Too Late for the Hospital: My 37-Week Unplanned Home Birth and the Helicopter Ride to the NICU
37 Weeks: Unpacked Bag and Early Signs
It was late winter, I was 37 weeks pregnant with our second baby, and knew better, but I hadn’t packed my hospital bag. With my first baby, labor was 11 hours, and the first part was bearable, with breaks so I could function. I figured we had time for this baby, too.
My third trimester was full of practice contractions (Braxton Hicks). My rule of thumb, gleaned from multiple internet searches, was simple: If I can walk through it, it’s practice, as long as they aren’t increasing in time or intensity.
On Thursday evening, I had difficulty sitting down due to discomfort, so I stood for a while. After that, I noticed the baby’s position felt lower, and I felt a fullness or weight between my hips, so I decided her head must have engaged. Unfortunately, Friday brought a stomach bug, and I was unable to eat. A true blessing, my Mom came over for a few hours. She made lunch for my 2-year-old, helped me change the bedsheets, and insisted I rest. I started to tolerate fluids in the late afternoon.
Unplanned Home Birth Story: A Rapid Labor
Contractions Begin
On Saturday morning, around 6:45, I had a contraction I couldn’t walk through on my way back to bed. When this contraction came, I squatted on the floor where I happened to be, which was our bedroom doorway. This is it, I thought. I decided to freshen up before heading to the hospital, remembering that long labor with Timberlynn.
I relocated to the bathroom, convinced a warm bath would help me relax or, at least, confirm these were real contractions (I had used baths to slow/stop Braxtons before). Instead, I ended up on the toilet. I thought I might be getting sick again; I didn’t realize at first that it was pressure from the baby’s head making me feel like I couldn’t get up, and some nausea from the contractions making me think I might be getting sick.
Too Late for the Hospital: Water Breaks & Labor Accelerates
After about 15 minutes from that initial contraction, something didn’t feel right. I felt incredible pressure inside; it was intensely painful. I called out for Carson in a desperate tone I did not intend to use. He jumped out of bed and came running to hold my hand; God bless my man, I love him so much. My mucous plug fell out, then it felt like an internal organ was violently popped like a water balloon. This was accompanied by the rush of my water breaking so forcefully that almost none of the splash went into the toilet where I was sitting. Breathless, I told Carson, “That was for sure my water breaking!” After he made sure I was all right, he went quickly to get dressed, pack a few things, call his parents to watch Timberlynn, and get the car ready.
Meanwhile, I still felt like I couldn’t get off the toilet and wondered to myself if this was where my baby was going to be born. Carson intervened at this point and told me he was sorry, but I needed to get off the pot. I reluctantly migrated to the bathtub, because it was close and I could grip the side of the tub while squatting.
I have a hard time staying still during contractions, so I constantly rocked and swayed, seeking the position of least pain or resistance. This was usually a squat, but sometimes it was standing and swaying my hips, and sometimes on all fours (I think in yoga they call that the cat-cow). I was just focused on getting through the next minute, but later realized my body was instinctively doing active labor positions I’d read about.
Unfortunately, I also handle the hormones and pain of labor by trying not to just scream—relying on gasps of “Owwww” or “Ohhhh” and a bit of desperate complaining. During my next contraction in the bathtub, I managed to tell my husband, through gritted teeth and trying not to cry, which just made me sound whiny, that “I want an epidural, right now.”
He tried not to laugh while gently reminding me, “Well, I don’t have that here, but put this dress on and we’ll go to the hospital.” It was a grey pregnancy dress. I pulled it over my head, grateful for it being very soft with no fasteners to bother with.
He quickly asked me what hospital I wanted to try for, and I called out, “The closest one!”—knowing full well at this point we didn’t really have any other choice. (Our original plan was a bigger hospital an hour and a half away, but I was pretty sure we wouldn’t make it there.)
“We Have a Head”: Carson Catches Baby Wrangler
In between contractions, I tried to grab a thing or two to help us get out to the car faster since my hospital bag was still unpacked. I then felt baby’s head shift dramatically inside the birth canal and realized, I am having her here, now!
“The baby’s coming! The baby’s coming!” I panicked out loud. Carson told me to get on our bed, and I obeyed. I was suddenly very grateful my Mom had helped me change the sheets the day before.
Then he went to get towels for the car, still thinking that if we left right now, we might make it to the nearest hospital. Unfortunately, Timberlynn, who didn’t understand why Momma was randomly yelling, was following Poppa around like a little shadow at his heels. When Carson spun around to grab the towels, Timberlynn fell down. She was unharmed but very upset. Carson felt terrible and pleaded, “If there is any way you can comfort her, please do so. I have to finish getting the car ready.”
Since I hadn’t fully weaned Timberlynn yet, I instinctively offered the best comfort I knew: nursing. I was in between contractions, so I told her, “It’s okay, honey. I’m sorry you fell, and I’m sorry Momma’s been yelling. Would you like some momma milk?” She latched for just a few seconds, then unlatched, stepping back with a quivering lip. “It’s okay, baby girl…” I tried again, and then a contraction struck, forcing me to yell, “Ahhh!” Timberlynn looked at me like something was seriously wrong and backed away slowly. Praise God, Carson’s Uncle, who lives just down the road, arrived a few minutes later to watch her until his parents could arrive. Timberlynn loves her Uncle, so he had no problem cheering her up and distracting her.
I had to get on all fours for that next contraction, and a baby’s head slipped out. Carson came in saying he was ready to help me out of the car. “Too late, we have a head,” I told him, still on all fours, trying to figure out how to support baby’s head. Carson helped me reposition in bed to lying down and took over supporting baby.
He quickly tossed me my phone and told me to call whoever I thought we needed. I hesitated then dialed 911, reasoning that they would at least have oxygen and people who knew baby CPR if things went south. As I dialed, Carson asked me if I could push at all to get baby out a little bit further. I let him know I was in between contractions, but I gave it a try. I got her to shift a little bit, and Carson encouraged me, “We have a shoulder now, so she’s not going to get stuck.”
I put the 911 operator on speakerphone, and was greeted by his calm, “Nine-one-one, what’s your emergency?” Another strong contraction hit me about this time, and all I could do was yell our address, that I was having a baby at home, and her head was out. I almost cried, saying I didn’t know if she was breathing or not. Carson interrupted to shout, “She’s breathing good!”
The operator stayed on the line, letting us know our small town’s ambulance was dispatched and they’d arrive in a matter of minutes.
At 7:19 AM, Carson caught our beautiful baby girl, Wrangler Smith, and toweled her off. She initially cried a little, but not for very long; she seemed content just to be held. The ambulance personnel came in and helped clamp the umbilical cord. They also checked her vital signs to make sure she was fine, and they all checked out. Since she was stable, we decided we didn’t need to ride the ambulance to the hospital, but would take our own car to the hospital to get checked out.
After things had settled down a little bit, Carson’s Uncle brought Timberlynn back in to meet her new sister. “What’s that?” Timberlynn asked excitedly.
“It’s your baby sister.” I smiled at her. “You want to touch her hand?” I helped Timberlynn place her finger in her sister’s palm and smiled as Wrangler clasped her little fingers around Timberlynn’s. “That means she loves you,” I told her.
NICU Journey Begins
Oxygen Drops and Helicopter Transfer
My only concern about our new baby was that she wasn’t nursing for me. Timberlynn had nursed right away, but our new baby, Wrangler, would latch like she wanted to nurse and then spit it out like something was preventing her from actually sucking.
Carson and his Mom helped me pack for a 24-hour hospital stay, and then Carson and I drove with her to the hospital. On the way there, I called so they would be ready for our arrival. When we arrived, Carson got me a wheelchair and pushed me in while I held the baby in my lap. The reception desk was free, so one lady checked me in and built my chart while the other lady did the same for baby. It made checking in twice as fast.
When we got to the OB department, I expressed my concern about her not wanting to nurse and that she might have low blood sugar from the stomach bug I’d had. The nurses checked her vitals and blood sugar for me. Everything was normal except her temperature, which was a little low, but they said that’s common in unplanned home births.
Wrangler was placed in the warmer, hooked up to the vital sign monitors. Her temperature quickly warmed up to normal, but her oxygen levels suddenly dropped.
First Hospital Dilemma: Low Oxygen and GBS Protocol
They put her on oxygen, and the levels quickly came back up to normal. They did labs and took a chest X-ray to check for pneumonia. I had not been checked for “GBS” because my last OB appointment had been postponed due to the weather, and then my baby arrived early. So she also got started on a round of IV antibiotics. (Note: “GBS” as nurses and doctors often call it when speaking to patients, stands for Group B Strep, a bacterium that can live in the birth canal and cause infections in newborns. According to the CDC, one in four mothers has it.)
All the labs came back normal, and the X-ray didn’t show any pneumonia either. The hospital was hoping it was taking her just a little longer to learn to breathe on her own outside the womb, and tried weaning her off the oxygen. She would do great and get on room air for about 10 minutes, then her levels would suddenly drop again. This happened several times. It was like she was using all her energy to breathe on her own, and once she couldn’t keep up, she needed help with oxygen.
Since she hadn’t been able to nurse, she was given a bottle, which she drank like a champ. I assumed it was easier to have the milk poured in her mouth than to perform the hard suction required for breastfeeding. She ended up drinking two bottles.
The Cardiac Concern and Transfer Decision
They checked her oxygen levels before and after it went through her heart (pre- and post-ductal). The levels were different before and after the heart, so they wondered if it could be a cardiac issue. There was also a surprising result when they took her blood gases. According to her carbon dioxide levels, we were giving her too much oxygen. So they took her off it for a bit and then had to put her back on, and it mostly leveled off like it was supposed to.
After this, the doctor spoke with us and explained that when it came to newborn care, they were only considered a level one hospital and weren’t technically allowed to keep a baby on oxygen for as long as ours had been without planning for transfer to a higher level hospital. Wrangler giving us false hopes of weaning her off every little bit caused them to wait to see if she’d stabilize and not need transfer.
Carson and I mentioned the larger hospital an hour and a half away from our home that we had originally chosen, but they told us it didn’t have its own helicopter team anymore due to recent changes and the last time they had waited on a transfer with them it had been at least a day later, since a third party company had to do it. However, there was another hospital about 3 hours from our home that was even a higher level than our original choice and had pediatric cardiac specialists if that’s what she needed, so we agreed to the transfer to the hospital in the big city far away.
We asked if either I or Carson could fly with her, and they explained she would have a whole medical team: a doctor, a respiratory therapist, and an advanced practice nurse, as well as the helicopter pilot, so there wouldn’t be room for anyone else. Once the helicopter arrived, we got to meet the wonderful transport team and hold our baby one last time, and were encouraged to take pictures before she left. She got transported in what looked like a baby box on a stretcher.
I was sorry to see her go, knowing it would be between a few hours to several before I would see her again. I prayed God would be with her and the crew, that they would have a safe flight, wisdom for the medical personnel, the right treatment for my baby, and that she wouldn’t be too sad without her momma. I also sent a quick update to our church’s prayer chain via text.
Carson and I went back home to repack for a longer stay at the hospital in the big city. Carson’s Mom had already packed us most of what we needed and laid out clean outfits for us to choose from. I was so grateful.
Timberlynn was happy to see Momma again. I had her nurse as much as she would while Carson and his mom loaded the car. Since Wrangler had not been able to eat yet, I needed to empty my milk supply so my body would know to make more and not dry up. Then we explained to Timberlynn that her baby sister was sick and needed us, and that she would be staying with grandma and grandpa for a while, and gave her hugs.
Then we drove to Carson’s parents, that was on our way, and met Carson’s big sister, who had been to that big city more than we had, and she had agreed to drop us off at the hospital. She had prepared a bunch of snacks for the trip and the hospital stay. She joked with Carson and kept things cheerful on the way up there.
During the long drive, I occasionally received encouraging text messages from praying friends and family and answered questions to keep our prayer warriors informed. One of the ladies at our church had experienced being a NICU mom herself, and she texted me to see if she could help at all and offer her best tips. She reminded me not to forget about my milk supply, as Wrangler would need it soon, and she recommended hand expressing as much as I could in the car. I tried a little but only got a couple of drops. I figured that Timberlynn must’ve drunk enough for now. Later, I wished I had continued working on it, though.
CPAP, Donor Milk, and Increasing Supply
Finally, we got to the big hospital, which was decorated beautifully for children; it made me think of Toyland. We checked in, walked down several halls, and up an elevator. Then around a little maze of halls till we finally got to Wrangler’s room. She had a tiny CPAP, a feeding tube, and an IV on the first night. It was kinda scary to see her attached to all those tubes at first, but she looked well cared for, was sleeping peacefully, and all her vital signs were stable.
I was concerned she might’ve been crying for her momma for the hours we were separated, and seeing her so content calmed my heart. I said a silent prayer, thanking God. It was just after shift change for the nurses when we arrived. The night shift nurse answered our initial questions and encouraged us to rest. Turns out baby wasn’t on oxygen anymore, just a CPAP (Continuous positive airway pressure) machine to keep her airway open and make sure her lungs fully inflate.
The night nurse also asked about feeding. In my absence, they had used formula, but if we wanted, donor breast milk was also available, and anything I could pump would be used in Wrangler’s feeding. I tried the pump the hospital provided (with all new tubes and flanges), but found it was pretty much ineffective that first night; the few drops that came out didn’t even make it to the container. I remembered the experienced NICU mom’s texts had mentioned hand expression being more effective for the thick colostrum (the bright gold liquid milk mom’s bodies make newborns their first few days of life).
She also had mentioned that just getting a few drops at first was normal, but I had thought I was different because Timberlynn wasn’t fully weaned. I switched to hand expression and was able to express out just a few drops at a time, carefully catching them in a container. That first night, I got a grand total of 11 mLs (tsp=5mL). I was a little disappointed that I didn’t have more, but I was assured by the nurses that was normal. Carson and I agreed to supplement with the donor milk till my milk could fully supply her needs.
I stubbornly continued to try to pump more out, but got none. Until my husband stopped me. He reminded me it was late, I had given birth and gone through an emotional roller coaster with only a short nap (when we were awaiting tests at the first hospital), and stress can affect milk supply. He told me the best thing I could do for my supply was to get a good night’s rest and try again tomorrow.
The Intensive NICU Pumping Routine
The next day, we got to meet Nurse “Bri,” she was the one who admitted Wrangler and was her nurse again for Carson’s and my first day up there. She was amazing! She answered literally hundreds of questions for us and filled me in on how my baby did with her the day before.
That first morning, Sunday, in the big city hospital, Wrangler was able to get off the CPAP and maintain her own oxygen levels. She also started nursing, with supplemental bottle feedings. That first 15-minute nursing session, Wrangler had a good latch, good suck, and good swallows, and it was so encouraging! Nurse Bri advocated for us when our baby was feeding well with a bottle to get her off the feeding tubes that first day, rather than later.
On Monday, we had Nurse “Gaby”. My breastmilk supply was just starting to increase, but we were still having to use some donor milk. Gaby helped us set new care goals and explained what needed to be done before we could take Wrangler home. She helped us with coordinating times for needed referrals: lactation consultant, occupational therapy, etc, encouraged me in my breastfeeding and pumping efforts, and also made sure that my husband got some rest. She was phenomenal, and I believe that because of her initiative, she shortened our stay by a few days.
The method we followed to increase my supply was intense. First, I would nurse Wrangler as much as she would take. Then I would pump for 10 to 20 minutes, depending on whether anything was coming out after the initial 10 minutes. After pumping, I hand-expressed whatever was left. Meanwhile, Carson offered Wrangler a bottle directly after nursing to make sure she was getting her volume. The whole NICU stay, she was kinda lazy while breastfeeding, but she chugged her bottles, which was fine because the hospital liked being able to measure her intake.
Monday morning was the last time we had to use any donor milk because I was pumping and hand expressing enough to cover her bottles. Monday afternoon, pumping became so efficient that there was hardly any left for hand expression. I dropped my hand-expression entirely at this point. By Tuesday, I had gotten to the point where I was pumping enough colostrum for more than one of her feeds at every single session. She’d been taking 20 mL in the bottle, and I achieved my highest volume yet, 82mL over a 20-minute pump session. It was definitely still colostrum (bright yellow), but the doctor seemed to care more about volume than my milk transitioning to mature milk. The lactation consultant thought that once my milk transitioned over, though, Wrangler would have increased interest in breastfeeding.
Homecoming
We found out we needed our car seat to check out because Wrangler had been admitted with difficulty breathing. She had to do a 2-hour car seat test to make sure she could breathe safely unassisted on the way home and at home. Unfortunately, we had left Wrangler’s car seat in Carson’s sister’s car because she planned on picking us up. We only thought the hospital needed to check that it fit and was fastened correctly. So Carson called his sister when they were sure it was our last day, and she brought the car seat for the test, which Wrangler passed.
We checked out of the NICU on Tuesday evening, and because it was late and there was some snow expected, we stayed at Carson’s sister’s house overnight. It was wonderful to rest outside the hospital. Wrangler kept me up most of that first night, though, because she wanted to nurse. I didn’t realize it until the morning, but my milk was transitioning. While she nursed, I worked on a hospital bag checklist of everything we were glad we had or wished we had from delivery to NICU stay (You can read it here.)
I noticed my baby’s big blue eyes would stay open and look around now. At the hospital, I only saw her eyes a few times, and whenever I did, she would only open her eyes a little bit and do a sideways peek. I realized sadly that she had withdrawn into herself during the NICU stay because things were uncomfortable, the constant vital sign monitoring, machines beeping, the IV, the labs that had to be drawn, all the different people handling her, therapists, nurses, doctors. It was just too much, so she got shy and shut everyone and everything out by keeping her eyes closed.
Finally, we made it to Carson’s parents on Wednesday and were reunited with our sweet oldest daughter. She was so excited to see Mom and Dad and just as excited to meet her little sister. We had our first family photo taken by Carson’s Mom. We visited a bit and then started loading up the car to go home.
The hardest moment hit when I buckled her into the car to drive home. She gave me a huge, brave smile and waved, “Bye, Mommy!” When I replied, “Sweetheart, I’m not leaving! I’m coming home with you!” she immediately burst into tears, realizing her long separation from me and her Poppa was finally over. I held her hand all the way home.
When we got home, we were surprised because our house had been cleaned by Carson’s mom, and decorated by my little sister and some girls from church who are also our neighbors. It was so good to finally be all together at home!
Lessons Learned: Planning for the Unexpected
What I plan to do differently if we have another baby:
- Pack my hospital bag as soon as I have a positive pregnancy test. I can swap things out as needed throughout my pregnancy, but I want a bag ready to go at all times, just in case. I wrote myself a hospital bag checklist on the way home so I wouldn’t forget anything next time, you can get it here.
- Order or put together two home birth kits, keeping one in the house and one in the car, just in case. (Maybe I will keep my hospital bag in the car too…I’ll have to think about that.)
- Find noisy birth videos to watch with older siblings. In the last couple of weeks before having Wrangler, Timberlynn and I watched siblings meeting their baby sister or brother for the first time on YouTube, and even watched a birth or two. I think it really helped, but next time I will try to find some videos of women who yell a little like me, so if I do go into labor around my kids again, we can talk about mommas needing to yell a little ahead of time.
