You’ve done your best laboring at home as long as you were able, and now you think it’s time to transfer to your birth place of choice (assuming you haven’t opted for a home birth! – in which case, if you have, you get to skip this not-so-fun step. Lucky home birthers!).
Side note: I once had a midwife tell me - partially in jest - she thinks one of the biggest reasons a lot of women choose a home birth is precisely to avoid this car ride in labor! Home birthers, would you say there’s truth to that? Haha
Here are some tips to help your transfer go as smoothly as possible:
1. Have someone on your birth team – partner, doula, whoever is coming to watch older kiddos – load the car BEFORE you feel like you’re at the point of needing to transfer. Waiting until you’re ready to go only adds more stress to that moment. Hopefully, your labor will have progressed to the point that you’ll likely need the continuous support of your partner and/or doula before you decide to transfer, and you don’t want them leaving your side to carry bags to the car!
2. Take some towels in the car to sit on – if you’re water hasn’t broken yet, there’s a chance it could while driving and a towel will help make that moment more manageable if it happens. I’ve also heard of those reusable table cloths being recommended for the same purpose. Ya know, the ones with a plastic/vinyl side and a cottony side – the idea being the cotton side would help absorb fluids while the vinyl side would keep the car protected. If you have one of these, great! But I think towels work just as well, and most people have at least a few around that they wouldn’t mind sacrificing to birth. There’s a good chance they won’t even get fluids on them, but this is a “just in case” measure!
3. Sit in the back seat so you can stretch out and move through the contraction waves. The worst part for most women about the car ride is not being able to work with their body through the surges – this immobility amplifies the pain sensations. But if you’re able to spread out a little in the back seat, you might be able to overcome this to a degree. You might try hands and knees across the seat or turning around and draping your arms over the back of the seat; both of these are likely to be more comfortable than sitting (but of course, won’t allow for a seat belt).
4. Make sure your partner (or whoever is driving) knows how to get to the hospital – and maybe even alternate routes in case of traffic, accidents, etc. If you are working on managing your contractions in the back seat, you won’t have any desire to help the driver navigate as well.
Remember, for healthy, low-risk pregnancies, laboring at home for as long as possible is one of the best things you can do to avoid unnecessary interventions. You’ll be more comfortable relaxing and letting go into the surges of labor in the privacy of your own home; this will help labor establish prior to a location change. At home, you’ll be more likely to maintain upright and mobile body mechanics to help baby descend through your pelvis and facilitate an easier birth.
American College of Obstetricians and Gynecologists (ACOG) supports delaying admission through the latent phase of labor which is defined as cervical progress of 4-6cm (6 cm is really the new definition, but your provider might be old-school and insist on 4 cm as being active labor). Barring any medically indicated reason of extended monitoring (like pre-eclampsia, cholestasis, or fetal abnormalities), it’s in mom and baby’s best interest to labor at home as long as able! Happy laboring, friends!
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