If you are expecting a baby, you should plan for his arrival. Your doctor or midwife will calculate your due date and the baby could arrive a few days before or after the date. This is why you should be fully prepared with all your shopping completed by your last month of pregnancy, and remain close to a hospital where the baby will be born around the due date. In rare instances, labour pains could start when least expected and progress quickly when you are far from hospital. If this happens, you will need to remain calm bearing in mind that giving birth is a natural phenomenon and many women give birth at home with assistance of relatives or birth attendants, and in case of real emergencies without any assistance at all.
Sudden births come with fast progressing stages of labour and are usually straightforward, so the main consideration should be your safety and that of the baby. If it appears delivery will not wait until you get to a hospital, call a midwife or doctor to attend to you at home, if this is possible. If it is not, call a neighbour, relative or friend to come to your house. It’s better to have your baby born at home than on the road as you try to reach a hospital. Get assistance from the most appropriate person around you at the time it happens – it could be your husband, your sister, your mother or even your house help. The information in this article is meant to help those who may be called upon to assist in an emergency delivery.
HANDLING AN EMERGENCY BIRTH
When a woman is about to give birth and it’s difficult to reach a hospital in time and you are the only person who can assist her, call a health practitioner or midwife if she has not done so already. In the meantime, sit the expectant woman on the f loor cushioned with towels, bed sheets or clean pieces of cloth. The birth of a baby should be celebrated if you prepare in advance, and even when it happens unexpectedly in an emergency birth you shouldn’t panic, as chances are the baby will be safely born. Help her to remove her underwear and ensure she keeps her legs wide apart. It would be reassuring to talk to her and keep her calm. Also, encourage her to listen to her body and act accordingly without panicking.
Gather clean towels and bed sheets and blanket close to you and ensure you have some warm clean water in a basin. You will need these to clean up the woman and the baby once born and also to keep them warm. Wash your hands thoroughly with soap and water before handling the woman. If you can find a clean blade or pair of scissors keep them at hand and if you have someone else who can assist you, ask them to sterilise these implements in boiling water. Also get some thread. You may need to use these to cut the umbilical cord and tie it if you cannot get the mother quickly to hospital after she has delivered.
If the woman has an overwhelming urge to push, encourage her to do so gently. Try to get her to breath in and out, or pant lightly, so that the baby’s head is born as slowly and gently as possible. Ensure she doesn’t hold her legs together as this may delay delivery and cause the baby to suffer brain damage. Massage her back gently to ease the pain. Ensure you do not leave her unattended for any length of time. Also ensure you are at a position where you have full view of the woman’s vagina, as you will need to be in control of the baby’s birth, especially the head.
When the baby’s head lodges into the vagina, the woman will feel a lot of pain due to the stretching so continue reassuring her that it will soon be over. Once you see the baby’s head coming out, be prepared to hold it and guide it slowly through the vagina. Once the head is out, the rest of the body comes out quickly. Ensure the umbilical cord is not around the baby’s neck as it could strangle the baby. The umbilical cord stretches and can be lifted over the head if there is need to do so. Ask the mother to hold the pushing while you manipulate the umbilical cord if you have to.
Once the baby is born, lift him and hold him upside down to encourage mucous to drain out of the nose and mouth. The baby will give a cry and this is a good sign that his lungs are functioning well. Some babies are born with a lot of mucus in the mouth and you should lay such a baby face downwards for the mucus to drain. If it does not drain you can remove the mucous gently with a clean cloth and ensure he does not inhale it. The baby might appear bluish at birth but his skin colour changes to a pink shade once he begins to breath on his own.
Once you are sure the baby is fine, cover him with a clean towel to keep him warm and lay him on the mother’s stomach. Encourage the mother to hold and bond with the baby. You should help the mother place the baby on her breast and encourage suckling. Nipple stimulation releases oxytocin, a chemical that triggers the uterus to contract and expel the placenta. This is normally an exciting and magical moment for a mother as she welcomes her new born and the feeling that comes with it makes her forget the pain she has just gone through. Ensure mother and baby remain warmly covered.
Now pay attention to the mother, cleaning her while waiting for the placenta to be born. If you are sure you have safe and sterile instruments to cut the umbilical cord, you can do so; otherwise it is safe to wait for a doctor or midwife to do it. Wait until the cord stops pulsating. Tie it with clean thread about two inches from the baby, then tie it off about two inches away from the first tie and cut between the two threads. If the placenta is born before the doctor or midwife arrives or before you can get the woman to hospital, do not discard it, as the medics will need to inspect it to ensure everything has come out to avoid any future complications.