Birth before arrival at delivery suite: Associations and consequences

The objective of this cohort study was to identify factors associated with birth before arrival (BBA) at the delivery suite in women planning a hospital birth. The secondary objective was to determine the initial consequences of this event for women and their babies. The study involved 124 women experiencing a BBA in a five year period, together with one general cohort and one parity matched cohort of women who gave birth on delivery suite as planned. We found that BBA was associated with multiparity and a previous short second stage of labour. Labour culminating in BBA was attended by less pain, less frequent contractions and later spontaneous rupture of the membranes than other labours. Maternal consequences included prolonged third stage, haemorrhage and blood transfusion. Neonatal consequences were limited to a failure to maintain body temperature. In conclusion, BBA is likely to remain common in modern obstetric practice but its consequences may be reduced by the promotion of skin-to-skin contact after birth and by training ambulance crews in third stage management techniques.