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 ambulances fairly good up there OP? I’m in south of England and here and they are rubbish and you’re likely to be kept waiting.

Have you asked the hospital? I know in paisley one of the midwife’s rented out space in her house to mothers from rural areas. Maybe you could find something cheap? A house swop? Also do look into what nhs would pay towards putting you up. If they can’t provide midwife’s they have to help you somehow like they do for islanders. We could get a helicopter/emergency plane quicker than you can drive to hospital!

You may find cheap accommodation in student digs as it’s summer and they are all away?

Ambulance wait times can be hours. You don't want to give birth in a layby without signal. Your DH will be busy driving and may not be able to pull over to help you easily. There will be shit all you can do with shoulders getting stuck, haemorrhage, placental issues, resuscitation if cord is around babys neck etc. I know you don't WANT an induction but it really could be the best option. Even a combination such as hotel or family for 1 week at 38 weeks and induction at 39 weeks.

It's money but if you have it, it's yours and childs life at stake. If you're in desperate times theres nothing you can do but if you are lucky enough to have £10K savings in the bank, if the hotel costs £1K - well I'd rather have £9K in the bank than £10K but to come home without a baby or without both of you. Chances may be that you'd be ok as second birth, but the severity of the outcome is so high I'd not risk it unless literally no other way.

According to this study https://www.bmj.com/content/371/bmj.m3377
women in your position (second child, low risk, no previous section) have an 8.8% chance of a complication during labour.
I think that’s pretty high.

just go a couple of weeks before to Inverness. It’s not worth the risk.

In your circumstances I would have a planned c-section. Ask Inverness what proportion of inductions there end up as emergency sections. A planned section is a very different experience to an emergency one and recovery is much better as you will not be dealing with the effects of the attempted induction as well.

To answer questions:

Toddler is not an issue - lots of family very close to us.
Cost of staying in Inverness for a month isn't possible for us. It isn't about inconvenience as some lovely folk have suggested.
The 8.8% statistic is worrying. But my risk isn't 8.8%. It's 8.8% if I don't make it to the hospital on time, which I hope to do! (if I do go down the Inverness route)
Ambulances are either very quick here, or very slow. Mostly there's a few about, but on occasion they seem to have all disappeared to Inverness doing transfers. I don't know the actual stats though.

You don't have a choice get a credit card book am air b and b for you and toddler. They will be cared for by hospital staff while your dh gets there if you are in active labour. You have had 9 months to save for this and that's if this was a surprise baby.

I would absolutely book a planned induction in your shoes, to me it would be reckless to do otherwise.

Also worth asking your midwife about air ambulance? I have someone in my extended family in rural Aberdeenshire who had a VERY fast labour and gave birth on the bathroom floor. It was a few years ago now, but I'm pretty sure they dispatched the air ambulance to get medical help to her more quickly? But as others had said, i would definitely be looking into relocating for a period (especially as someone that had a baby come at 38w). Sorry you are having to think about this on top of everything else!

i wouldn’t be faffing about in a car in I’m honest, do your local GP service not provide midwifery care? That’s usually the case in areas like yours. Giving birth in a car sounds awful, if you can’t stay near the hospital I think I’d rather stay put.

The issue with air ambulance is what else is happening. On a quiet day it's no problem, one accident on the A9 and it isn't available. Unfortunately the reality is that living in remote areas means help isn't immediately available whether that is medical help or a power cut. The cost of replicating the service available in even remote parts of England would be significant.

I really don't want an induction. There are sound reasons for this which I'm not prepared to go into.
I want to be clear that the medical advice I have received is to get into the car at first twinge and drive to Inverness. They know how fast my first baby came and this is still what they think is the best option for me. If I do this I'm not being reckless, I'm following medical advice.
However if I do follow medical advice I still want to get as much knowledge as possible in advance to deal with situations we CAN manage.
I might decide not to follow medical advice and go down the stay at home and call ambulance route, or just turn up at the small local hospital an hour away (without any midwives). They don't want me to plan to do this, but I might go rogue.

Thanks for all the people who gave helpful info on what extra equipment to pack and what possible complications to consider. And thanks to those who commiserated with me! 😁

Also worth considering op, is that you may not want to be far from bathroom facilities if you’re in active labour. TMI but I had the worst diarrhea and occasional vomiting once contractions started. I don’t know how I’d have managed it on a car journey but it would have been pretty undignified I imagine 🙈

I don't think you can rely on yourself or dp in worst case scenarios. I don't know about other risks, but I had shoulder dystocia last year, in hospital. They had to flip me onto my back, stick an arm up to free her, and then spent 10 minutes resuscitating and checking her. My dp is fairly competent and non flappy, but I'm not sure any amount of research would have helped him with the manoeuvre as a non medic, particularly with me there screaming without pain meds. I had no risk factors at all, besides the very fast labour.

Will they issue you with a home birth pack, they have so much useful stuff in them.

I haven't rtft but Samantha Gadsden doula in South Wales offers an online course or Facebook group for freebirth prep, might be worth looking at.

Given that you had a straightforward first birth it's very likely that your second will also be very straightforward. Not that there is ever a guarantee.

There is a freebirth / born before arrival group on Facebook that helps talk through all the stages, issues that can occur and what to do. Might be worth doing.

I have a midwife friend in a similar situation as you. She felt confident that she would get to hospital in time etc. She didn't, things went very wrong (despite all her knowledge and training etc.) and she now has complex PTSD.

In your shoes I would be putting a lot of energy in being creative in trying to find somewhere you could afford in Inverness. Worth contacting doulas etc. to see if they could put you in contact with anyone who had a spare room for minimal cost, university accommodation etc.

I would schedule an induction for 39 weeks without the slightest hesitation, OP.

If something goes wrong, lack of gas and air will be the least of your concerns. I've always had amazing births, until the one that wasn't. I'm glad I wasn't so far from the hospital. Maybe it will all be fine but if something could happen, the amount you pay to stay near the hospital will seem like a bargain. The inconvenience will seem minor. I'm very pro attended home birth but there's also that small chance things can go wrong. When they go wrong, they can go wrong big time. It's a shame you have lost your local birthing services.

Knew that's what you were going to say. It's absolutely shocking how far services have been cut that leaves women up here in this situation.
One thing to remember though is that 999 may still work even with no network signal and they will dispatch the air ambulance if you get caught in an emergency.

A friend of mine was snowed in a few years ago and was told that if she went into labour they would send in the air ambulance to get her to Raigmore. Thankfully it didn't come to that though.

I would be asking about planned induction too.

When did you going into labour with your first?

If i were you I would go on Trusted Housesitters and see if I could find a house sit in Inverness and I would go maybe three days before the due date, on my own, and husband can drive there when you go into labour. Have someone to be on standby to take the toddler.
at this time of year there will be loads of house sits.