The Unexpected Home Birth

Usually during your childbirth education classes you hear about how long a labor can be.  But what if your labor goes really fast?  So fast that your midwife can’t get to you or you don’t have time to get to your planned birth place?

While it’s a rare occurrence for first time mothers, it’s not a rare concern.  Here are the answers to some common questions surrounding precipitous birth and fast labor.

What is fast labor? Fast labor is considered to be less than three hours and is also called “Precipitous Birth.” It is not an emergency. However, it can be intense and sometimes frightening for parents.

How common is it? Between 2-3 percent of births are considered precipitous, however it is much more common in second (or more) time mothers than first time moms. If a mother has already had one fast labor, she is more likely to have another. The chances of a first time mother having a fast labor is very small.

Is it a problem? While it is not an emergency, (generally labor that is progressing quickly means everything is working just right) it can be frightening. Sometimes the contractions are very strong or right on top of one another and it can be difficult to relax through them. Often it can be emotionally hard for a woman to deal with precipitous labor because she begins to feel overwhelmed or out of control and is struggling to cope with -what she may believe to be- early first stage labor. Physical risks include the possibility of tearing during the pushing phase, although listening to your body can often prevent this.

What should we do? Mothers, if you think you are having a fast labor, the first thing to do is ask for help. If your partner is not there, call a neighbor, friend or someone close by. You should not be alone.

If you are not sure if it is really precipitous birth, partners and helpers should look for emotional signs. It is not uncommon for a mother in fast labor to skip the first stage emotional signs completely and move straight to the emotions typically associated with transition: fear, panic, feeling overwhelmed, as well as the physical signs of shaking, hot/cold flashes, sweating, etc.

If you think it might be fast labor, call your midwife or doctor. They will probably coach the partner/helper through what to do. If labor is progressing really quickly, they will most likely want you to stay-put rather than risk you driving to your birth place and then needing help on the way.

Effective positions for slowing labor down include side lying, rather than upright positions like sitting, standing or squatting.

If she is feeling the need to bear down or push, she should stay where she is, get to the floor and lie down on her left side. It is not necessary to get to the bed or the bathroom, but standing up presents a risk of injuring a baby that is born unexpectedly. Calling your midwife and/or 911 is preferable to trying to get anywhere on your own. Again, it is not an emergency, but calling them will have a care provider come to you. To slow the pushing phase, some find blowing “horse lips” to be an effective technique.

Coaches/Partners/Helpers should remember:

  • Look for emotional signs to determine where mom is at in labor.
  • Do not leave mom alone.
  • Encourage her that everything is going fast because everything is all right.
  • Remind her that this is just a variation of normal and that she is doing a great job.
  • Try positions that slow labor like side lying, and if she wants to push, have her get to the ground.

What if the baby is born before the midwife or EMT arrives?

  • Fast labors are generally safe and babies are usually born easily.
  • Partners should help catch the baby, and allow the mother to push on her own. It is not an emergency. You main job is to make sure the baby doesn’t fall on the floor.
  • If the cord is around the baby’s neck, slide your finger underneath and slip it over the baby’s head.
  • Immediately put the baby on the mother’s stomach or chest, and cover both with a dry towel or blanket. If mom still has a shirt on, have her lift it or remove it so that the baby is skin to skin with her. This keeps the baby warm.
  • It is normal for mom to be shaking after the birth. It is an effect of the birth hormones.
  • If the baby doesn’t cry right away, rub him or her on the back to help stimulate them. It is normal for babies to have bluish hands and feet. After they cry, the rest of their body and face should be pinkish/the same tone as the mother’s.
  • The baby should stay on mom, chest to chest, until the placenta is born. This will help them clear their airways and stay warm.
  • The is no need to tie, clamp, or cut the cord. Wait until the placenta is born before even thinking of messing with the cord. Do not pull on it as this can cause hemorrhage.
  • Stay where you are to deliver the placenta. There is no need to get up or walk around at this point. Again, do not pull on the cord.
  • If the baby wants to nurse, let him or her latch on. The baby’s sucking will help stimulate contractions to deliver the placenta and then contract the uterus to control bleeding. If the baby doesn’t nurse, you can use manual nipple stimulation to help.
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