Emergency child birth

You’ve probably seen at least one television show where one of the characters is about to give birth. This is usually portrayed with comedic panic. The characters are put into this situation when they are least prepared. Perhaps you have seen this first-hand in real life. While the possibility of having to assist in an emergency child birth is rare, it could happen. Child birth is a natural process and there are still many countries where babies are not delivered in hospitals. Most deliveries are normal. Knowing what to do before the imminent can make the process less hectic and an exciting event, joyous.

When a woman is in labor, there are some factors that need to be considered in order to decide if there is time to get her to the hospital. Is this the first child or has the mother had other children? Labor is generally slower during the first pregnancy. How far apart are the contractions? A rule of thumb is that if the contractions are 5 minutes apart or longer, there usually is time to go to the hospital. If the contractions are 2 minutes or less apart (especially if the mother has had other pregnancies), the baby is coming soon. Has the mother's water broken (Amniotic Sac ruptured) and if it has, how long ago. If it ruptured several hours prior, the delivery may be more difficult and there is an increased risk of infection. If the mother feels the urge to move her bowels, this is a sign that the delivery is imminent. The baby’s head in the mother’s vagina presses against the rectum, causing the sensation of needing to have a bowel movement. Also, determine whether there is crowning. Do this by examining the mother to see if any part of the baby that comes out first (usually the head) is visible.

Position the mother on her back and place a folded sheet, blanket, or whatever else may be available under her buttocks. Have her bend her knees and spread her thighs apart. Cleanse your hands as thoroughly as possible. If gloves are available, use them! Encourage the mother to relax and concentrate on her breathing. Advise her to take slow deep breaths though her mouth. When having contractions, the mother will want to push. While she is pushing, watch for the baby’s head to start to emerge from the vagina. When it starts to emerge, support the head gently to prevent an "explosive" delivery (the baby comes out too fast). Never pull on the baby. If there is any membrane covering the head after it emerges, tear it with your fingers. This lets the amniotic fluid escape and also enables the baby to breathe.

Make sure the umbilical cord is not wrapped around the baby’s neck. If it is, you will need to try to slip it gently over the baby’s shoulder and head. If this doesn’t work, securely tie or clamp the cord 2 inches apart. Use whatever to do this but find the cleanest items available. Shoelaces or similar items can me used to make do. After the cord is clamped or tied, cut it between the clamps or ties. A small amount of blood may be seen. After cutting, check to make sure there is no bleeding from either side. If there is, you will have to tie or clamp it again on whatever side is bleeding.

After the head is delivered, the shoulders will be next. You may need to gently assist the baby as the shoulders are delivered. Gently guide the baby’s head downward to help the upper shoulder deliver. Then guide the head upward to help the lower shoulder deliver. Once the shoulders are delivered the rest of the baby is going to come out rather quickly. The baby is going to be extremely slippery, kind of like holding onto a bar of wet soap in the shower. When the baby is fully delivered, hold it along your arm like a football. Make sure you hold the baby’s arm and shoulder between your fingers. Use your other hand to support the baby’s head and neck. You want to have the baby’s head somewhat lower than the rest of its body. This will help to aid drainage of fluids. Wipe away any blood, mucus, or other slime from the baby’s nose and mouth. Use the cleanest items available. The baby’s nostrils and mouth also need to be suctioned. If you are lucky enough to have a bulb syringe, use this. Squeeze the air out of the syringe prior to inserting the tip into the nose or mouth. Release the bulb slowly to suction. Expel the contents of the bulb into a garbage can or other container. Repeat the suctioning as needed. Other items may need to be substituted for the bulb syringe. A good substitute is a turkey baser or similar type item.

The baby should already be breathing and hopefully crying. If not, it needs to be stimulated. Contrary to what is often done in the movies, don’t hang the baby upside-down and slap it on the behind. Stimulate by rubbing the baby’s back or slapping the soles of its feet. If this doesn’t work, you will need to breathe for the baby. Babies lungs are small, so keep in mind that you will want to give small puffs. Place your mouth over the baby’s nose and mouth creating a tight seal. Give small puffs while watching for the baby’s chest to rise. Follow current CPR guidelines as to the number of breaths per minute, etc. Hopefully the baby will begin to breathe on his own. The skin color should become pinker. If the baby doesn’t breathe on his own or has no pulses, start CPR according to the current CPR guidelines. Hopefully, if this happens, 911 will be on the way so the baby can be treated by Paramedics.

If you had a normal delivery and the baby is doing fine, now is the time the umbilical cord is normally cut. Be sure to wait until the baby is breathing and the cord pulse has stopped. This should take between 5 and 10 minutes. Again use two ties or clamps placed 2 inches apart. Place the first tie or clamp approximately 8 inches from the baby’s belly. Place the second tie or clamp 2 inches from the first (away from the baby) and cut the cord. Check both ends for bleeding. If one is bleeding, clamp or tie again and reexamine to ensure the bleeding has stopped. Wrap the baby in a clean blanket, towel, or similar item. The baby needs to be kept warm. You can either lay the baby on the mother’s abdomen or chest.

The placenta will be delivered next. This takes up to 20 minutes after the baby is born. As the placenta separates from the wall of the uterus, there may be some bleeding. If this occurs massage the uterus or have the mother nurse the baby. This will stimulate the uterus to contract and slow or stop the bleeding. Never pull on the umbilical cord to attempt the placenta to deliver faster as this could cause serious damage or bleeding. Once the placenta is delivered, put it into a container or plastic bag. The placenta will need to go to the hospital with mother and baby to be examined by the doctor. If any pieces of the placenta are retained, this could cause serious or persistent bleeding. Examine the area between the mother's anus and vagina for any tears. If there are tears and there is bleeding, apply pressure with a sanitary pad. Place another pad over the vaginal opening and either take the mother to the hospital or wait for Emergency Services to arrive. If the placenta has not delivered with 15 minutes of the delivery, go to the hospital without any further delay.

Some complications of emergency child birth can be life-threatening to mother, baby, or both. Hopefully, in any of these situations, Emergency Services will be on the way. Paramedics receive special training to deal with these situations. Some of the abnormal deliveries can only be treated surgically. There are some steps that can be taken prior to getting to the hospital or before Emergency Services arrive that can buy some time.

If you are assisting in a delivery and the baby present with his buttocks first, continue the delivery as if normal, supporting the baby as it comes out. If the baby’s head is not delivered within three minutes action needs to taken to keep the baby from suffocating. Don’t attempt to pull or jerk the baby out. Place your hand in the vagina with your palm towards the baby’s face. Form a V with your fingers on either side of the baby’s nose while pushing the vaginal wall away from the babies face. Do this until the head is delivered. If the baby is not delivered within three minutes, go quickly, but safely, to the nearest hospital if Emergency Services is not available. Keep the mother’s buttocks elevated and if possible with the mother in the knee-chest position. Keep your hand in the V position the entire way to help ensure the baby’s airway.

Another abnormal delivery is a prolapsed umbilical cord. This is when the cord comes out before the baby. The baby is in great danger of suffocating because its head compresses the cord against the birth canal, cutting off its blood supply from the placenta. Place the mother in the knee-chest position and place your hand in the vagina. Locate the baby’s head and gently push it up the vagina several inches to keep the cord from being compressed. If Emergency Services is not available, get to the nearest hospital while maintaining pressure on the baby’s head.

If you see an arm or a leg presenting, there is nothing you can do. Either wait for Emergency Services or go to the nearest hospital if Emergency Services is unavailable. Multiple births should be handled as single births, but the cord of the first should be tied but not cut again only after waiting five to ten minutes.. After both are delivered, tie and cut the cords as normal. If the second baby isn’t delivered within ten minutes and Emergency Services is unavailable, go to the nearest hospital.

This information is not intended to encourage people not to seek professional help in child birth. It is intended to help gain basic knowledge in the case of emergency child birth. Knowing the basics can make a stressful situation a little less so. If Emergency Services is available, by all means utilize them. Use common sense and try to remain calm until either help is on the way or the baby is successfully delivered.