And what to do if Baby actually does arrive before you get to your planned birthing location
Precipitous births, also known as "super speedy, can't-wait for-the-hospital, side-of-the-road" births have a way of making headlines. You might think that these wild and crazy deliveries happen all the time, but the truth is, they're rare.
Hard data is difficult to come by, since unplanned out-of-hospital births are lumped into one data pot by the Centers for Disease Control, but it's estimated that only about one to two percent of all labors are "precipitous," meaning it takes less than three hours to go from the first contraction to delivery.
While a quick delivery might sound like a dream come true, precipitous births aren't necessarily any easier than a normal six to 12-hour labor. In fact, they often pack all the power of a lengthier labor into a compressed, intense and super-stressful time period. Example: One of my babies was born after a four-hour labor. That's not technically precipitous, but I wouldn't have wanted it to happen any faster. It felt like my baby was on a blasting rocket, and I would have been happier if she'd just taken a plane.
Jennifer Slater, author of En route Baby: What to Do When Baby Arrives Before Help Does (Wyatt-MacKenzie Publishing, 2013) had precipitous births with both of her babies. She delivered her first baby in two hours and her second in just 20 minutes—in the back of her Jeep.
After that second birth, Slater began researching the subject, and discovered that about 30 precipitous births are reported to the media every month in the U.S. and Europe, and far more go unreported. "It's scary to think about having to deliver your own baby, but you can absolutely manage it if you're prepared," she says. "I want other parents to know what to do if their baby comes too quickly, and how to do infant CPR, just in case." (Still, Slater notes that in all the research she has done, the mothers and babies have been delivered safely.)
Why are some babies in such a rush?
We don't know for sure, but many healthcare providers think precipitous births happen because the body is working properly: "I think they're a sign of physical efficiency—the body knows what to do and gets right to it," says Desiree Bley, M.D., an obstetrician in Portland, Oregon. That's why these births rarely happen to first time mothers: "They're more common with second deliveries because the uterus has figured out the system," says Dr. Bley. Still, others say precipitous births are a malfunction of a uterus that contracts with abnormal strength, combined with a lack of resistance in the cervix and other soft tissues in the vagina.
What if it happens to you?
First, if things are happening too fast, call 911, your hospital and your provider; make sure help is on the way. Unlike what you see on TV, don't push if you don't feel the urge; wait until help arrives. Slater provides in her book a full course on what to do if you're facing a precipitous birth, but offers the condensed version here, with these six tips:
1. Get into a fairly comfortable position, preferably lying down or kneeling.
2. Place a disposable or waterproof pad beneath yourself and remove any clothing that's in Baby's way.
3. Have a towel or other fabric ready—Baby will be slippery and cold.
4. As soon as the head is delivered, check to see that the umbilical cord isn't wrapped around Baby's neck. If it is, carefully slip your little finger between the cord and the front of Baby's neck and gently slip it away from and over Baby's chin and head.
5. When Baby emerges, use the towel to catch him (never pull) and briskly rub him dry. Immediately wrap him to retain his body heat and loosely cover his head.
6. Rub Baby's back or gently flick the bottoms of his feet to stimulate breathing. Use Infant CPR only if necessary. (You'll need to take Baby's pulse first. See below.*)
Note: Once the baby is delivered, get to the hospital ASAP. Don't worry about the placenta. It will deliver itself shortly after birth, usually (but not always), within 20 to 30 minutes, if not sooner. In the meantime, don't cut or pull on the umbilical cord. Should you deliver the placenta before arriving at the hospital, wrap it up and place next to the baby, still keeping the umbilical cord intact.
* To take Baby's pulse, press lightly where the his umbilical cord attaches to his tummy. You should feel about 120-160 beats per minute. To time the heart rate, count beats for 6 seconds and multiply by 10. For example, if Baby's heart beats 12 times in 6 seconds, his heart rate is 120. If the heart rate is slow, check if he's breathing, wipe any obvious blood and mucous out of his mouth and rub his back vigorously. If his heart isn't beating and he's not breathing, make sure an ambulance is on the way and do CPR.