Rapid labor and not making it to hospital - Mothering Forums
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#1 of 51 Old 04-09-2009, 11:28 PM - Thread Starter
 
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Hi,

I have history of rapid labors. My 1st Dd was 2 weeks past due date and came in 4.5 hours: My 2nd Dd was 1 week past and came in less than 2.5. I am now PG with our son, due in about 2 months. I plan to deliver in hospital, but I've been visualizing having him at home, due to the rapid labor history I have and the fact that homebirth is really appealing to me. In the event I don't make it to hospital, what should I have at home to deliver him safely--just in case?

BTW, I love all the homebirth stories here and would LOVE to commit to this but my Dh is in the emergency profession and he just doesn't feel good about me doing this at home (but I want to plan for homebirth just in case). I am in an OBGYN care.

Thanks for any insight or info you can share.

Penny

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#2 of 51 Old 04-09-2009, 11:43 PM
 
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I'm looking forward to seeing answers to this because I've BTDT. First labor was precipitous and we ended up with a baby in the car. I definitely want a back up plan this time!

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#3 of 51 Old 04-09-2009, 11:47 PM
 
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Having had a too-fast labor intended for the hospital, knowing it might happen, we had prepared with the very basics of a homebirth... we had those fuzzy-backed vinyl tablecloths (to make cleanup incredibly easy), we boiled the scissors and a new shoelace (next time will use embroidery thread, it's cuter and ties better), and some towels. Also had on hand hydrogen peroxide to wash the towels with after, to get the blood out of them. No stains at all on the white towels.

Really, there wasn't much to it. Very simple and straightforward. Anything you might want for a planned homebirth, you should probably keep around as a just-in-case type of thing, including a spare kit in the car (again, at least the basics... probably want a blanket in there as well for the car. Could be cold). If you're at home, you're likely to already have anything you might want, hanging around, other than the cord clamps if you choose to use them. I'd also take a class in infant CPR, if you're not current on that.
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#4 of 51 Old 04-10-2009, 12:14 AM
 
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I'm on the lookout for a precipitous birth (last time total labor was 5 hrs but went from 5 cm to delivering in under 90 min). I was under the impression that if the baby came too quickly at home, I'd keep the baby on my chest (or belly or as far as the cord would allow without pulling) and Dh would call 911. The hospital is about 10 minutes away but I think there's an ambulance at the fire station up the street.

I'm also interested to read the other responses.
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#5 of 51 Old 04-10-2009, 12:36 AM
 
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I'm on the lookout for a precipitous birth (last time total labor was 5 hrs but went from 5 cm to delivering in under 90 min). I was under the impression that if the baby came too quickly at home, I'd keep the baby on my chest (or belly or as far as the cord would allow without pulling) and Dh would call 911. The hospital is about 10 minutes away but I think there's an ambulance at the fire station up the street.

I'm also interested to read the other responses.
If the baby is out and breathing, and you're not bleeding profusely, why would you call an ambulance?

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#6 of 51 Old 04-10-2009, 01:09 AM
 
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I'm on the lookout for a precipitous birth (last time total labor was 5 hrs but went from 5 cm to delivering in under 90 min). I was under the impression that if the baby came too quickly at home, I'd keep the baby on my chest (or belly or as far as the cord would allow without pulling) and Dh would call 911. The hospital is about 10 minutes away but I think there's an ambulance at the fire station up the street.

I'm also interested to read the other responses.
Before committing to this, you should talk to the nurse manager in the ER and the L&D wards. In some hospitals, it is standard to put the baby in the nursery and possibly even start antibiotics after an unplanned home birth. You just want to know what you are getting into.
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#7 of 51 Old 04-10-2009, 01:13 AM
 
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If the baby is out and breathing, and you're not bleeding profusely, why would you call an ambulance?
I'll be on heparin 10,000 units twice per day (last time I went into active labor suddenly a couple hours after my shot). So, bleeding is a rather significant possibility. But mostly after my last one, I really couldn't move for some time - the fetal ejection reflex a.k.a. freight train really hit me hard - it's hard to imagine being able to get up and get to the hospital as soon as I would prefer to be there. I don't know, I guess it's also hard for me to imagine riding in the car with a baby on my chest and DH driving - I'm not crazy about dealing with the cord/placenta ourselves (this is going to sound *really dumb*, but if we were in the car, shouldn't the baby be in the carseat? I know that if I were in an ambulance I'd be strapped to the thing and holding the baby - I've done that with one of my kids as an older baby - but at least that's following the "rules"). I know I'm starting to sound ridiculous, but I'm not exactly into unassisted homebirth for my own personal scenario (vbac on anticoagulants).
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#8 of 51 Old 04-10-2009, 01:19 AM
 
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Before committing to this, you should talk to the nurse manager in the ER and the L&D wards. In some hospitals, it is standard to put the baby in the nursery and possibly even start antibiotics after an unplanned home birth. You just want to know what you are getting into.
Sorry if I was confusing - I'm hoping to deliver at the hospital with my OB. Definitely NOT wanting to deliver at home - I was just thinking about what would happen if we didn't make it in time. The only wrinkle I haven't quite worked out is getting child care to the house in time for DH and I to go (why do I always go into labor in the middle of the night).
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#9 of 51 Old 04-10-2009, 05:21 AM
 
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Hi,

I have history of rapid labors. My 1st Dd was 2 weeks past due date and came in 4.5 hours: My 2nd Dd was 1 week past and came in less than 2.5. I am now PG with our son, due in about 2 months. I plan to deliver in hospital, but I've been visualizing having him at home, due to the rapid labor history I have and the fact that homebirth is really appealing to me. In the event I don't make it to hospital, what should I have at home to deliver him safely--just in case?

BTW, I love all the homebirth stories here and would LOVE to commit to this but my Dh is in the emergency profession and he just doesn't feel good about me doing this at home (but I want to plan for homebirth just in case). I am in an OBGYN care.

Thanks for any insight or info you can share.

Penny
Go take a look at the unassisted childbirth forum, loads of info there on delivering your baby at home, what you need and what you can do 'just in case'.

But really you don't 'need' anything, some plastic sheets to keep your floors clean... some scissors you can boil for 5 minutes and some shoe laces (for the cord) although you don't really need to worry about this you can keep placenta/baby/cord all together (like a lotus birth). There are some herbs you can keep on hand to help get the placenta out and stop bleeding. Heart in Hands ( i think thats what its called) is a pretty good midwives pregnancy/birth book with lots of - if this happens - do this etc.

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#10 of 51 Old 04-10-2009, 07:05 AM
 
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My husband caught our last baby who came very quickly. The midwife said the ones that come fast are pretty much healthy. To the supplies already mentioned, I wish I would suggest one of those bulb things - is it called a nasal aspirator? I didn't need it, but I was just nervous that I *would* and didn't have one if the baby had a bunch of mucous that made it hard to breathe.
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#11 of 51 Old 04-10-2009, 08:37 AM
 
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just curious here: why would you need scissors if you're not cutting the cord? :

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#12 of 51 Old 04-10-2009, 11:13 AM
 
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I also have fast labors. in my case, since I have no medical problems, I truly believe hb is far safer. I could deal with going to the hospital before the baby was born but going after the birth sounds horrendous. And giving birth in a car is obviously not ideal.
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#13 of 51 Old 04-10-2009, 11:20 AM
 
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If the baby is out and breathing, and you're not bleeding profusely, why would you call an ambulance?
Who else would you call? I have a little 'birth kit' at home just in case. If I do happen to deliver at home, I know I'm not driving to the hospital, and DH will probably have a stroke and die, so he won't be driving. So I will be sitting there, alone, with a baby still attached to me just... sitting. I think a lot of us need someone or something to at least point us in the right direction.

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#14 of 51 Old 04-10-2009, 12:00 PM
 
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Who else would you call? I have a little 'birth kit' at home just in case. If I do happen to deliver at home, I know I'm not driving to the hospital, and DH will probably have a stroke and die, so he won't be driving. So I will be sitting there, alone, with a baby still attached to me just... sitting. I think a lot of us need someone or something to at least point us in the right direction.
I think the idea is that once the baby is born and breathing and such- there is truly no need for medical intervention. Much less emergency intervention.

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#15 of 51 Old 04-10-2009, 01:00 PM
 
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My DH isn't comfortable with a homebirth, either . . .maybe I'd look at it this way. Chances seem pretty good that you WILL give birth at home, right? I would explain to DH-- either way you will probably give birth at home, so wouldn't it be better to be prepared (in your case, with a MW) than not? I'd rather have the baby at home than in a car or have to be whisked off by an ambulance.

My only thing is, could you find a MW fast to do this at home?

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#16 of 51 Old 04-10-2009, 01:06 PM
 
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You may not go faster! My first was less than two hours, and my second jumped up to four hours! If I were you and was birthing at a hospital, the second you realize you may be in labor, high-tail it over to L&D! Not a big deal if they send you home!

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#17 of 51 Old 04-10-2009, 01:28 PM
 
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#18 of 51 Old 04-10-2009, 01:35 PM
 
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You may not go faster! My first was less than two hours, and my second jumped up to four hours! If I were you and was birthing at a hospital, the second you realize you may be in labor, high-tail it over to L&D! Not a big deal if they send you home!
Ah, but we run into one problem with that idea. Hospitals are most likely to use/suggest/force unnecessary interventions at just that point, when a woman is just far enough to stay but still has some labouring to go. Even short labours, all it takes is being there for one hour and a doctor that recommends pitocin, or the
use of EFM tying mum down and therefore slowing her labour, or constant nagging "offers" for an epidural she didn't want originally but gives in, etc. All it takes is the EFM and epidural to slow labour down, which leads to pitocin, which leads to low heart rates, which leads to a cesarean. Obviously, it isn't always the case, but the earlier you go, the more interventions you risk. Now, I might go and labour in the parking lot and have them wheelchair me in once I hit transition. More uncomfortable, but safer.

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#19 of 51 Old 04-10-2009, 01:57 PM
 
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I think the idea is that once the baby is born and breathing and such- there is truly no need for medical intervention. Much less emergency intervention.
:

I just meant that 911 is to be used in case of an emergency. A breathing baby and a mama who isn't bleeding out isn't an emergency. It just seems like an abuse of the system. And I know my medical insurance won't pay for a non-emergency ambulance transport, I'd be stuck with that bill. I'd much rather make prior arrangements with a HBMW, that in case of a precipitous labor she'd be available for the immediate post-partum care so you wouldn't have to go into the hospital after baby is born. If you call her, you pay her, if you don't call her, you don't pay her.

The book is called Heart & Hands by Elizabeth Davis, and it covers all the basics. If you expect that your labor will be fast and your birth precipitous it would probably be a good idea to read up on what to do if X, Y or Z. Both for you and your DP.

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#20 of 51 Old 04-10-2009, 02:02 PM
 
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In the event I don't make it to hospital, what should I have at home to deliver him safely--just in case?
My first thought is- people.

A pediatrician who is ready to do a home visit or take an unexpected homebirth baby on the third or even first day.

A backup midwife who would come during or after the birth, with a set fee, JUST IN CASE- just as backup- who could also do the birth certificate, cord clamping and paperwork, and check out baby, as well as suction. She might be thousands cheaper than an ambulance and a lot nicer IF you did not have any indications.

A couple of people who would agree to drive you and baby to the hospital so your DH would not pass out on the interstate or whatever.

Child care for your first child if you do not want said child to have to go with you, say, in the middle of the night.

Other than that: lots and lots of receiving blankets for DH to put in the dryer to keep baby warm, and a space heater to ensure that if your house is cold, you can heat up your room quickly to keep you and baby warm.

A carseat for baby if you go in a car (actually this would be a huge advantage of an ambulance, that you could probably hold baby! if you did have to go to the hospital) installed and ready, and make sure your husband or your drivers-on-call know how to install it in the car you will go in.

Chux pads for under you and menstrual pads.

Keeping baby warm, attached to placenta or not, and having someone with lots of experience on hand as well as a medical bag, are the most important things.

I would also call an ambulance, just to have people who were experienced in evaluating the health of the newborn and mother, if necessary, but I'd prefer a backup midwife.

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#21 of 51 Old 04-10-2009, 02:07 PM
 
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I just meant that 911 is to be used in case of an emergency. A breathing baby and a mama who isn't bleeding out isn't an emergency. It just seems like an abuse of the system. And I know my medical insurance won't pay for a non-emergency ambulance transport, I'd be stuck with that bill. I'd much rather make prior arrangements with a HBMW, that in case of a precipitous labor she'd be available for the immediate post-partum care so you wouldn't have to go into the hospital after baby is born. If you call her, you pay her, if you don't call her, you don't pay her. .
ah... What about states what don't have HBMW? Plus, I'm pretty sure mainstream America would view having a baby at home grounds to call the squad.

Honest questions! I'm not trying to be snarky! If I were to birth at home, (which I secretly want to do) I wouldn't know what to do with myself after I got the baby out! Would I just call my mom? Would I even have to go to the hospital? I've heard its a nightmare and a half to get a birth cert if you aren't born in a hospital.

I'm not ready (nor do I have the time LO is due in a month!) to research a full on HB. What about emergency HB or crash course HB?

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#22 of 51 Old 04-10-2009, 02:36 PM
 
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ah... What about states what don't have HBMW? Plus, I'm pretty sure mainstream America would view having a baby at home grounds to call the squad.
I think all (or almost all) states have HBMW. They may not be licensed in every state, but you should be able to find a lay midwife almost anywhere.

If you want to birth at home -go for it! If your state doesn't have Certified Nurse Midwives or Certified Professional Midwives - find a lay (or Direct Entry) Midwife to help you with your delivery. She will help direct you in terms of what to do, take care of the birth certificate, etc.

Thousands of women have planned homebirths, either with midwives or unassisted, and never go to the hospital. There just isn't any need to for a normal birth.

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#23 of 51 Old 04-10-2009, 02:53 PM - Thread Starter
 
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Wow! All this is great information, thanks (((((((((EVERYONE))))))))). I had no idea that if I ...uh-hem... accidentally HBed that I could possibly find a MW to come and do the birth certificate and usual stuff. Now the trick for me would be to convince hubby that there was no need to go to the hospital after baby is born.

Interesting idea about going in an ambulance and being able to hold baby instead of carseating him. I wondered about that. I hate the idea of going in an ambulance with all the sirens a blazing. My DH works in emergency communication and he says that it's standard for ambulance to have sirens on, unless transportee has been announced d-e-a-d.

I'm in Raleigh, NC. Any ideas where I could look for a back up MW? Also, would a midwife have vit k drops? If we are in hospital I was just going to do the shot, but would actually prefer drops.

As for "medical" babycare, would the MW do weights and measures on baby and then I could go to our pediatrician's office for the newborn screenings/testings?

Wow, this is really giving me lots ot think about.

Penny

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#24 of 51 Old 04-10-2009, 03:02 PM
 
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hi OP!

first off, for perspective, be THANKFUL you have short labors! many who don't are very envious!

My 2nd child was born after 1 1/2 hours, accidentally at home (we were planning to birth with a hospital based midwife practice). I was actually on the phone with my midwife when I started pushing, and after the baby came, she came to my house, delivered the placenta, checked me and the baby, etc. It was an amazing experience and i was totally on a high from it being so fast and easy!

#3 we just had in a different city, where I did decide I wanted to deliver at the hospital (homebirth midwives here are two hours away, which I couldn't risk after baby #2!). I ended up going to the hospital pretty early while my contractions were still managable, and instead of going to labor and delievery, I sat in a lobby on my birth ball reading a magazine. my labor totally stalled doing that, so we drove back home and labored there before going back (it ended up being a labor of about 5 hours total).

anyhow, if you really want to be at the hospital, I do recommend just hanging out in the parking lot or lobby until you're really ready.
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#25 of 51 Old 04-10-2009, 03:12 PM
 
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As for "medical" babycare, would the MW do weights and measures on baby and then I could go to our pediatrician's office for the newborn screenings/testings?

Wow, this is really giving me lots ot think about.

Penny
I would check out the homebirth forum here to get more information. It sounds like you could benefit from really researching homebirth some more. Having a planned homebirth just might be the thing for you.

I am pregnant with my first child, and planning a homebirth. My prenatal appointments are covered by my hb midwife, the birth will be at my house attended by my midwives (and whoever else I choose to be there), and all the immediate post-natal tests (weights, measures, apgar, birth certificate, etc) will be attended to by the midwives (on my bed, while I hold the baby - no separation). I will not see an OB or go to the hospital ever during the pregnancy and birth (unless an actual medical issue arises.) A normal birth (and the vast majority of births are perfectly normal) is a physiological process, NOT a medical event - even though most people treat it like it is a medical problem. You do not NEED to go to a hospital either to birth or immediately after for a normal birth.

Again, check out the homebirth forum here. Also, check out the movie The Business of Being Born for an amazing look at homebirth. It's available on Netflix and at Blockbuster.

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#26 of 51 Old 04-10-2009, 03:19 PM
 
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If the baby is out and breathing fine and you're in ok shape, there is almost nothing that you have to do. If you want to tie off the cord and cut if after it is done pulsing you can. But you don't have to. At some point (generally within an hour or so)you'll need to push out the placenta, so you might want a bowl for that.
You could call your mom if you wanted, of course. But you wouldn't *need* her there. Just hold the baby on your chest, cover up with blankets and at some point he should start rooting around and find your breast. If you want to you can wipe him clean, but a bath is not a requirement.
Even if I weren't planning on a homebirth, if one happened "accidentally" and both baby and I were fine and healthy there is no way I would possibly go to a hospital.
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#27 of 51 Old 04-10-2009, 03:21 PM
 
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I hate the idea of going in an ambulance with all the sirens a blazing. My DH works in emergency communication and he says that it's standard for ambulance to have sirens on, unless transportee has been announced d-e-a-d.
That's interesting. Twice I have ridden with my kids, when they were older babies (two different kids in two different states - major deja vu), in ambulances with no sirens, just driving the normal speed of traffic. Both times we were being transported from the ped's office to the hospital for oxygen (bronchiolitis).
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#28 of 51 Old 04-10-2009, 03:36 PM - Thread Starter
 
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I should clarify ... sirens are not used if it's a non-urgent transport. I have to talk with Dh again about this, as maybe I misunderstood him. It sounded like they would regard new baby as an urgent transport.

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#29 of 51 Old 04-10-2009, 03:53 PM
 
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Originally Posted by Penny4Them View Post
I should clarify ... sirens are not used if it's a non-urgent transport. I have to talk with Dh again about this, as maybe I misunderstood him. It sounded like they would regard new baby as an urgent transport.
Thanks for clarifying - that's even more interesting.
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#30 of 51 Old 04-10-2009, 04:02 PM
 
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You really don't need a lot of *stuff*, as other people have mentioned. Just lots of towels. Perhaps it would be most prudent to prepare for a few of the more common urgent/emergency situations if you have a precipitous labor and are still at home:

1) hemorrhage (esp if you're on anticoagulants): would your OB perhaps give you a Rx for a shot of Pit or oral Methergine in case this situation happens? Does your dh know how to administer an intramuscular shot? It's not too hard to learn how (my husband had to when I was doing fertility treatments--got a shot of progesterone in the butt every night for 2 weeks, so now he's a pro!)
2) neonatal resuscitation (especially how to recognize when to start resuscitation & how to do mouth-to-mouth on a newborn. Karen Strange's classes are awesome if she is ever coming to your area)

I like the idea of laboring in the hotel lobby if you do get there and have more time than anticipated!
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