Unexpected Home Birth

May 2020

Sometimes babies arrive more quickly than expected; even first babies occasionally do this although it is more usually a second or third baby. It is something we are often asked about in our antenatal courses:

“What do we do if it’s too late to go to the hospital and the baby is coming”

We always say that there is no such thing as a silly question and this is a good example – this is a very good question!  A fast, unattended, labour and birth story appeared recently on a cord tie Facebook page –Heart-strings. Unbelievably, in 2020 in the UK, the woman’s partner was told over the phone to find a shoelace and a safety pin.  Why you might ask?

safety pin

Well, let’s start by exploring what you don’t need shall we? You really don’t need a shoelace or a safety pin. These items are occasionally suggested by people who don’t know any better, as they are still on some of the emergency services telephone scripts.  There is currently a campaign to get this changed #nomoreshoelaces!

pink boots

The shoelace is apparently to “tie the cord”; yet one thing we know is very important for unexpected BBA (born before arrival) babies is to keep the cord intact, so that they can carry on getting all their lovely oxygenated blood as they transition to breathing air for the first time, not to mention valuable iron and stem cells.   

Research midwife Sara Wickham (SW) has written a great blog describing all the other things you could find in your house that would be better than a shoelace anyway, in the unlikely event that somebody did need to tie a cord. Oh – and let’s not use a dressing gown belt out of the boot as one father was advised when his baby was born in the back of the car on the roadside in South Norfolk!

If you are wondering what the safety pin is for, apparently it is to pop the bag of membranes in the very unlikely event that your baby is born still inside;  please don’t be tempted to do this!  Babies are occasionally born “en caul” and this is not a problem, just gently break open the sac using your fingers – near to the baby’s head is probably a good place. 

baby in net 

So – what do you need if your baby starts to make an appearance before the midwife?

The woman just needs to get down low on something comfortable, in any position she feels is right; and let it happen. She needn’t worry about anything – babies that arrive this fast are usually absolutely fine.  The partner or anyone else there, needs to appear calm and reassuring (even if they are not feeling that inside!) and, assuming there’s time, do these things:

  • Get the woman comfortable with lots of soft things underneath her – duvet, towels, pillows;
  • Make a quick phone call to 999 to let them know what’s happening and where you are;
  • Check the front/ back door is open for midwife/paramedics;
  • Go back to the woman and help her into whatever position she wants to be;
  • If she’s upright you might need to “catch” the baby; if she’s on the floor it can just slip out.

Encourage her to take things as slowly as she can as she gives birth, follow her instincts, light panting breaths and gentle pushes; you don’t need to put your hands on the baby. 

When the baby is born leave the cord alone, unless you need to untangle it from around the baby, in which case you can do that carefully without pulling.

Gently dry and wrap the baby in clean cloths/towels and let the mother do whatever she wants to do; her instincts will take over and she will usually hold the baby close to her, skin to skin.

If the placenta arrives before the midwife or paramedics just cover it over with a clean towel and keep it attached to the baby.

There you go – no need to panic – no need for shoelaces!

 

familiy

References:


Sara Wickham says – Let’s Keep Our Shoelaces on! https://www.sarawickham.com/riffing-ranting-and-raving/unexpected-home-birth-lets-keep-our-shoelaces-on/

Advantages of not tying or cutting the cord.
https://www.sarawickham.com/articles-2/the-value-of-leaving-the-umbilical-cord-intact/

Blood to Baby Hannah Tizzard critiques the way the media report BBAs
https://www.bloodtobaby.com/post/bloodtobaby-s-response-to-the-mirror-article1

Amanda Burleigh who started the #nomoreshoelaces campaign
https://www.waitforwhite.com/