Tuesday 23 October 2018

When babies come early

While most first-world pregnancies end with a delivery in hospital, or at least with medical help on hand, some babies just don't hang around. It makes for some great stories, but what to do if it happens to you?

Linda Daly

IT was a sunny May weekend in 2012 when Vicky Coogan packed her bag and headed for her annual trip away with her father and sister Mariesa. Despite being almost five weeks from her due date she felt great, and excited for the traditional father-daughters weekend.

The destination was Mount Wolseley Hotel and Spa in Carlow, and the three arrived on a Saturday. That night they had a great time, staying up until 4.30 in the morning for a sing-song with a party of golfers, Vicky on the water but lasting all the same. On Sunday, she went to the spa and had a pregnancy back massage, went off for dinner in Tullow village and then returned to the hotel.

It was around then that she started to feel uncomfortable. She felt thirsty and kept drinking lots of iced water, but thought the discomfort was due to having eaten too much food. Vicky went to bed early, but felt she had a long night stretched out in front of her.

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"I couldn't get comfortable, and thought I was too full. I kept getting up to go to the toilet, and had a little back pain, but I didn't twig at all," she says.

Vicky didn't want to ruin the weekend, so let her sister and father sleep.

"I had convinced myself it was Braxton Hicks and that the baby was going to be late because everyone kept telling me she would be. It was 4 in the morning and I was sitting in Mount Wolseley overlooking this fabulous golf course, but bent over in pain. I didn't want to trek all the way to the Rotunda to be sent home."

At 6.45am Vicky rang her sister-in-law, who eventually convinced the mum to be to call the Rotunda. She was told to come to the hospital.

She went for a shower, blow-dried her hair, and put on her make-up before finally checking out of the hotel. By the time she got to the front door of Mount Wolseley with Mariesa and their dad she was in a significant amount of pain.

So off the three trotted at 8.30am into rush-hour traffic on the N7. It was at Newlands Cross that it came to a standstill. Despite laughing for much of the previous few hours between grimaces of pain, Vicky began to panic. Luck was on her side though when her dad waved down a Garda on a bike, and he offered to give them an escort to the hospital.

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By the time the car got to the Luas line at Inchicore, the Garda decided to speed things up. He managed to stop the Luas trams and directed the car down the tracks. Amidst the panic, driver Mariesa almost drove into a bollard. Vicky got to the hospital before her husband Ray, who was coming from Celbridge.

When the midwife checked her, she was 3.5cm dilated and was told she had a good while to go before the baby was born. However, within two hours, baby Charlotte rushed into the world after just one push, while Vicky was kneeling up.

"We couldn't believe she was here. It was just 13 minutes after my mum had found out that I was in hospital. Charlotte weighed just 5lb 10 oz. She's two and a half now, and is perfect."

War stories

For many women, our labour is our war story. We like nothing better than to tell it to anyone who will listen at any given opportunity. But some people, like Vicky Coogan, have particularly interesting versions.

Did you hear about the woman who gave birth last year while mid-flight from Nigeria to the United States? Or about the British woman who gave birth on a New York pavement earlier this year, after another woman had jumped out and 'stolen' her cab?

The good news is that most births won't be as eventful as that, and the likelihood is that you'll have a perfectly normal birth in a perfectly normal hospital, says Helen O'Carroll, nurse and midwife.

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"It is very unusual for a first-time mum to deliver anywhere other than the place she had planned for her baby. However, if you've had a very quick first labour you can expect to have a very quick labour subsequently. If you find yourself on the way to the hospital and you start feeling that you need to push, that tells you the baby's birth is reasonably imminent," says O'Carroll.

In the event that this does happen, she advises that you pull over, stop your car and make sure that the doors are unlocked.

"Put on the warning lights, keep the car warm and heat on. The first thing to do is to phone for an ambulance. Phone 112 or 999 to get through to the operator. You don't need any credit, and even if a phone is locked you can phone those two numbers.

"The partner should flag down another car for help, because you will need some assistance. They should tell the dispatcher your location, that you are having a baby, and are pushing. Tell them what hospital you are booked into."

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The dispatcher should stay on the phone, and may be able to get a doctor or midwife from the hospital on the phone to talk you through things until the ambulance gets there.

"Having had one baby, you're somewhat an expert at this stage, so don't panic. You've done it before, you've done it beautifully, you are an expert at giving birth.

"The practicalities would be to put a blanket or towel underneath the woman, and keep another blanket or towel warm beside the heater to dry and cover the baby if the birth occurs. Pant if you can… until you can't."

Express delivery

O'Carroll says babies and mums who have fast labours usually deliver with ease.

"If the baby is coming, deliver the head gently and the baby's little body up onto mum's bare tummy. Skin-to-skin contact is essential now. Your warmth, your heartbeat, your voice, your smell, helps the baby to feel secure. Regulating the baby's temperature and stabilising the baby's heartbeat and breathing. This is often referred to as kangaroo care."

Once the baby is on your tummy, put a towel over him, tapping him dry gently and keeping him warm against your skin. You shouldn't interfere with the umbilical cord.

Even if you hadn't planned on breastfeeding, O'Carroll advises that you try to get the baby sucking at your breast.

"This will release the hormone oxytocin, encouraging contraction of your womb, and helping the placenta/afterbirth to detach wholly from the side of your uterus (womb). This will enable the womb to clamp down, and helps prevent bleeding from it."

If the placenta does deliver, you should rub your abdomen below the navel, which will aid and stimulate contractions following the delivery of the afterbirth and preventing bleeding. Once the afterbirth has separated, the risk of haemorrhage is minimised.

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When the ambulance arrives on site, it will take you to the hospital, and then newborn and mum will have thorough examinations, and staff will check that the placenta is complete.

"Many babies worldwide deliver with mum alone. The baby, your instinct and your womb know what to do. Nature knows what to do, trust in that," says O'Carroll.

But she has this piece of advice: "If your waters go in the early stages of the labour, you go to hospital. Even in the event of no contractions.

Helen O'Carroll, nurse and midwife of 20 years' experience, offers private, antenatal classes in Dublin and new home services for mum. Check out 1dayantenatalclass.com

Irish Independent

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