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Precipitous birth not occurring on a labor and delivery unit

Vanessa A Barss, MD, FACOG
Section Editors
Susan M Ramin, MD
Robert S Hockberger, MD, FACEP
Deputy Editor
Kristen Eckler, MD, FACOG


The term precipitate or precipitous labor has been defined as a labor that lasts no more than three hours from onset of regular contractions to delivery. Each year, hundreds of deliveries in the United States occur precipitously in emergency departments and medical and surgical hospital rooms, as well as outside of the hospital setting in homes and cars. In most of these cases, labor and delivery results in good outcomes in the absence of physician/midwife intervention or a traditional delivery site. This topic will review the key points for assisting women during an imminent delivery of a fetus in cephalic presentation. It is intended for healthcare providers who do not perform obstetrical deliveries as part of their usual practice.


The birth process is illustrated in the diagrams (figure 1 and figure 2) and photographs (picture 1A-F).

Several videos that show how to deliver a baby are available online. Clinicians who may find themselves in this situation may want to periodically review one of these films (eg, www.operationalmedicine.org/ed2/Video/delivery_of_a_baby_video.htm).


Call for help. There are two patients in an obstetrical delivery, the mother and the infant; each should have at least one healthcare provider. An obstetrician and pediatrician or family practitioners should be summoned, if available.

Ask the woman her gravidity and parity. Find out if she has any obstetrical or medical problems, such as twin gestation, preterm fetus, previous cesarean delivery, fetal anomalies, maternal bleeding diathesis or other medical conditions that may complicate delivery or immediate newborn care. Also ask if she has a headache, scotomata, or epigastric pain, which are signs of preeclampsia. Lastly, find out if and when her "bag of waters" ruptured.


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Literature review current through: Sep 2016. | This topic last updated: Sep 17, 2015.
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