The time I missed a birth – Precipitous Birthing

When you hire a doula, you get a lot of perks. She’ll likely be a presence through your pregnancy and postpartum period. But for most clients, the real selling point is the birth. They want an expert there in the room, helping them through the process. The birth is important to me too. I want to be there, and barring the most extreme circumstances, I will be. In my contract we go over the details. Give me an hour transit time. I’ll send a back up if there’s an emergency. Someone, one way or another, will be there. Except when we can’t. When everything just moves too quickly.

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Former client, F, contacted me to attend her third birth. This would be her first attempt at a drug free delivery. They were a military family, and her husband was due to head out to training less than a month before her due date. I was preparing myself to provide primary support for a natural birth. But one detail concerned me. Her previous births had occurred prior to 38 weeks, in under 5 hour of labour.

There’s no magical way to determine when and how a baby will arrive. But sometimes, trends appear. We know, statistically, subsequent births tend to be faster than first births. If one mother has, say, a 5 hour first labour and a 3 hour second labour, one can assume that same woman may have a very quick third labour as well. I usually go on call for a birth at 38 weeks, but not this time. I had a feeling she’d have a baby in her arms by 38 weeks. I went on call at 36 weeks, advised her to call me in at the first signs of labour, and I waited.

At 37 weeks, I got a text. She was a little crampy, but it was probably just a bout of Braxton Hicks contractions. It was the day before her husband left for training, and they were spending time together as a family. I asked her to call if anything changed. Shortly after I got another text. “I think they’re getting stronger. I’m going to make the kids lunch and then get checked out. Meet me at the hospital?”.

It took me 45 minutes. 45 minutes to get dressed, drop my youngest at grandpa’s house, and rush to the hospital. She wasn’t in triage, she’d been taken to labour and delivery. I opened the door, smiled and mouthed “I’m the doula” to the midwives who smiled back and whispered “she’s fully!”. I hurried and washed my hands, and dumped my supplies in a corner. I rushed over to the bed and found my client squatting down on her knees, with her husband at her side. I brushed her hair out of her face, and pressed her hips and back through two contractions before a tiny baby entered the world. She reached through her legs and pulled his little body up to her chest. She did it, she had a natural birth without me. The Midwives mentioned they would have missed it too, if they hadn’t already been at the hospital with another patient. I started jotting down my notes, and asked the primary midwife “how long was active labour?”. She just laughed. “Like, maybe 20 minutes?”. She left the hospital 12 hours later with a 7lb 5oz 37 week baby, just in time to wave goodbye to her husband. It was almost like it was meant to be. Especially because, eerily enough, she delivered in the exact same room where I’d had my own precipitous birth three years prior.

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A precipitous birth is defined as a labour with a duration of under 3 hours. There can be multiple factors in play that determine whether or not you’ll have an extremely fast birth. One indicator is a fast previous delivery. In my case, my first birth was just two hours faster than average (10 hours rather than 12). That was enough for my midwife to caution me not to labour too long at home, or risk an unplanned unassisted birth. She was right, my second birth took place in two hours. Causes of precipitous birth range from a long, gentle early labour (gradual progress occurring with such small contractions that one isn’t aware they’re in labour at all, or greatly underestimate how far they’ve progressed), to extremely effective contractions and low resistance from the mother’s tissues.

There are pros and cons to any birth, precipitous births included. Anecdotally, precipitous births are reportedly “easier” in a sense. Parents who go through a very fast birth aren’t as physically and emotionally exhausted, and may have an easier time coping and finding the energy needed for delivery. On the flip side, precipitous births can be overwhelmingly fast. There’s no time to emotionally prepare. One moment the reality that this is your baby’s birthday is sinking in, and the next you’re in transition. The contractions can be a bit overwhelming. They have the same amount of progress to make in a much shorter time, and may feel more intense accordingly. If the second stage is as rapid as the first (which isn’t always the case, and was not the case for me) you may be at a greater risk for tearing during delivery.

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If you feel you’re at risk for a precipitous birth, there are a few steps you can take to improve your experience.

•Get a doula. This isn’t me self serving, this is a reality. You may not have time to request an epidural, and you may experience overwhelming sensations. Having professional comfort care will benefit you greatly.

•Call early. Trust me, we won’t be upset if it’s a false alarm. Call your midwife/OB and doula as soon as possible when you suspect something is happening.

•Get educated. What do you do if your baby arrives in a moving car? Find out ahead of time.

•Have a “just in case” plan in effect. You may not have time to leave home. Do you have a neighbor willing to take your older children? Does your partner know to call 911 and follow their instructions for delivery? Have you considered purchasing a just-in-case home birth kit?

•Consider delivering in an alternative position, and pant out contractions rather than grunty pushing. If your baby’s descent is very quick, this may help slow them and decrease your risk of tearing.

•Breathe. The prospect of precipitous birthing can be a bit overwhelming. But you will get through it. My client did. I did. And you will too.

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