Emergency car-birth kit

I have a friend who’s pregnant with her second child right now. Her first labor went very quickly and easily for her—she got to 4 cm dilated without even being aware that she was contracting in the first place. With second babies, labor tends to go even more quickly and easily, so my friend and her husband and doctor are all concerned that she might not make it to the hospital in time. She has very strict orders to head in as soon as she feels anything, but just to be on the safe side, in case she accidentally does have her baby in the car on the way there, she asked me to put together an emergency car birth kit for her. I don’t think she’ll need it, but as she said, she’d rather be safe than sorry, and it would ease both her and her husband’s minds. So, I thought about what instruments and necessities are on the birth table at the hospital, and I trolled around a few homebirth sites and looked at what comprises a normal homebirth kit, and this is what I came up with:

2 plastic sheets or sheet covers to protect car seat from various juices (you probably only need one, but two is safer. Could also use a drop cloth or tablecloth.)
1-2 re-sealable sturdy gallon sized zip-lock bags for placenta.
3 plastic cord clamps – you can buy these online at home birth supply sites. (When the baby first comes out, put two clamps on the cord, about one inch apart, and cut in btw the clamps to seperate baby from placenta. Put the third clamp closer to the baby’s umbilicus, and then cut off the excess.)
1 pair of bandage scissors to cut cord. (These should be as close to sterile as possible, in order to prevent infections in the cord/ baby. Boil the scissors for 10 minutes in water, with the blades apart, then use a pair of tongs to lay them out on sterile gauze to dry; wrap in the sterile gauze without touching with your fingers, and place the wrapped scissors in a zip-lock plastic baggie.  If this isn’t possible, at the very least wipe the blades of the scissors with alcohol and allow to air dry before using them to cut the cord).
1-2 warm baby hat(s)
1 16 oz. alcohol bottle.
1 bottle of betadine.
1 Peri Bottle (a squirt bottle, basically, filled with water to clean off your vulva and labia after delivery.)
2 packs of 4×4 Gauze (usually 12 gauze squares per pack.)
6 Lube Packs.
1 2.5 Bulb Syringe (be sure bulb is compressed before inserting it into the baby’s nose, so that it only sucks fluid *out*, and doesn’t push any air *in*)
1 rectal thermometer to check baby’s temperature.
1 pack of sanitary napkins, Maternity Size.
1 pair of loose, comfortable panties that you don’t mind bleeding on.
4-5 large, absorbant towels.
2-3 warm baby blankets to wrap baby in (although the best thing to do would be to put the baby on your chest, and then wrap both of you.)
1 large blanket for yourself, in case you get the shakes on the way to the hospital.
4 pairs of latex gloves, in whatever size needed for whomever will be doing the delivering (her husband, most likely.)
4 single, sterile gloves (for checking position of baby as s/he descends the birth canal.)
1 large plastic trash bag for waste materials.
1-2 liters of water to re-hydrate yourself with, after you’ve delivered, and some snacks to eat.

It’s probably more than she’ll need, but I felt it was better to err on the side of too much rather than too little. I also included a few instructions on how to use the equiptment, how to massage the fundus after delivery of the placenta, how to check for a nuchal cord, and what to do in case she bleeds excessively, either from a tear or a soft fundus, but I really hope it doesn’t come to that.

For some reason, the idea of her having her baby in a car makes me a bit nervous. It’s not that I don’t think she’s capable of it—she’s young, fit and healthy, and takes very good care of herself—and it’s not that I really think anything will go wrong. After all, most births are blessedly uneventful, normal, healthy affairs, and women accidentally having their baby in the car on the way to the hospital is nothing new; you read about stories like that in the newspaper from time to time. Once, at work, we had an irate cabby storm up to our unit demanding payment from the patient we had just admitted, who had accidentally had her baby in the back of his cab on the way to the hospital and left the placenta on the floor of the taxi. I absolutely, unequivocably support homebirth, and Birth Centers, and having your baby in unconventional locations, and I have always believed that all the hysteria about birth—the emergency waiting to happen mindset—is unnecessary. Women’s bodies are designed for birth, and if left alone and supported and encouraged, most women are more than capable of delivering their own baby safely into this world. So why the nerves, kiddo?

I think it’s just the idea of her giving birth without a skilled birth attendant present that makes me nervous, just in case something unexpected happens. For what it’s worth, I really hope my friend makes it to the hospital in time. Given her history, they may have to drive pretty fast.

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