Q&A: What Happens If I Can't Make it to the Hospital?

Q. I'm terrified that I'll have a fast labor like my mother did with me and that I'll end up delivering my baby at home or in the car on the way to the hospital. What do I do if I end up in that situation?

A. First of all, you probably won't end up in that situation. You're already aware of your genetic predisposition to birth your baby faster than most, so you'll probably be timing those contractions from the moment labor begins and already on your way to the hospital in plenty of time because you're anxious. However, if you've been in labor only a little while when you suddenly are overcome by an urgent need to push, stay calm. Whether they appear in hospitals, taxis, kitchens, cars, elevators, or log cabins, babies usually do a fine job of coming into the world all by themselves. However, being prepared for an emergency delivery at home may help ease your anxiety and give you confidence that you'll be able to handle the situation, in the rare case it should arise.

The American College of Nurse-Midwives (ACNM) launched a campaign several years ago called "Giving Birth in Place" to educate people about emergency delivery preparation. For a detailed guide, including a list of supplies and step-by-step directions that you can print out and save, see the ACNM website (www.midwife.org).

According to ACNM, if you go into labor at home and don't think you can get to a hospital or a birth center in time, you should stay where you are; it's better to have your baby at home than in the backseat of a car. Call your practitioner immediately. If she's there, she might be able to instruct you over the phone until emergency help arrives. If you can't reach your practitioner, call 911. Ask for emergency assistance with the birth and ask the 911 operator to contact both your practitioner and the hospital.

The ACNM recommends that pregnant women put together a supply kit that can be used during an emergency delivery. The supplies should be kept in a waterproof bag away from children and pets. The kit should contain the following:

• A bag of large-size underpads with plastic backing to protect sheets from messy fluids
• Baby-size bulb syringe (made of soft plastic, often called an ear syringe; should not be a nasal syringe, because the plastic tip does not fit into a baby-size nose)
• A small bottle of isopropyl alcohol
• A package of large cotton balls
• A box of disposable plastic or latex gloves
• White shoelaces (to tie umbilical cord)
• Sharp scissors (to cut umbilical cord)
• Twelve large sanitary pads
• A chemical cold pack (the kind you squeeze to get it cold)
• A hot-water bottle (to help keep baby warm)
• Six disposable diapers
• Pain pills such as acetaminophen or ibuprofen
• A small bar of antibacterial soap or liquid antibacterial hand sanitizer

Originally published in You & Your Baby: Pregnancy.

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