So if there was a strong possibility that you could end up labouring very quickly, alone, with no medical people about, or anyone else for that matter, what would you do to prepare?

[NatalieJaneIsPregnantAgain]

Other than shit it obviously, that goes without saying!

I am talking practically, what things/equipment would you want to hand, and what medical info would you want to know about that you perhaps have missed despite giving birth before? I'm talking exactly what they do to a baby in those split seconds after he's been born.

I need to know everything please else I think I might just go slightly insane.

I wouldn't bother with suction thingy.

Main thing - keep baby WARM and as dry as possible. Grab two towels, one to dry baby and one to drape over both of you after you have put him/her skin to skin. Put your baby to your breast straight away - suckling will reduce bleeding and help placenta come away.

And don't panic. The vast majority of full-term babies who are bba's are born in great condition and don't need help. The majority who are admitted need to go in because they've got chilled, so keep baby warm at all costs.

BTW - did you know you're much more likely to come out of a bba with your fanjo intact than you are if you have a hospital birth?

Morning

Thanks to everyone for all of the advice, after speaking to DH last night, I have decided to be pro-active, am not going to panic, am not going to go into mental melt down between now and seeing the cons. and I'm not going to let the cons. usher me out of his office until he has come up with something that is going to put my mind at rest.

I am going to get a pile of stuff together, one upstairs, one down stairs, with the bare essentials, just in case, but as with everything else, no matter how much I worry about it, the baby has to come out, and if it happens to be at home with no one about then that is the way it is, I have given birth twice before, I should know what I'm doing, and what ever happens happens, I can't do much about it.

Am I convincing anyone yet?!

BTW, I like the sound of an intact fanjo, whether it be at home, in hospital, on a bus, on a lovely sunny beach in the Caribean, or anywhere else!

I had my DS at home BBA. The advice has been good especially about drying baby and keeping baby warm. Also, if you can ooch into a sitting or kneeling position, keep baby on your lap at the same level as your placenta, that way the baby's blood does not flow back into it if too high or fill up with too much if too low. There is no need to cut the cord. When my ambulance turned up they said they wouldn't do anything with the cord unless I delivered the placenta. Have things like blankets or dressing gown handy for you as well, I was starkers and the shock afterwards made me very cold. My baby was very mucusy because he came out so quickly and usually a slower birth will squeeze all the gunk out but unless the baby has breathing difficulties, rubbing them and getting them warm usually sorts that out. Good luck and don't worry, although you're nervous your instincts will kick in and you will cope beacause you have no choice and you will feel very proud of yourself afterwards!

honeybunmum - I'm surprised that paramedics told you to keep your baby low down ie, away from the breast - physiologically this really doesn't make sense at all to me, not in evolutionary terms anyway! Babies are born with the instinct to crawl towards the breast and attach themselves. This causes a rush of oxytocin which makes the uterus contract down, reducing chances of mum having a problematic bleed after the birth. It will also make the placenta detach, which is what you want.

Well, It was actually in the DK Pregnancy & childbirth book not the paramedics. They were quite useless really and just stood there drinking my tea! But I do agree and having rather large breasts I was able to offer my boy what he needed and keep him low down so I guess that was a good solution. I don't know if it would be possible if one had smaller boobs or even if it's necessary, it's just what I read,( spookily an hour before it happened)

Lots of towels. Wrap the baby, keep it warm, check breathing etc.

DD2 was born in the car and we didn't have enough towels with us. The ambulance got to us very quickly afterwards though (one of those paramedic in a car ones) and all they did is wrap her in a blanket to keep her warm. They kept asking us if we'd cut the cord (with what, DH wanted to know?!) but I would have thought it was of positive benefit not to. The ambulance man cut it when he came (or was it the main ambulance who came a bit later - can't remember). Placenta was left it until we got to hospital.

If everything happens very quickly then there is a good chance your baby will be fine. makw sure you dry them and keep skin to skin as this helps regulate temp and heart rate. Babies do not really need suctioning after birth, it is something that is often over played on TV dramas and happens frequently in US birth programmes. Over vigerous suctioning can cause problems with the heart rate and oxygen saturation levels. Leave the cord well alone, it will stop pulsating in it's own time, you may feel some strong after pains with the placenta seperating, if you have an urge to push or bear down then just go with it, if not, don't worry, a physiological third stage can sometimes take a while, you may wish to put the baby to the breast if you are intending to breast feed as this will help. If you do deliver the placenta before help arrives, still leave it, you can wrap it in a towel and tuck it in with baby if you feel like it. There is no need to keep the baby lower than your uterus, the cord will still be pulsating for a while, there is no "free flow" off blood, your baby will get the correct ammount of blood it requires, no more, no less. There really is very little equipment needed, a midwife/paramedic will have everything needed to help make you comfortable afterwards so don't worry about that. You will probably get a sudden hit of adrenaline if you do labour quickly wich will help you make a phone call, it's in our instinct to do what we need to in an "emergency" situation.

Thanks again everyone, it does help to hear good stories of similar things happening. Curly, I think you are right about the adrenaline kicking in, I have quite a cool head when I am in an 'emergency', hopefully the instinct will kick in.

Just one more question, very unlikely to happen and feel a bit silly even asking it, but if my waters hadn't gone and were still in tact when he's born, I do pop them yes? And take him out of the bag?

Not that I am over thinking this at all!

"you may wish to put the baby to the breast if you are intending to breast feed as this will help"

Frankly given that pph is one of the risks associated with unplanned homebirth, I think adhering to the physiological norm (ie putting baby to the breast) is something to be recommended whether the mum intends to bf or not, given that it contracts the uterus down and reduces the risk of a problematic bleed. Doesn't mean the mum has to carry on and breastfeed afterwards. (obviously not the case if mum is hiv+ or has some other major problem that stops her from putting her baby to the breast even once).

I will be putting him straight to the breast regardless of when/where he's born (and carrying on BF'ing afterwards)

gabygirl, i could never be this dictatorial about instigating a breastfeed if the mum really didn't want to. The risk of a PPH with BBA is very difficult to quatify as it is a retrospective study and we really don't know how much "fiddling" there had been with the cord by lay people. There is often a fixation with needing to cut and clamp a cord straight after birth, when people are not aware of the physiology of the third stage. It is imperative that women who are at risk of a BBA are fore armed, with good information, firstly to help them relax and secondly to improve maternal and neonatal outcomes.

NJ, if, by a very teeny chance the baby is born in caul, yes you will need to break the membranes. I have only seen one true "in caul" birth in 15 years of midwifery. More are covered in the caul but the waters have broken, making it easier to peel the membranes back over the face. If the baby is in a bag of fluid try not to panic, it is similar to a waterbirth in that the cord will still be pulsating and therefore the baby will still be getting oxygen and there will not be the same stimulation for the first breath that would normally occur. the mebranes will be quite tough, you will need to try to squeeze and area to make a pocket of fluid and try to pop it with a sharp fingernail (maybe this should be on your list of essential item...a sharp fingernail ). There is such a remote possibility that it will happen please do not worry yourself about it

"gabygirl, i could never be this dictatorial about instigating a breastfeed if the mum really didn't want to"

Jeez, how on earth is it 'dictatorial' to recommend or advise a woman do the physiologically normal thing because it reduces bleeding after birth, in the absence of oxytocic drugs?

You're not telling her she has to breastfeed - only that it's a good idea if she puts her baby to the breast as it will reduce bleeding and help the placenta detach.

Honestly - no wonder 1 in 4 babies in this country are never put to the breast at all. Midwives seem to fall over themselves to remind mothers that it doesn't really matter - even in a situation where it will have an immediate physiological benefit for both mum and baby. God forbid that you be accused of being a bf bully though....

I know its easier said than done but try not to worry.
My dd was BBA, my labour lasted 44mins from start to finish and I will forever be grateful to the operator as she was fantastic.
Luckily for me dh was there and the operator talked him through everything and stayed on the phone until the paramedics arrived. By the time they reached us dd was safely snuggled up on my chest.

Just make sure you have lots of clean towels to hand.

Good luck. xx

Nat my tip would be, if you can, call 999 from your house phone if at all possible. Even if you don't speak your address should come through on the Caller Line Identity in the control room and they will know where to send an ambulance too.

Mobiles are harder for them to pinpoint if there is no speech.

Think were would be best to give birth & know where your phone was. I planned if this happened (& it nearly did) to be in the downstairs cloakroom as it's near the front door & the floor is easy clean plus towels are handy.

you need to read this

I had a v fast labour last time and had an unplanned homebirth. By the time I realised that I was definitely in labour I couldn't move. The midwives' phone numbers were on my notes in my bedroom a few feet away but I couldn't move to get to them, and my DH was in the garden out of earshot. If I hadn't had my mobile next to me I'd have delivered on my own.

I've had the odd shiver down the spine moment thinking about how things could easily not have gone as well as they did. Don't know if they'll be any use to you but this is what would have worked for me:

keep your mobile with you ALL the time (literally on your person) and have relevant phone numbers stored on it - eg midwife, hospital, DH, local friends. Get as many neighbours' phone numbers as possible. Anyone who can open the door to paramedics and keep your other child/children safe. Keep your phone charged up all the time too.

hide a front door key outside the house - somewhere you can describe easily to a 999 operator. If I'd been on my own there's no way I could have opened the front door.

Get some basic information about delivering a baby! eg don't cut the cord, bum in the air to slow things down etc. Be ready to catch the baby as it comes out.

Get the mobile numbers of your community midwives. Mine was off duty but thankfully answered her phone, contacted her colleague and the two of them were at the house within 5 minutes. The baby arrived 15 minutes later!

If I was planning any more children this is something that would be hanging over me for the whole pregnancy, so I really sympathise with you. I'd learned hypnosis techniques and had my music on and that stopped me from panicing, and made the delivery much easier for me and the midwives. I know that you're asking for practical tips but I strongly recommend the hypnosis for keeping yourself calm.