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7 lessons learned from a car birth

September 2, 2017

As a doula, I've been told that it was inevitable. Some day I would attend a birth so fast that we wouldn't make it to the hospital. My first 83 birth clients (With U Birth) delivered in their intended locations. And, for the record, I will never be present for an intentionally unassisted birth. In our prenatal meetings, I tell my clients that if I am at their home with them in labor and baby starts coming crazy fast, I will be the one calling 911. I will keep people calm, collect supplies, and guide the dad or other support person as they catch the baby.

 

But what if we are in the car and dad is driving? I hadn't really pictured that situation. And then it happened.

 

The full story is written in a previous post (see Wild Ride.) For such a quick birth, it turned into a long story. But while we were driving down a busy road with my client saying, "The baby's right there" I was actually thinking, "Doulas need more training for this!" Of course I had witnessed quite a few babies making their way into the world. But being the only one present to catch the baby is another thing. 

 

My saving grace was the stories I had listened to at my DuPage Doula Network gatherings, where local birth professionals meet to share ideas and encourage each other in our professional development. I had listened with my ears wide open as more experienced doulas told of their unexpected catches. (Shout out to Deb Lawrence and Heather Karlson, thank you for sharing the details!) As the baby was coming, I distinctly remembered the things they had said: Call ahead to the hospital! Support the baby! Release the cord from around the neck! Don't mess with the placenta!

 

So now it's my turn to share my experience delivering a baby in a car in hopes that some part of it will come in handy for a fellow doula or other accidental baby deliverer.

 

1. Bring towels.

I encourage all my clients to bring a few towels in the car when they go to the hospital, whether or not their water is leaking. You never know when it's going to happen and you really don't want amniotic fluid in your upholstery. In our case, the towels also protected the baby from being born onto his big sisters' snack crumbs.

 

2. Don't panic.

Make no mistake, I could feel the stress sweat trickling down my back. But confidence is contagious and we all needed some. I kept any worries inside my head so that my clients could stay in the moment. This was the moment of their birth! They needed my reassurance that they were doing a beautiful job and that all was well. Though safety was our top priority, I didn't want make decisions purely out of fear. As the dad recounted later in his birth story: Taking my cues from [my wife] and Tara, neither of whom was freaking out, I was just doing my best to stay on the right side of the road. As long as she was doing well and Tara wasn't feeling in over her head, I knew we'd be all right.

 

3. Call the hospital.

If you're arriving at the hospital with a precipitous birth, it's much smoother to have a team ready and waiting to receive you with a wheelchair and supplies. Since my experience, I have spent time loading my contacts with the direct phone numbers of the labor & delivery units of all the hospitals in my area. I was lucky in this case to have a wise friend & neighbor offer to make the call (shout out to Leslie W, you were an amazing help and encourager). Without that help, I would have been fumbling to search for the number, and probably taking extra time going through the hospital operator. It was a huge help to have a labor & delivery nurse waiting with the ER team. She provided a seamless transition from car to the birthing floor (thanks, nurse Jen, you were delightful).

 

4. Trust your gut.

Before the car birth, I had traveled in a client's car only one time, with a first-time mom who appeared to be in transition at home but labored in the hospital for many more hours before baby arrived. 

This time, the client was exceedingly calm and not vocalizing the way many do in active labor. But I felt that I needed to stay with her. I offered to come along in their car, and 20 minutes later their baby was in my hands.

 

5. Pack gloves.

My birth bag weighs 22 pounds. It's a beast. Many doulas carry fewer things with them as they gain experience. Not me. I find that clients all have different needs and I can never tell which one of my tricks and tools will be their favorite. For some it is the carefully curated playlist of songs playing on my iPad. Some love the weight of my heated rice bag on their lower back. Some are delighted by the choice of honey sticks and colorful straws. A whiff of my peppermint essential oil on a cotton pad keeps nausea at bay for many. But I had never used my gloves. Local doula trainer Lisa Upham told me to always keep a pair handy just in case, so I had added a sealed plastic bag with several pairs of non-latex gloves to my kit. I was thankful for this advice as I dug through my bag in the backseat of a minivan and pulled on clean gloves to support the pristine head of a fresh new baby. 

 

 

6. Support the baby.

As in, let the baby and the mom do the work, don't pull. As I reflected later, I realized that if I had only witnessed the standard hospital birth, I would have assumed I had a lot to do to help the baby out. I would have thought I needed to get my client onto her back and tell her how to push while twisting the baby's body just so. But because I had been present for some midwife-assisted births, I had seen babies come out with no help except for a waiting pair of hands to catch them. As the car drove quickly toward the hospital, I supported the baby's emerging head with one hand and slipped the cord over his head with the other. With just his head out, I had one scary flashback to a shoulder dystocia birth, so I asked the client to give a little push. With that, he slipped out into my hands and gave a reassuring cry. I lowered him into the towel, rubbed his body with it, and massaged his chest gently with my fingers until he cried some more.

 

7. Thank God.

Though I had just met these clients an hour before the birth, we quickly discovered we shared a belief that God is the creator and sustainer of life. It was with this deep assurance that I trusted we were all here together in this place and time for a reason. I fully understand that this doesn't mean we were safe from complications or tragedy. No one is spared from pain in this world. But we all stayed calm because we were anchored to something much bigger than ourselves or our fears. Most people, no matter their belief system, find it natural to toss requests for help to the heavens in times of great need. And I was certainly asking God for wisdom and peace as the car sped down the road with a baby emerging from his mother's body. It takes a deeper faith to thank God for his goodness and presence, no matter the outcome. When it was over and we were safely in the hospital with a wild story to tell, our thankfulness to God acknowledged that he heard our prayers and was merciful. The dad quoted a refrain from the Psalms in Toby's birth announcement: "Give thanks to the LORD, for He is good. His steadfast love endures forever." Tobias (Toby) means "The LORD is good." We pray that Toby's life will be marked by a quiet confidence and assurance of the goodness of God, and that through him others will come to that same assurance.

 

 

 

 

 

 

 

 

 

 

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