Wait "as long as possible" to go to hospital?

[Ambivalent Dreams]

I am planning on waiting "as long as possible" before going to the hopsital. Only thing is, I'm not sure what that means. The hospital is about 25 minutes away. When should I leave the house? When contractions are 3 minutes apart? When I start to feel the urge to push? When my body says "go"?

[MaerynPearl]

Originally Posted by Ambivalent Dreams

When I start to feel the urge to push?

LOL dont wait THAT long unless you want a baby born in the car!

I personally went in with DD when my contractions were 5 minutes apart and was there for 3 hours before she was born... but if I had waited until they were closer together I would have been in transition and never had made it to the hospital! As soon as I came down from transition my body was pushing without my help.

Its really going to have to be... trust your instincts. Mine told me that if I didnt go then I probably wouldnt have made it... which was right, if I had waited until my contractions were stronger/closer together, my babys place of birth would have been along the highway.

[organicpapayamama]

well it all depends.... first a couple questions:

1. is this your first baby?
2. why are you looking to wait as long as possible? to avoid interventions/ pain meds?

if it is your first and you go at roughly the 411 rule or 311 (4/3 min apart lasting a min long and its been going on for an hour) by the time you get to the hospital on average ive seen most moms be only around 3-4 cm. (im a doula) I would honestly wait long than that, unless of course your family has a history of fast deliveries. If you are wanting to go naturally and avoid interventions then wait until the pain is pretty much unbearable. For some women this is early on. For example my sister has a low pain tolerance and was in back labor and even though she waited a day to go to the hospital when she got there she was only 1 cm even though she reached her pain tolerance max... so every woman is different. But generally speaking wait till the pain is intense and you cant talk through contractions any more would be a good general rule to follow.

If this is your second + baby then the 411/311 rule would be good as second + labors tend to be shorter and babies come faster. It also depends on how far you have to travel to the hospital.

also wanted to add that with my first term baby I went at the 411 rule and was only 3-4 cm. DS wasnt born for another 12 hours. I def plan on waiting way longer this time.

[Galatea]

I'm a big fan of Bradley emotional signposts... if you are still laughing/talking, then stay home... once you can do nothing other than concentrate on the contractions, then go.

[MammaB21]

I agree with what others have said about going only when you can't talk through contractions. If you're thinking, "Hhhmmm....things are getting a bit more intense. Maybe it's time to go in." - it's not time. If you're thinking, "OMG aaahhhhhhh" - it's time to go in.

But than it really all depends on you, what you want out of your labor and what your personality is. In my case, I wanted to be in the hospital before things got intense because I was more worried about feeling comfortable in my surroundings. I wanted that time to settle in, get into my own clothes, make sure all the attendants had seen my birth plan, set up my birth environment with dim lights and music, request a birthing ball, etc. In the end I was at the hospital in labor for 21 hours. Things didn't quite go as planned and I did get some pressure from staff to do things against my birth plan which I think made my labor go even slower. That's why this time I'm staying home.

[aleatha5]

DDC crashing, I waited until I couldn't talk/joke through my contractions. I'm happy I did, I wanted no pain meds. I got to the hospital fully dilated, so it was too late for pain meds. That was good, because I maybe would have caved (probably would have caved ) I used an online contraction timer too to make sure I wasn't "misremembering" how often or long the contractions were.

[jennica]

When I had Ds (my first) I woke up with contractions 5 minutes apart. Two hours later we left for the hospital and contractions were about 2 to 4 minutes apart, but coming doubled up, so I would get two about a minute apart or closer, then 2 to 4 minutes later another two would come. There was really no rhyme or reason to my contractions and no sense in even timing them. If I had waited for them to be consistently 2 minutes apart for an hour I would have delivered in the car on the way to the hospital, and some were 3 minutes apart, some were 1 minute apart, some were on top of each other. The midwife and my doula both told me to stay home and that I had more time since I was a first time mother. I went against their advice and headed to the hospital (a 45 minute drive) and ds was born 3 hours after we arrived. I didn't escape any interventions that way, and I really think they slowed things down by being so interventative. It just made things much more hectic and scary for me to arrive that far along and not be able to really take in my surroundings or negotiate for better care. But, if labor is starts up really slowly I see the wisdom in staying home for most of that early labor stuff. I just didn't have any early labor.

[Ambivalent Dreams]

1. is this your first baby?I am going for a VBAC this time. Second baby, first vaginal delivery. With my first baby, I had a c-section for breech presentation. My labor started when my water broke at 40 weeks. We went to the hospital right after my water broke and I was only 1 cm dilated when I was taken to the OR.

2. why are you looking to wait as long as possible? to avoid interventions/ pain meds? Yes, and yes. I am trying to avoid a repeat c-section in a very intervention happy area of the U.S. I fear if I labor "too long" at the hospital, they will tell me that they have to do a c-section instead of letting me finish labor on my own.

[organicpapayamama]

Originally Posted by Ambivalent Dreams

1. is this your first baby?I am going for a VBAC this time. Second baby, first vaginal delivery. With my first baby, I had a c-section for breech presentation. My labor started when my water broke at 40 weeks. We went to the hospital right after my water broke and I was only 1 cm dilated when I was taken to the OR.

2. why are you looking to wait as long as possible? to avoid interventions/ pain meds? Yes, and yes. I am trying to avoid a repeat c-section in a very intervention happy area of the U.S. I fear if I labor "too long" at the hospital, they will tell me that they have to do a c-section instead of letting me finish labor on my own.

good to know. You may also want to factor in your risk for uterine rupture. Though slim its def something you should consider. as well as if you have any other risks like GD or high PB or anything like that.

since you said your hospital will tell you they have to do a c-sec Im guessing your ob doesnt know your plans to vbac or does he/she?

[dogretro]

I just did a drug-free hospital vbac after a breech c/s, so I feel ya! I, too, wanted to wait "as long as possible" to avoid dumb hospital b/s and interventions. We live about 15 mins from the hospital & it was in the middle of the night anyway, so 10 min drive, lol. It took us about 20 mins to get the car loaded & get to the hospital.

Since I wasn't sure what "alap" meant, I went w/ my instincts. We timed contractions using contractionmaster.com. Mine never hit 411 b/c they only averaged 30-40 seconds long. What mattered for me was the intensity. Every so often the intensity would ratchet up even though they would not lengthen. I would also think to myself "Am I ready to wear a monitor and have a heplock?" If the answer was "no" then it was not time. By the time it was "time" I was mentally eager to get to the hospital. I was at ctrx 2-3 mins apart, 30-40 secs long. I had started vocalizing during them, but I could still function in between them.

I absolutely got to bypass several dumb procedures, such as urine collection. I got bloody show in triage & I was at 7cm. The midwife ushered everything along after that & I only labored at the hospital for 3 hours, the last one of those being pushing. I am very glad that I stuck w/ my goal of waiting as long as possible. What will be important is paying attention to the rhythm of your body. Had I gone in when ctrx were 3-4 mins apart, it would have been way too early for me.

[wills_mom]

I know people on the VBAC boards and on ICAN are big on the "show up when youhave the urge to push" but for me that is just cutting it a little too close, lol. I am hoping for a VBA2C, so I will probably be going in when my contractions are around 5 mins apart. I like the idea of going when you have trouble talking through them/really have to focus. With my first DS I did dilate to 10 and pushed for a long time, so I know what those later contractions are like vs. the earlier one. His contractions started 3 minutes apart from the get-go though. DS #2 was a preemie breech birth, but I did labor with him for a bit before I called the nurse to tell her I was having consistant contractions. They were 4-5 mins apart when I called them to my room (I had been there 4 days, so was only getting an NST every 8 hours at that point, but my water had been broken since I got there).

Anyways, I will probably be going in when my contractions are about 5 mins apart and I am having trouble talking thorough them. Do you have an OB or MW that is supportive of your VBAC? My OB is, but she wants me there at 10 mins apart. Not gonna happen unless my water breaks. :P

[apmama07]

Hummm....it really is tough to answer because it really is so different for everyone it seems. Personally, I just KNEW that it was time to go. I had a looonnggg early labor and then BAM active labor started and within a couple of hours it was intense. As others said, once I had to intensely concentrate my way through contractions I just felt that I needed to go get settled at the birth center.

I think you have to weigh a lot of things and only you will know for sure when it's time. (Sorry that's not much help! ) We all have a different tolerance for the car ride too, and like a PP said some of us might need more time to feel settled in the birth location (I was one - I ended up being there for about 8 hours but was happy with that).

[seashells]

I don't have personal experience on this (had a home birth) but if I for some reason wanted to birth in a hospital and it was 25 minutes away, I'd consider either lobby-labor (don't check yourself in, just hang out in the hospital wherever - feel free to go to the cafeteria, or find some benches in a quiet place to chill, whatever). Of course that might not be really feasible in a large, city hospital - I'm having trouble picturing any hospital other than my local one, which is tiny and quiet and has lots of low-traffic areas you can hang out in.

Or, I'd pick out a hotel or motel nearby and labor there for a while. 25 minutes isn't so bad but honestly half hour in the car during transition sounds like torture to me. I'd rather go somewhere earlier on and just hang out and wait until transition. When I was in transition, they wanted me to get out of the birthing tub so they could drain and refill it (it was really murky by then) and I told them, as nicely as I could, "over my dead body." (They drained it halfway with me still in it and refilled it - a nice compromise that met everyone's needs). Anyway, I didn't even want to get out to go to the TOILET, I can't imagine being strapped into a car in a seated position during transition.

But on the other hand, women do it every day, they really do. So if that's what you're looking at, you can do it too. Those are just my ideas to reduce the amount of torturous travel time, to travel when it's still easier but stll don't check in.

[dogretro]

Originally Posted by wills_mom

I know people on the VBAC boards and on ICAN are big on the "show up when youhave the urge to push" but for me that is just cutting it a little too close, lol.

Yeah, showing up at urge to push time is WAY too close, imo. Plus, by that time, I was literally screaming my head off, unable to walk, etc. Leave before then!

Originally Posted by seashells

Anyway, I didn't even want to get out to go to the TOILET, I can't imagine being strapped into a car in a seated position during transition.

Oh hecks no, I was NOT strapped in in a seated position! I was kneeling in the backseat. I knew from moment one that there was no way I would be able to sit in the front during labor. We have a hatchback so I was even draped over the backseat during one ctrx, lol. I actually would have preferred to transition in the car as opposed to the hospital b/c there would have been no one messing w/ me and trying to do stuff to me. Transitioning in triage was pretty booty. However, the car would have looked like a crime scene & the screaming would have probably distracted dh while driving, so it's good to have avoided that!

[VillageMom6]

Originally Posted by seashells

Or, I'd pick out a hotel or motel nearby and labor there for a while.

I am seriously considering doing that this time. We live 45 minutes from the hospital. That would be a looong ride whilst in active labor.

On the other hand, getting there too soon is a bummer. I'm pretty sure that I got stage fright when I arrived early on last time and my labor never did pick up.

So I am torn between wanting to get there as late as possibe versus not wanting to deliver in the car. I think a hotel with a swimming pool near the hospital sounds like a nice compromise!

[RedOakMomma]

Originally Posted by Galatea

I'm a big fan of Bradley emotional signposts... if you are still laughing/talking, then stay home... once you can do nothing other than concentrate on the contractions, then go.

Yup. Check out "Natural Birth the Bradley Way" for a good description of this.

Also, if your dp notices you're attached to/deeply focused in a particular routine when you're contracting (a "ritual" in some books), and when you get upset about that routine/ritual being broken...it's a good sign that things are speeding up. When dh found me and realized we had waited too long (second birth), I was alone in a room, doing hip figure-8s on a birthing ball, staring down at the circle of my glass intently. I snapped at him when he tried to take and refill my water glass, saying "I need that!"

We're about 10 minutes from our hospital, and dh and I counted mainly on the 411 rule that time. MISTAKE! I went very quickly from contractions 5 minutes apart to 3 minutes apart, and was going through transition in the carride. Not cool. It was a very hectic arrival at the hospital, and I wish I'd gone in a *little* earlier.

If dh had been a little more focused on the Bradley signposts, we would have left about 30 minutes earlier than we did. It's not his fault...he was getting the kids settled for naptime just as I started getting really focused on contractions...but timing-wise it wasn't ideal.

This time we're going to be all about the signposts. Who knew I'd go from laughing to crowning in less than an hour?

[VillageMom6]

Originally Posted by RedOakMomma

Who knew I'd go from laughing to crowning in less than an hour?

Dear Heavenly Father,

Could I have that, please? Thanks!

Love,

Me

[slgt]

I've only done one birth, we live about 35 minutes from the hospital (and then it takes almost 10 minutes to get up to the birthing center, at the OPPOSITE end of the hospital and top floor from the underground parking garage!). Anyways.

My ctx were 5 minutes apart for a couple hours when I finally decided it was time to go in. I hadn't been able to do much other than focus on contractions, and I was quite dehydrated from vomiting/diarrhea, couldn't keep any food/water down, so I also wanted IV fluids!

by the time we got to the hospital I was maybe 3-4 minutes apart (can't remember), and was 6 cm. It was another 5 hours before DD was born, but it went by fast. I think it would have gone much mroe quickly if I had chosen to get up & walk around but, I chose a labor position that slowed things down & turned baby posterior. Still, 5 hours was not a problem at the hospital, and I have never been so glad to get an IV in my life!

This time, we'll have to play it by ear a bit more since we may have to drop DD off someplace. I'm generally anticipating that we'll use roughly the same timing though - go in around 5 minutes apart.

It's impossible to guess, isn't it?!

[RedOakMomma]

Originally Posted by VillageMom6

Dear Heavenly Father,

Could I have that, please? Thanks!

Love,

Me

It was nice, in hindsight. During the experience, though, it was like some crazy alien force was taking over my body. Totally overwhelming, more than a little scary, and being rushed into the hospital by my dh over bumpy highways didn't help much. At least I got to skip triage!

[OrchideZ]

Originally Posted by Ambivalent Dreams

1. is this your first baby?I am going for a VBAC this time. Second baby, first vaginal delivery. With my first baby, I had a c-section for breech presentation. My labor started when my water broke at 40 weeks. We went to the hospital right after my water broke and I was only 1 cm dilated when I was taken to the OR.

2. why are you looking to wait as long as possible? to avoid interventions/ pain meds? Yes, and yes. I am trying to avoid a repeat c-section in a very intervention happy area of the U.S. I fear if I labor "too long" at the hospital, they will tell me that they have to do a c-section instead of letting me finish labor on my own.

I am also in the same boat mama.
Going for a Vbac with my 2nd birth.

My OB is very well-known in this area for being Vbac and breech birth friendly as well as backing up home birth transfers with 40 years experience so I know he will support me as best he can.
He did tell me that when I go into labor, he wants me to labor at home as long as I can. I live 15 min. from the hospital.
He also told me that when I am in labor, to call/page him, go into his office (which is at the hospital) rather than going to the hospital unless its night-time b/c he worries about interventions and other staff.
I had to sign a hospital form a few weeks ago which stated I was requesting a Vbac and knew the risks. This is the hospital's way of dealing with liability I suppose.
I will be bringing a birth plan along with us to the hospital and my doula.
My doc did tell me he may have my labor augmented depending on the sitch. I am assuming this might mean if I show up and am not very dilated yet am contracting a bunch.
I was already 2 cm as of last week so he tells me there is a good chance this week is it for me.
I will come back and post how it goes for you if I do go soon.