How common is it to give birth before you even get to the hospital?

It's highly unlikely that you'll find yourself unexpectedly giving birth at home or in the backseat of a taxi – particularly if it's your first baby – but it can happen. If you've had no labor symptoms or only intermittent contractions and suddenly feel an overwhelming urge to push, it may signal that your baby is about to arrive.

If you've had a previous labor that was fast and furious, it's important to be especially attuned to the signs of labor. Be prepared to make a mad dash for the hospital or birth center, because subsequent labors can go even faster.

But if it feels like you're not going to make it and you find yourself at home (or elsewhere!) with contractions coming fast and strong or a sudden overwhelming urge to push, the following steps can guide you while you wait for the emergency team to arrive.

What should I do first?

Call 911. Tell the dispatcher that your baby is coming and that you need an emergency medical squad immediately.

Unlock your door so the medical crew can open it. You may not be in a position to get to the door later.

If your partner isn't there with you, call a neighbor or nearby friend.

Call your doctor or midwife. She'll stay on the phone to guide you until help arrives.

Grab towels, sheets, or blankets. Put one underneath you and keep the rest nearby so you can cover yourself and your baby immediately after birth. (If help doesn't arrive in time and you forget this step, you can use your clothes instead.)

Take off your pants and underwear.

Lie down or sit propped up. If you deliver standing up, your baby could fall and suffer a serious injury.

If you feel an overwhelming urge to push, try to put it off by panting or using breathing techniques.

What should I do if my baby arrives before help does?

While you're waiting for medical help, try to get your baby to nurse – but only if you can keep the umbilical cord slack, not taut (sometimes, if the placenta is still inside you, the cord won't be long enough to allow you to bring your baby to your breast).

If your baby doesn't breathe spontaneously at birth, stimulate him by firmly rubbing up and down his back. If your baby still doesn't start breathing, lay him on his back and rub his chest or tap the bottoms of his feet. If he still doesn't breathe, give him mouth-to- mouth resuscitation.

Try to stay calm. Babies that arrive quickly usually deliver with ease.

Do your best to guide the baby out as gently as possible.

If the umbilical cord is around your baby's neck, either ease it over his head slowly or loosen it enough to form a loop so that the rest of his body can slip through. When he's fully out, don't pull the cord, and don't try to tie off or cut the cord. Leave it attached to your baby until help arrives.

Stay where you are until you deliver the placenta, which should arrive shortly.

Rest your baby on your tummy, skin to skin, and warm him with your body heat. Cover yourself and your baby with a dry blanket.

Ideally, keep your baby's head lower than his feet until he starts breathing.

If your baby doesn't breathe spontaneously at birth, stimulate him by firmly rubbing up and down his back. If your baby still doesn't start breathing, lay him on his back and rub his chest or tap the bottoms of his feet. If he still doesn't breathe, give him mouth-to- mouth resuscitation.

While you're waiting for medical help, try to get your baby to nurse – but only if you can keep the umbilical cord slack, not taut (sometimes, if the placenta is still inside you, the cord won't be long enough to allow you to bring your baby to your breast).

Besides offering him comfort and security – and giving you a chance to see him close up – his suckling will prompt your body to release more oxytocin, the hormone that stimulates contractions, which will help the placenta separate and be delivered.

What about delivering the placenta?

You'll likely feel contractions and pelvic pressure, but it's usually much milder than what you feel during the delivery of a baby. Sometimes the placenta delivers on its own, and other times it doesn't. Do not pull on the cord to deliver the placenta. It's okay if the placenta remains in your uterus until medical help arrives.

If the placenta does deliver, leave it attached to the cord, too — medical personnel will take care of it. Nursing after the placenta comes out can help your uterus continue to contract – and a well-contracted uterus is necessary to keep bleeding in check. If your baby won't nurse right away, manually stimulating your nipples will help release the oxytocin.

After you deliver the placenta, firmly massage your uterus by vigorously rubbing your belly right below your navel. This will help your uterus contract and remain contracted.