Basic Emergency Delivery Instructions
Delivering a baby at home, unassisted, can cause fear in the most courageous heart, but really, it needn’t. Birth is a very natural process and, in most cases, not a medical emergency. Unplanned homebirth, even unplanned CAR birth, happens all the time with happy results all around.
- Calm yourself. Take deep breaths. You can do this!If you are outwardly calm the mom will be, too. Being calm will make her delivery much easier as her muscles will be relaxed and she will be working with her body rather than against it.
- Calm the mom. Tell her it will be o.k…it will! During hard labor, especially transition, it is normal for her to feel panicky, anxious, and overwhelmed. In fact seeing these emotions should alert you that birth is imminent.
- If you have time get her on a clean surface, clean towels, clean sheets, etc. Being on the floor will be better than a bed or softer surface.
- Try to get her up in a squatting position. This will shorten the birth
- Remind her to breath deeply and push when she feels like pushing. She will make loud noises and groans, maybe even scream. This is more about the work and effort involved than the pain, although it is painful.
- When you see the top of the baby’s head, this is called crowning. DO NOT TRAY TO PULL THE BABY OUT AT ANY TIME. Reassure the mom that the baby is about to be born in the next few pushes.
- As the perineum bulges gently support it with your hand to minimize tearing.
- Gently cradle the baby’s head and guide it out of the birth canal with the pushes of the mom’s body. It will usually turn to the side as it emerges.
- As soon as the baby’s head is out clear it’s nose and mouth of fluids by stroking downwards on the nose and mouth gently, or using a bulb syringe, gently.
- It is not unusual for a cord to be around a baby’s neck. If you can slip a finger between the cord and the neck try to slip
- The baby’s head will come out then the first shoulder, then the second, then the rest will slip out quickly.
- Hold the baby securely with the head at a 45 degree angle to allow the fluids to drain from the nose and mouth. The lower part of the body, including the feet should be above the head. Do not hold the baby by it’s feet though.
- DO NOT PULL OT CUT THE UMBILICAL CORD!!
- If the cord is long enough have the mom lay with the baby on her chest and cover both with a warm blanket. Keep mom and baby warm.
- If the mom is willing to nurse the baby immediately it is best that she do so. This will help the body to expel the placenta and stops bleeding by releasing oxytocin in to the body.
- Allow the placenta to be expelled on it’s own. DO not pull it out, to do so could cause severe, and life threatening, bleeding. Save it, the doctor or
- If you are awaiting the arrival of a doctor, get the mom a drink of orange juice or herbal tea and rejoice with her while you wait.
- If no doctor is able to get there, wait until the cord stops pulsing completely. There is no need to hurry. Tie it with clean thread about 4 inch from the baby, then tie it off about 4 inches away from the first tie. Cut between the two threads.
- Massage the mom’s abdomen every 15 minutes or so, to help the uterus return to size and bleeding to stop.
- Good job!
Once in a while things do go differently than planned. If this happen, STAY CALM!
- If the shoulders seem stuck- try pushing down just above the mom’s pubic hair. If this does not work try to get her in a hands and knees position. Sometimes this will help a stuck shoulder slip past the pelvic bones. Never pull on baby!
- Babies can be bluish when born. After a few breaths it will pink up. If it doesn’t breath immediately
- If the baby is not breathing do mouth to mouth gently by blowing a few breaths (gently!) into the baby’s mouth.
- If the baby is breech (butt first) allow the birth to progress as above. You might try putting a finger along the baby to push the vaginal wall away from the face during birth.
- During the birth process the perineum will bulge a lot! Someone once called my midwife in a panic because they believed that somehow the baby had moved and was coming out the mother’s anus. This won’t happen. Expect everything to look odd.