What to do if you have to deliver a baby in an emergency ?
What to do in an emergency if a woman is ready to give birth, before reaching the hospital? How do you assist her in childbirth at home? How do you help a woman deliver a baby if you have never assisted anyone during childbirth? Here is a step-by-step guide on assisting in childbirth.
Emergencies come unannounced. For instance, a woman can go into labour and be ready to deliver before she can be shifted to the hospital. There could be a 'bandh' or a curfew in your city, making it impossible to step out. She could be ready to deliver while she is being transported to the hospital. You could be in a remote area when she goes into labour. There can be different scenarios where you might be called in to help. What will you do?
Having a baby is one of the most normal biological processes. Let's face it; women have been having babies, since Eve. Right! And then there are a few communities, around the world, where women deliver babies on their own, unassisted. Incredible! However, in civilised societies, such a thing is unheard of. Doctors, nurses, midwives and healthcare professionals are always present to assist a woman during childbirth.
I am not advocating unassisted deliveries, but, one must be prepared and know how to handle an emergency delivery. The birth of a baby cannot wait until the woman reaches a hospital. It is not something that she can control. People can be faced with emergency situations and must know how to assist a woman to deliver her baby.
How to conduct an emergency delivery ?The first thing to remember is to remain calm. Do not panic and do not let fear grip you. If you are there alone, with the woman, prepare yourself to assist with the delivery. Keep in mind that birth is a normal process and is normally, not a medical emergency.
Follow these steps –
- Stay calm : Breathe deeply as this helps calm edgy nerves. This is not the time for you to become nervous. Wash and sanitize your hands. You staying calm will have a calming effect on the mother-to-be. It is important that she does not panic. For if she becomes tense, she'll not be able to relax her muscles and that would prevent her from assisting with the delivery
- Reassure the mother-to-be : Let her know that things are under control and that you are there to help her. If the woman is experiencing severe contractions at short intervals, it is an indication that the birth is imminent. The hard labor could make her scared and restless and overwhelm her. Maintain your calm; continue speaking and reassuring her in a soothing voice
- Sanitize the environment : If there is time then move the mother-to-be onto a clean surface. Use clean bedspreads, towels or whatever you can find, so there is a sterile environment available for the birth. It is advised that the delivery is assisted on the floor, rather than on the bed
- Best position for delivery : The woman can be made to lie on her back, with her legs bent at the knees or made to squat. If she is squatting, she should have something sturdy to hold on to, for support. Squatting is said to increase the oxygen supply to the uterine muscles and the baby. The position dilates the cervix quicker and eases the pain. There is also the advantage of 'gravity' assisting
- Breathing & pushing : Ask the woman to take deep breaths and push during contractions. The 'pushing' must be rightly done. She should push as though she is emptying her bowels and not push at the top of her belly. The woman will scream in pain or make grunting noises. She will also break into a sweat, but all this is more from the effort involved. However, the pain aspect must not be undermined. Of course, she is pain
- Crowning : As the labor progresses and it's time for the delivery, the baby's head becomes visible. This is called 'crowning'. The baby will soon be born. At no point in time must you attempt to pull the baby. Let the mother know that a few more pushes and the baby will be born
- Prevent tearing : The perineum will begin to bulge and tear. Prevent tearing of the area by softly supporting it with your palms
- Cradle the baby's head : As the mother bushes, the baby's head slowly emerges from the vaginal cavity. The baby's head normally turns towards one side, at this moment. Cradle it gently
- Clear the baby's nose : The amniotic fluid in the womb, can enter the baby's nasal passage. When the baby's head is visible, gently clear its nostrils and mouth of any fluids, by making gentle downward strokes
- Release the umbilical cord : It is quite common for the umbilical cord to get wound around the baby's neck. Try to gently slip the cord over the newborn's head. Leave it, if you cannot disentangle it. However, DO NOT CUT THE CORD
- Prepare to hold the baby : In a normal delivery the baby's head comes out first, followed by the shoulders. The shoulders come out one at a time. First, one shoulder comes out, followed by the next, and then the rest of the body slips out
- Hold the baby :The baby will be covered in amniotic fluid and will be slippery, so hold it carefully. Once the baby is delivered, hold the baby such that the head is at a 45° angle. This allows any amniotic fluid trapped in the mouth and the nostrils to drain out. Here is a tip, the baby's feet and the lower part of its body, should be above the head. However, THE BABY SHOULD NOT BE HELD BY ITS FEET
- The Umbilical Cord : The umbilical cord will be attached to the baby. Do not cut it or pull it
- Lay baby on mom's chest : You can now lay the new-born on the mother's chest and let her cradle it. Meanwhile, throw a blanket or thick sheet to keep the infant and the mother warm
- Help the mother nurse : If the mother is fine, encourage her to nurse the baby. Nursing the baby immediately after birth is good for the baby and it also helps the womb to expel the placenta. This, in turn, releases the hormone oxytocin into the body, and stops the bleeding, by tightening the blood vessels in the uterus
- Wait for the placenta : The body will expel the placenta on its own. Do not attempt to pull it out, as this could lead to medical complications, including life-threatening bleeding. Preserve the placenta so the doctor can examine it, to ensure that it has been expelled completely
- Tea and coffee for the new mom :The new mom can be given something to drink now. A cup of coffee or tea
- Detaching the umbilical cord : In a situation where no medical assistance is available, even after the birth, you will need to attend to the umbilical cord. The umbilical cord pulsates for 3-5 minutes. Wait until it stops pulsating. Then tie a clean twine on the cord, approximately 4" from the baby's navel. Tie the twine a second time, 4" away from the first one. Use a sterilized blade to cut the umbilical cord between the two ties
- Don't neglect the mom : Remember to massage the new mom's abdomen, every few minutes, as it helps stop the bleeding and makes the uterus to return to its original size
Things can go wrongEven though giving birth is normal and not categorized as a medical emergency, there can be instances when things go terribly wrong. So, what do you do if things do not go as planned and you encounter problems during and after the delivery?
- Stay calm : Do not panic. Stay as calm as you can, so your brain remains clear and you can think and act efficiently
- Shoulders stuck : In a scenario where the baby's head has come out, but the woman is struggling to push the rest of the baby out, she will require assistance. Gently but firmly press and push downwards just above the region where the pubic hair is. This often helps push the baby out. If this does not work then have the mother-to-be get down on her hands and knees, as in this position the baby's shoulder dislodges from where it is stuck between the pelvic bones, in the birth canal and slips out. Remember to NEVER PULL AT THE BABY
- Blue Baby : It is common for some babies to be blue at birth, but once they breathe in oxygen they soon get the flushed pink color. But, there can be occasions when a baby does not give out a loud wail and begin breathing immediately after birth. The baby might appear limp. In which case, you can gently slap the bottom of its feet. The shock would prompt the baby to let out that loud cry that announces all is well
- Baby is not breathing : What do you do if, despite everything you do, the baby does not begin to breathe. Give the baby a mouth to mouth resuscitation, by gently blowing into its mouth. Be gentle. If all goes well, the baby will begin to breathe on its own
- What to do if it's a breach baby ?: In case the baby is breech, which in medical term means the butt comes out first, instead of the head, don't panic. This is a medical emergency and great practice and skill are required to deliver a breech baby, vaginally. Medical experts suggest the 'Zavanelli manoeuvre' where the baby that begins to show, is pushed back into the vagina, so the woman can be rushed to a medical facility for an emergency caesarean delivery. It is an emergency and the woman should be rushed to a hospital promptly
- Things may look odd : Assisting in the birth of a baby is not easy, and if you are not trained at delivering babies you'll be in for a lot of surprises. The perineum tends to swell a lot during childbirth. It looks scary, but it is normal
The ProvisoThis article is only a guide, and a very basic one at that to help you handle an unexpected birth. This is not medical advice; it is just to help you handle an emergency situation. Even though childbirth is a normal thing, in today's world, nothing can replace the presence of a trained medical practitioner to assist with the birth.