If you’ve ever watched a TV program or a movie where a woman goes into labour, you know the drill.

Cue manic music and a dramatic race through the streets in a speeding car.

The point being made? They have to get to the hospital before she has her baby on the side of the road.

For many women, this is a very real concern.

What To Do When Baby Is Born Before You Get To Hospital

Considering the advice to stay at home for as long as you can when labour starts, the concern is understandable.

Many women who live in rural areas are anxious about travelling long distances and getting to their birthplace in time.

Plenty of women simply hate the idea of being in a car while they’re having contractions, and they put it off for as long as possible.

There are several reasons why birth happens before women arrive at their birth place, and new research has shed some light on the consequences of giving birth before arrival.

What Is Birth Before Arrival?

In Australia, babies who are born outside a hospital, birth centre or planned home birth are recorded as ‘other’.

They might have been born, unplanned, at home, on the way to hospital, or in an ambulance.

This happens in about 5 out of every 1,000 births and occurs more frequently than planned home births.

What Did The Study Find?

The research study looked at over 1 million births in NSW (Australia) over a ten year period.

The study’s authors found babies born before arrival:

Were more likely to be premature (12.5% compared with just over 7%)
Had a lower birth weight (an average of almost 210g difference)
Were admitted to a special care nursery or neonatal intensive care unit
Had a much higher (34.6% compared with 9.6%) rate of perinatal mortality (number of stillbirths and deaths in the first week of life)

Babies born before arrival were more likely to experience complications: respiratory distress; suspected infection; hypothermia; congenital abnormality; and neonatal withdrawal symptoms.

The research found women who gave birth before arrival:

Were likely to be in the lower socioeconomic range
Had previously given birth to more than one baby
Had high rates of smoking (30.5% compared with almost 14%)
Were more likely to have a postpartum haemorrhage requiring transfusion

Giving birth before arrival was more likely to occur in areas where the distance to a maternity unit was greater than two hours’ drive, in coastal regions, and in areas where there were high rates of planned home birth.

Factors Affecting Birth Before Arrival

There are many reasons why babies are born before arrival at their birth place. The most common are:

The need to drive long distances to reach a hospital
A fast (precipitous) labour and birth
Waiting too long at home during active labour
Transferring from planned home birth to hospital
Giving birth at home without a midwife or doctor
Bad weather or traffic interruptions.

Although the research demonstrates babies born before arrival tend to have more complications, most are likely to be due to prematurity. Premature birth increases complication risks for all babies, regardless of where they are born.

How To Deal With Birth Before Arrival

It’s very unlikely a first time mother will give birth before arrival, but it doesn’t hurt to know what to do:

Stay calm. This might not be easy but it will help you cope with the situation and follow through with what needs to be done.
Call emergency services on 000 (in Australia).
Make sure you are low to the ground; place a towel or blanket under you to provide a soft landing for the baby.
If possible, warm some blankets or towels on a heater or in the dryer, ready for the baby.
As soon as your baby is born, bring her to your chest and rub her dry with a towel. Keeping your baby covered on your chest is the best way to keep her warm.
Blow on her face, if she doesn’t take a breath; this might make her gasp and kickstart respiration. If it doesn’t work, rub her back with a towel to stimulate her breathing.
If your baby doesn’t respond to these steps, use CPR (this is rarely needed).
There will be some amniotic fluid and bleeding after the birth; this is normal. If the bleeding is excessive or you feel unwell, make sure emergency services are on their way.
There is no need to cut and tie the umbilical cord; leave it attached to the baby.
There is no urgency to birth the placenta, and no need to pull on the cord, which can cause serious bleeding and possibly pull out the uterus.
Stay warm and keep your baby skin to skin until assistance arrives.

While it rarely happens, birth before arrival can be exciting and most often very straightforward, as there’s less interference with the normal process of birth.