Family Matters

A Baby Is Born on Train to NYC: Why Labor Is So Unpredictable

A woman delivers a baby boy on a commuter train to Manhattan. Are pregnant women not recognizing the signs of labor?

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Louis Lanzano / AP

There are home births and then there are train births. Rabita Sarkar, 31, of Harrison, N.J., experienced the latter on Monday when she unexpectedly delivered her son on a PATH commuter train to New York City.

Babies are not renowned for their patience, of course. But demanding to be born on a moving train? Or in the driveway, as my friend’s sister’s baby did on Friday? Or in the hallway of her home, where another friend ended up giving birth years ago as she tried but failed to make it to the hospital? For women like me — who can count 24 hours from first contraction to baby’s arrival — these on-the-fly scenarios are completely implausible.

Anecdotally, are such unplanned births happening more often? “Not to my knowledge,” says Dr. Juan Vargas, director of obstetrics at San Francisco General Hospital and associate professor of obstetrics and gynecology at the University of California, San Francisco.

Although home births and deliveries at birthing centers are gaining traction in many communities, hospital births remain the norm. In a recent study of deliveries in 19 states,  17% of non-hospital births in 2006 were unplanned births — the kind that take a woman by surprise in a train car or an elevator.

These crazy birth stories are everywhere, catapulted to Internet fame by their can-you-believe-it factor. In November, a woman delivered a son in a bathroom at Baltimore’s airport after disembarking from a flight. And in December, a Santa Fe nurse’s assistant, Russell LeFevre, delivered his daughter in the front seat of a truck on an icy New Mexico highway.

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Of course, just because a birth unfolds in an unusual locale doesn’t mean it’s unplanned. In October, performance artist Marni Kotak gave birth in a Brooklyn art gallery she’d outfitted as a labor and delivery suite, complete with birthing tub and bed. “…By giving birth in public, I can bring to light something that our society clearly has many issues surrounding,” wrote Kotak in an e-mail to Healthland before her son was born. “It troubles me when I hear women speak disdainfully about their own bodies, especially when it involves birth, as that is truly women’s greatest power.”

Sometimes, labor — like life — simply doesn’t go according to plan. Delivering in front of a bevy of Manhattan-bound commuters only underscores just how little we know about what triggers labor and how it progresses. Because the signs of labor can be different for every woman in every pregnancy, it can be difficult for a woman to know she’s actually begun the process of giving birth. Take Braxton Hicks contractions, for example. Essentially warm-ups for the real thing, they can start weeks before a baby is born.

“We have no reason to believe there is an epidemic of women not recognizing the signs of labor,” says Vargas. What may be happening, says Vargas, is a phenomenon in which some women don’t feel the pain of labor contractions. In other unusual situations, women who don’t realize they’re pregnant in the first place don’t identify contractions for what they are. As obesity rates rise, that scenario is likely to become more prevalent. For her part, Sarkar said she had felt pain but didn’t think she’d gone into labor because her baby wasn’t yet due.

According to the Associated Press:

“It’s just that this guy had other plans, and he came out earlier,” Sarkar said as she held her infant son in her arms in the hospital. The couple declined to reveal the boy’s name or due date.

It was on the train ride that Sarkar started feeling her pains come more quickly, and she told her husband to check what was happening to her. He looked and saw that his son’s head had already started to come out.

With guidance from another woman on the train, her husband, identified in published reports as Aditya Saurabh, was able to deliver the baby around 10 a.m. Fellow riders offered encouragement, and the couple said one little girl offered her jacket to keep the baby warm.

Although most women deliver in a hospital setting, it’s important to remember that birth is not a dangerous event, per se. “The majority  of women have normal gestations and normal births,” says Vargas. “As physicians, we need to be mindful of this. We should do our best not to intervene unless there is a valid reason or medical indication.”

MORE: Is It a Bad Idea to Run a Marathon While Pregnant?

In keeping with that mentality, Vargas notes that if you’re pregnant, there’s really no reason to freak out and fear that if your water breaks in front of your boss’ office, Junior will arrive moments later. Giving birth is generally a far more protracted process, with first-time moms taking up to 20 hours and others up to 14 hours to deliver from the moment contractions start to do their job of dilating the cervix. Chances are, you’ll make it to the hospital with plenty of time to spare. After all, the reason these airport/truck/train-en-route-to-Manhattan stories are newsworthy in the first place is precisely because they’re outliers.