Precipitous Labor & Birth Story
This week, we are celebrating the birthday of my middle child, which has us all reminiscing of his sweet, chubby little cheeks and remembering the chaos that was his birth story.
Precipitous Labor is an abnormal labor pattern, sometimes called rapid labor. Precipitous Labor is often defined as a birth that takes less than 3 hours from the onset of contractions, in contrast to the average labor time of 12 - 24 hours for a first baby and 8 -10 hours for subsequent births.
In the case of my third baby, it was 2 hours exactly start to finish. The first 45 minutes felt similar to Braxton Hicks. There was nothing remarkable about the contractions or the labor pattern. It wasn’t painful or intense at all. I was Group B Strep+ and it was my third birth, so instead of following the 5-1-1 or 4-1-1 rule, my birth plan was to go to the birth center when I thought I was in active labor. I remember getting into the car and as soon as I sat down, I felt reassured that I was actually in labor and that it wasn’t a false alarm, but I had only been in labor for 45 minutes to an hour at this point and everything was progressing normally. Everything was normal, until it wasn’t.
We were about 40 minutes from the hospital when my contractions intensified significantly. There was very little time between contractions at that point. The contractions were nearly continuous; one would end and there would be seconds before another started. I was really concerned we wouldn’t make it to the birth center in time.
Contractions in the car aren’t comfortable under any circumstance! I laid the front passenger seat all the way back at some point and I was rolling around trying to find a comfortable position. When we made it to the birth center, around 1 hour and 45 minutes after the start of contractions, I felt instantly safer in my birth space and more relaxed. Getting out of the car was the biggest relief! Being able to walk around again felt so much better than having to sit in a car without much range of motion.
We walked to our room and a nurse handed me a gown and a cup to urinate in. I tried to sit down on the toilet a couple of times and I told her I couldn’t get into that position. I remember she looked and me and said she was going to step over to the door and holler for my midwife because we were having a baby NOW. I knew we were probably in transition at this stage, but something about hearing confirmation of that, without a cervical check even, felt shocking to me because everything was moving so quickly.
At this point, I was ready to push, but I didn’t have an IV in yet and I needed Pitocin. PITOCIN WHEN YOU’RE ALREADY READY TO PUSH? Yes! One of the concerns with precipitous births is postpartum hemorrhage. Basically, your uterus was doing the absolute most and you’re at risk of it getting tired and producing less effective contractions. The contractions are needed thru the delivery of the placenta and after to clamp those blood vessels where the placenta was attached. So, if you’re identified as at-risk for postpartum hemorrhage, your provider may choose to administer Pitocin to help prevent it. Most providers will also administer it upon request, if you’re concerned about postpartum hemorrhage. Research shows it is effective in reducing rates of postpartum hemorrhage.
So, I had two nurses trying to put in an IV as fast as humanly possible while I began to push. After the first or second push, my water broke. With a couple additional pushes, he was born - just 2 hours after the onset of contractions and about 1 hour and 15 minutes after I realized I was truly in labor. He weighed 9 lbs. 9 oz. as was the largest of all my babies, with the sweetest little rolls on his arms and legs. And thankfully the delivery of the placenta and following postpartum period was totally and completely uneventful. I went on to have two more children, and despite my fears, I never had another precipitous birth. BUT I was prepared with an emergency birth kit, just in case.
We often focus on the timing of our contractions. We’re told 4-1-1 or 5-1-1. I called my birth center and left my home before 5-1-1. If I would have waited for my contractions to start following a discernible pattern, we definitely wouldn't have made it to the birth center in time. Remember, Braxton Hicks may vary - some may be painful and others may be mild. If you can’t walk and talk and live life thru them, they are probably not Braxton Hicks. If your contractions feel intense or very painful and you’re having to use coping techniques, they are probably real contractions and not Braxton Hicks.
TL;DR - Precipitous Labor, sometimes called rapid labor, lasts 3 hours or less from the onset to the birth. These births are fast and hard and will not follow a normal labor pattern. Instead of being 100% focused on waiting for the contractions to fall into a given pattern, focus on how you FEEL during them.