In the baby-catching industry, an accidental home birth is referred to as a BBA, ‘Born Before Arrival’. While this is a fear of many parents who aren’t planning to birth at home, as a midwife who has assisted a LOT of births, I can assure you that BBAs occur very rarely. It’s important to make this clear from the start, because while a small percentage of babies are in a hurry to meet us, the vast majority (especially first bubs) give us ample warning, allowing plenty of time to make it to hospital.
To give you an idea of how rare accidental home birth is, one Australian study found that approximately 4 in 1000 births that were planned to take place in a hospital ended up accidentally occurring before arrival (Thornton et al, 2018). This figure also includes babies born in the presence of paramedics and in hospital car parks, not just those born at home into the hands of a stunned partner and an even more stunned mama.
Still, as rare as it is, to fear accidental home birth is quite normal, and it’s totally understandable that parents have a strong desire to avoid this scenario where possible.
But what if things are moving fast and it doesn’t look like you’re going to make it?
Generally speaking, if labor is progressing quickly, you are full term and have had a low-risk pregnancy the chance of complications is very low. That being said, welcoming a baby on your kitchen floor can leave you feeling very shaken, regardless of whether you and your baby are in perfect health.
Typically, midwives and doctors will advise that if you genuinely think bub is on the way with no time to spare, remaining at home and calling an ambulance is a better, safer option than attempting the drive in. Some signs your baby may be coming include:
- Intense pressure in the vagina or bottom
- An overwhelming urge to push
- The ability to see or feel the head at the entrance of the vagina
If this is where you find yourself, here’s what you do:
- Try to stay calm and call an ambulance. If you are alone, put the phone on speaker beside you, and the operator will take you through these steps, while ensuring help is on the way.
- If, during contractions, the urge to push is overwhelming and you feel your body bearing down, lower yourself to the floor and place a towel or pillow between your legs. If your body just wants to push, go with it.
- Once the head emerges, don’t tug or pull on it. Sometimes the head and body are born in one mighty contraction, other times you will have to wait for the next contraction and push again, just as you did before. The shoulders should pass through quickly, followed by bub’s body.
- If a few minutes have passed with no contraction, or you are pushing but the baby’s body has not come, roll onto all fours or into a forward lunge position with one knee on the floor, to help the shoulders through.
- Once your baby is out, lift them up to your stomach or chest, being cautious not to overstretch the cord. Don’t try to cut the cord, leave it and await the arrival of an ambulance.
- Most babies are a blue-ish purple color at birth but will turn pink and cry within the first minute of life. If your baby isn’t crying, use a dry towel to gently rub their back, and you will find this stimulation helps them take their first breath. Continue holding them close to your chest.
- If you can, remove your top and bra, place your baby directly on your skin and then cover the two of you with a blanket or towel. Skin-to-skin contact helps newborns stay warm and regulates their breathing and heart rate.
- Take some slow, deep breaths. You are okay Mama. Wonderful job! If the ambulance hasn’t arrived already, they aren’t far away. Keep holding your baby close to your chest.
- You may find that after another 10-15 minutes, your placenta is ready to come. This can feel like another contraction and a ‘fullness’ in the vagina. The placenta may just slip out on its own, or you make feel like pushing again. Both are OK but again, just leave the cord attached and await assistance.
People will forever be in awe of your birth story, and with time you may also feel really positive about accidentally welcoming your baby at home. However, a BBA can also be a very intense start to parenthood and it’s not uncommon to feel shaken or startled in the days that follow. While this will likely settle, if you or your partner feel at all traumatized by the experience, seek support through your midwife, GP or PANDA.
References / Resources
Thornton CE, Dahlen HG Born before arrival in NSW, Australia (2000–2011): a linked population data study of incidence, location, associated factors and maternal and neonatal outcomes BMJ Open 2018;8:e019328. doi: 10.1136/bmjopen-2017-019328
Expert author: Beth Ryan
Beth Ryan is a registered midwife with a Master’s degree in Public Health. You can find out more about her by following her on Instagram here.