The delivery of a baby is best accomplished with the help of an experienced midwife or obstetrician, but those professionals will be hard to find in a collapse situation.If there is no chance of accessing modern medical care, it will be up to you to perform the delivery.
The following is a simplified explanation of the procedure, and is in no way meant to cover all of the issues that may be involved in birthing. Seek professional care if it is available.
As the woman approaches her due date, several things will happen.The fetus will begin to “drop”, assuming a position low in the pelvis.The patient’s abdomen may look different, or the top of the uterus (the “fundus”) may appear lower.As the neck of the uterus (the cervix) relaxes, the patient may notice a mucus-like discharge, sometimes with a bloody component.This is referred to as the “bloody show” and is usually a sign that things will be happening soon.If you examine your patient vaginally by gently inserting 2 fingers of a gloved hand, you’ll notice the cervix is firm like your nose when it is not ripe, and soft like your lips when the due date is approaching.
Going into Labor: What You Should Know
Contractions will start becoming more frequent.To identify a contraction, feel the skin on the soft area of your cheek, then touch your forehead.A contraction will feel like your forehead.False labor, or Braxton-Hicks contractions, will be irregular and will go away with bed rest, especially on the left side, and hydration.If contractions are coming faster and more furious even with bed rest and hydration, it may just be time to have a baby!A gush of watery fluid from the vagina will often signify “breaking the water”, and is also a sign of impending labor and delivery.The timing will be highly variable.
To get ready for delivery, wash your hands and then put gloves on. Then set up clean sheets so that there will be the least contamination possible.Tuck a sheet under the mother’s buttocks and spread it on your lap so that the baby, which comes out very slippery, will land onto the sheet instead of landing on the floor if you lose your grip on it.Place a towel on the mother’s belly; this is where the baby will go once it is delivered.It will be very important to dry the baby and wrap it in the towel, as newborns lose heat very quickly.Newborns are also susceptible to infection, so avoid touching anything but mother and baby if you can.
Labor is usually longer in those who are having their first baby, and faster in women who have had several. As the labor progresses, the baby’s head will move down the birth canal and the vagina will begin to bulge.When the baby’s head begins to become visible, it is called “crowning”.If the water has not yet broken (which can happen even at this late stage), it will appear as a slick gray surface.Some pressure on the membrane will rupture it, which is okay at this point.It will help the process along.
To make space, place two gloved fingers in the vagina by the perineum.This is the area between the vagina and anus.Using gentle pressure, move your fingers from side to side.This will stretch the area somewhat to give the baby a little more room to come out.With each contraction, the baby’s head will come out a little more.Don’t be concerned if it goes back in a little after the contraction.It will make steady progress and more and more of the head will become visible.Encourage the mother to help by taking a deep breath with each contraction and then pushing while slowly exhaling.
As the baby’s head emerges, it will turn to the side.The cord might be wrapped around its neck.Gently slip the cord over the baby’s head. In cases where the cord is very tight and is preventing delivery, you may have to doubly clamp it and cut between. Gently holding each side of the baby’s head and applying gentle traction straight down will help the top shoulder out of the birth canal.Occasionally, steady gentle pressure on the top of the uterus during a contraction may be required to help an exhausted mother.Once the shoulders are out, the baby will deliver with a push.Mom can rest.
Put the baby immediately on the mother’s belly and clean out its nose and mouth with a bulb syringe.It will usually begin crying, which is a good sign that it is a vigorous infant.Spanking the baby’s bottom to get it to cry is rarely needed, and is more of a cliché than anything else.A better way is to rub the baby’s back; this action will stimulate a baby to cry.
Dry the baby and wrap it up! Clamp the cord twice with Kelly or Umbilical clamps, and cut in between with a scissors. Delivery kits are available online with everything you need, including a bulb syringe.
Once the baby has delivered, it’s the placenta’s turn. Be patient, the placenta will deliver in a few minutes in most cases.Pulling on the umbilical cord to force the placenta out is usually a bad idea.You can ask the mother to give a push when it’s clear the placenta is almost out.Expect some bleeding.
The uterus (now around the level of the belly button) contracts to control bleeding naturally.In a long labor, the uterus may be lax after delivery.Gentle massage of the top of the uterus will get it firm again and thus limit blood loss.
Place the baby on the mother’s breast soon after delivery.This will begin the secretion of “colostrum”, a clear yellow liquid rich in substances that will increase the baby’s resistance to infection.Suckling also causes the uterus to contract, again, a factor in decreasing blood loss.
The above assumes that all proceeds normally during the labor and delivery. Don’t consider doing this by yourself if there is a midwife or doctor available that can recognize problems and has experience with the procedure. Having knowledge of the birthing process, however, is helpful for the prospective mother and father even in good times. Don’t ignore the opportunity to learn more.