Emergency Planning During Pregnancy

Pregnancy creates specific medical and physical circumstances that change emergency planning requirements at every stage. The plan that works for a non-pregnant adult does not account for nutritional demands, obstetric care needs, mobility changes in late pregnancy, or the possibility of emergency labour during a crisis event.

Planning should begin in the first trimester and be updated as pregnancy progresses. By 36 weeks, all plans should be final, confirmed, and known to all relevant people.

Medical Documentation — The Core of Pregnancy Preparedness

The most critical preparation is ensuring your medical documentation is accessible, current, and protected.

What to Carry or Have Available

Document	Why Critical
Antenatal notes / maternity records	Obstetric history; current pregnancy status; risk factors; due date
Hospital registration details	Which hospital; consultant name; booking reference
Blood type and antibody status	Critical for emergency obstetric care
Current medications	Prescribed vitamins, iron, insulin, anticoagulants, or other
Allergies	Drug allergies — essential for emergency care
Obstetric history	Previous pregnancies, births, complications
Group B Streptococcus (GBS) status	If known; affects birth management
High-risk indicators	Pre-eclampsia, gestational diabetes, placenta praevia, etc.
Community midwife contact	Direct line if available
Obstetric consultant contact	For high-risk pregnancies

Keep these in a waterproof pouch in the go-bag. Antenatal notes are typically provided as a physical booklet — keep them accessible, not buried in a drawer.

Trimester-Specific Planning

First Trimester (Weeks 1–12)

Physical limitations are usually minimal. The main considerations:

• Nausea and food access — maintain access to tolerable foods; include safe crackers, plain biscuits, or preferred foods in emergency food supply
• Prenatal vitamins — in the go-bag medication supply
• Early pregnancy risk — miscarriage is more common in the first trimester; access to emergency obstetric care should be confirmed for any evacuation destination
• Medical confidentiality — pregnancy may not yet be known to all household members; decide who needs to know for planning purposes

Second Trimester (Weeks 13–26)

Generally the most physically comfortable period. Planning focus:

• Complete all documentation while energy and mobility are good
• Confirm hospital plan — what to do if you are not near your registered hospital
• Vehicle comfort for evacuation — long vehicle journeys become uncomfortable; plan breaks
• Register at a second hospital near any known evacuation destination if possible

Third Trimester (Weeks 27–40+)

Physical and logistical complexity increases significantly:

Week	Key Planning Milestone
28	Hospital bag prepared; go-bag updated with birth supplies
32	Evacuation route to nearest maternity unit from each planned evacuation destination confirmed
36	All plans finalised; everyone knows the plan
37+	Term; could go into labour at any time; plans must be immediately actionable

Evacuation Considerations in Late Pregnancy

Mobility

From approximately 32–34 weeks:

• Walking pace is significantly reduced
• Balance is affected — rough terrain is more hazardous
• On-foot evacuation distances must be reduced accordingly
• Stairs become more difficult — this affects multi-storey building evacuation planning

For late pregnancy (36+ weeks), on-foot evacuation should be treated as a last resort. Vehicle evacuation should be the primary plan; accessible transport as the backup.

Vehicle Position

In vehicle evacuations, second trimester and beyond:

• Front passenger seat is safer than rear (airbag risk is managed by seat position, not elimination)
• Seatbelt position: lap belt below the bump (across the pelvis), shoulder belt across the chest between the breasts — not across the bump
• Regular stops for circulation and comfort
• Know the location of the nearest maternity unit along the evacuation route

⚠️ The seatbelt must always be worn during vehicle evacuation, regardless of discomfort. An unrestrained pregnant occupant is at significantly higher risk of serious injury in a collision than a restrained one. The correct seatbelt position — lap belt below the bump — reduces the risk to both mother and baby.

Nutrition and Hydration

Pregnancy increases caloric and nutritional requirements:

Nutrient	Requirement in Emergency
Calories	Additional 200–300 kcal/day in second and third trimester
Folate/folic acid	Continue supplement if in first trimester
Iron	Continue supplement; iron-rich foods where possible
Calcium	Include calcium sources if diet is restricted
Hydration	At minimum 2L/day; more in heat or physical exertion

Emergency food stores must include sufficient quantity for the additional caloric needs. Standard emergency rations calculated per adult will be insufficient.

Stress and Blood Pressure

Pre-eclampsia and gestational hypertension require monitoring:

• Know your normal blood pressure readings — ask your midwife for your baseline readings so you can identify elevated pressure
• Emergency warning signs (seek obstetric help immediately): severe headache, vision changes, pain below ribs on the right side, sudden severe swelling
• Stress can elevate blood pressure — in emergency situations, rest when possible; avoid sustained physical exertion without breaks
• If blood pressure medication is prescribed: this must be in the go-bag; do not omit

Emergency Labour — Basic Preparation

If standard maternity care is inaccessible during a crisis, know the basics:

Know When Labour Has Begun

Sign	What It Means
Regular contractions (less than 10 min apart, increasing)	Active labour beginning
Waters breaking	Membrane rupture; contact maternity services immediately
Bloody show (pink/red mucus)	Cervical changes; labour may be near
Strong pressure in pelvis	Late labour

If Emergency Services Are Unreachable

1. Call 999/911 — even in crisis, attempt to reach emergency services for guidance
2. Find trained help — paramedic, nurse, doctor, or midwife in the area
3. Prepare a clean, warm space — clean surfaces; clean towels; warmth for the baby
4. Do not rush the birth — allow the body to work; pushing before full dilation is harmful
5. Cord cutting is not immediately necessary — the baby can remain on the cord for several minutes safely; wait for help if possible
6. Warmth first — immediately dry and warm the newborn; prevent heat loss (dry immediately; cover head)

Emergency birth instructions are not a substitute for professional care. The goal of this preparation is to reduce panic, not to plan for unassisted birth.

Go-Bag Items for Pregnancy

Item	Why
Antenatal notes	Medical history for any provider
Prenatal vitamins	Continue throughout
Blood pressure medication (if prescribed)	Must not be missed
Other prescribed medications	Full 7-day supply
Clean towels and pads	Birth preparation if needed
Newborn hat and bodysuit	Thermal regulation for newborn
Maternity pads	Post-birth and in late pregnancy
Comfortable, loose clothing	Third-trimester comfort
Snacks for nausea	First trimester
Water (extra — at least 2L additional)	Hydration needs are higher
Hospital contact numbers	In writing; not only in phone

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Quick Reference

Trimester	Key Preparation
First	Documentation; vitamins in go-bag; early pregnancy obstetric access confirmed
Second	Hospital plan complete; evacuation route confirmed; second registration near destination
Third (32–36 weeks)	Hospital bag ready; all plans confirmed; maternity unit at destination known
Term (37+ weeks)	All plans immediately actionable; everyone knows the plan
All	Seatbelt: lap belt below bump; shoulder belt across chest
Pre-eclampsia watch	Know your baseline BP; warning signs: headache, vision changes, right-sided pain, sudden swelling
Emergency labour	Call emergency services first; clean warm space; dry and cover newborn immediately