the point you and your baby need it. Your choice is either to move closer to the hospital or arrange home care. There are no other options.

I am sorry that the NHS is failing women in your area, the loss of healthcare in rural areas is a national disgrace.

My first was 12 hours active labour (34 hours from first contraction)
My second was 2 hours from first contraction (they didn't feel super intense either!) to baby being born, we live 30 mins from the hospital and made it with less than 5 mins to spare. Not to panic you but if your first was only 5 hours I wouldn't be planning on getting to a hospital that's over 2 hours away ... I would either plan an induction for 38 weeks or stay MUCH closer to the hospital.
I know logistics are difficult but it's not just your safety to think of it's the baby too so I'd be doing absolutely everything in my power to not put myself in the stressful and potentially life threateningly situation of making that journey with no medical assistance.

This

I think I'd just set off after your first contraction and hope labour establishes.

What do your Trust say when you ask what you're supposed to do? I'm so appalled by what you're telling me.

I live on Scottish islands we are expected to leave two weeks before due date so I’ve spent 5weeks, 4 weeks and 2 weeks on Mai land within 20mi d of hospital for 3 babies. Fortunately we could afford it although nhs do reimburse some of the costs involved. I’ve never had an easy birth and I wouldn’t be happy at the idea of driving for 2.5 hours in labour. I’d try your best to move near Inverness before the birth.

I think, if baby (or you, or both) died during childbirth you (and/or your husband) would re-evaluate very quickly, and sadly too late, the level of upheaval and inconvenience required for a temporary move closer to medical care.

Back in the day they did ship first time mothers to Inverness a couple of weeks in advance, and they stayed for free. Now they don't pay for you, so if you want to do that it's at your own cost. It's just too much for us, it would be into the £1000s for that many nights. Ditto for getting a private midwife to come and stay locally in advance of the birth.

It's such a shame. A couple of years ago we had full midwife cover here with a MLU less than an hour away and home births were available too. A couple of midwives left and they can't replace them. People have been hired for the roles but can't take up the positions because they can't find housing. It's not the NHS fault, it's the government's fault for not tackling the second home epidemic.

Anyway the political situation is not going to be fixed in three weeks so it is what it is.

I think I will tell the midwife I'm not going to try to get to Inverness (instead of just asking nicely) and see what happens. Paramedics with gas and air sound better than the layby with no gas and air.

How helpful do you think that is really @Justchooseone?

It’s utterly shit that the NHS can no longer provide the basic service required to keep women and their babies safe. But that is NOT the fault of those women. Unfortunately the kind of midwifery that would need to be practiced to service rural areas adequately is just not the kind of midwifery that is compatible with a good work life balance for midwives, particularly the way the Tories wish to run the service - cut as close to the bone as possible.

Lots can go wrong and I’d suggest looking into cord prolapse, shoulder dystocia, PPH and newborn resuscitation.
Do you have any risk factors?

I am a third year student midwife and I would not risk birthing alone personally.

Where do women move to, out of interest? Into hotels/Air B&Bs? Rental properties? Must cost a fortune??!

It's maddening that staffing means you can't have a home birth.

My in laws live just outside of Inverness and I always wondered what women further away do (they moved up when children were grown so didn't have this situation).

I wouldn't worry about cutting the cord, baby can stay attached to the placenta even when it's delivered. Keep baby skin to skin and covered with dry towels/blankets. Replace them as they become wet. Keep a hat on baby. Phone for an ambulance as soon as it's apparent baby is making an appearance and you can't get to hospital.

Best of luck OP

Sorry I see you've answered my questions already, slow typer!!

You do not need to cut the cord. If baby is born on the way, just keep him/her warm, ideally skin to skin with you, if the placenta follows just strap it up and leave attached.

Hypnobirthing, visualising your calm journey to the hospital. Affirmations.

I put my trust in my body to deliver me safely to hospital where I will give birth to my baby.

There is a fine line between expecting everything to go smoothly and being ready for whatever birth brings.

Talking through scenarios with your partner.

Might be worth talking through with a birth doula, to help you get your head in the right space.

I know not every birth goes to plan so I am not offering this as a guaranteed solution but I have seen quite a few women, arrive at hospital and give birth to their babies shortly afterwards. One woman really wanted to wait until her sister arrived but she went into labour the day before. Once her doula had arrived, contractions went from far apart, not intense, not long and not regular to intense, close together, regular... baby born safely an hour later. I have also seen this the other way... myself and my sister both waited until my mother was not there before going into labour... in my sister's case, Mum and Dad went out promising to be no longer than 2 hours.. my sister went into labour and baby was born in that time slot! Another woman wanted to be at hospital in case her baby needed help but wanted to labour at home and didn't really want to give birth at the hospital. She had a midwife with her who phoned ahead and asked the on call midwives to meet her in the car park. It is quite a story but it is exactly as she had wished.. close enough but also on her own terms. All anecdotes and I am sure people have stories to counter them.. as I said .. not saying this will 100% be the outcome for you.. but trust in your body, your baby and your partner. I wish you a wonderful stress free beautiful empoweted birth without fear.

TL:DR The mind body connection is strong, as is the primal urge to wait until a place of safety before giving birth.

I had one induced Labour and it was by far my favourite.
No pain relief and he came back to back, he was 10lb13, he was fantastic!

Prior to the induction I was so scared of being induced. Like, convinced it would be awful. It wasn't at all. I think we've all heard induction horror stories, but it really may be worth considering in your position having one?

Good luck deciding though! Even though where you live sounds idyllic, this kind of thing is the downside I suppose.

My first Labour was 5.5 hrs from 1st contractions to baby and the midwife made a point of saying if I decided to have another I should make my way to the hospital fast.

I think you need to be thinking of a fast Labour so if you absolutely can't move nearer to a hospital in advance then be ready to leave on first contraction and be prepared to call an ambulance from the road as soon as you have phone signal.

Also.. might not be your thing but consider homeopathy.. https://remedyseeker.com/childbirth-guide/

If your first labour was 5 hours I would be planning for a homebirth with paramedics in attendance. And get some robust childcare options in place for your toddler.

I do know someone who travelled back to the UK from Africa to ensure her 3rd baby was born in an NHS hospital. Baby was born on the bedroom floor with only her husband and mother in law in attendance. Things can happen quickly.