Emergency Birth Procedures

July 06, 2008

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Emergency Birth Procedures

by Lisa Rodriguez, R.N. and Marjorie Greenfield, M.D.
reviewed by Marjorie Greenfield, M.D.

The thought of emergency birth may bring to mind situations like those you've seen on TV, where a woman is about to give birth in a cabin in the mountains with a blizzard outside or a mom-to-be is pushing out her baby in the aisle of an airplane. Despite these commonplace portrayals, however, the reality is that out-of-hospital emergency births don't happen very often, and when they do, they generally go very quickly and end well--with a healthy mom and a healthy newborn.

You may worry that this kind of unexpected event could happen to you. Hopefully it won't, but on the off chance that it does, you and your partner will likely be able to deal with the situation more calmly if you are somewhat prepared.

A couple of things to keep in mind
As you prepare for the birth of your baby, it may help to remember that birth is, in fact, a natural process that mostly takes care of itself. A support person typically needs to be there to hold the baby's body as he is born and to encourage the mom through the birth process. Please know that this short instructional article is not a substitute for professional pregnancy care; planned home birth requires the presence of an experienced midwife or doctor and substantial planning.

If you are home alone when you go into labor, call a friend or neighbor who can arrive in a timely fashion. This is no time to be by yourself! If things are progressing quickly and you suspect you are heading toward an unplanned out-of-hospital birth, you and your support person need to assess the situation and decide whether you can make it to a medical facility (which is usually a better option than trying to handle it yourselves).

How to decide if birth is imminent

Is this your first baby? Usually with first babies, labors take longer, with as much as a few hours needed to actually push the baby out.

How far apart are the contractions? If they are five minutes or more, an expectant mother typically will have time to get to the hospital. If the contractions are two minutes apart or less and are very strong, the baby is coming soon. This is especially true if the mom-to-be has had other children previously and has had short labors.

Often before the mother is fully dilated, she goes through a stage of labor called transition. She may feel panicky and may seem irrational. With a first baby you usually will still have time to get medical care. Mothers who have given birth before are generally very close to delivery at this point.

If the mother-to-be is feeling the urge to have a bowel movement, delivery may be right around the corner. As the baby moves through the birth canal, his head creates a pressure feeling as on his mother's rectum and gives her the urge to push.

As a good general rule, a laboring mom who declares that the baby is coming is usually right.

What to do if the baby is coming
When the birth seems about to happen, it is important for the expectant mother to find an appropriate place to deliver the baby. If she is in a car, it's best to pull over to the side of the road in a safe area and turn on the emergency blinkers. The back seat of most cars generally provides sufficient room. If the baby is determined to make her debut in a public place, try to find one that offers some privacy, if possible.

It's useful to have several clean towels, sheets, or blankets on hand. Even newspapers will do in a pinch. Make sure the area is as clean as possible. The person who will be delivering the baby and any others who may be helping should make every effort to wash their hands and put on sterile gloves if, by chance, any are available.

If possible, call 911 immediately. Emergency crews are trained in childbirth procedures and have oxygen and other medical supplies with them. In addition, a 911 operator may be able to help walk those involved in the delivery through the process by giving directions or advice.

No matter what the scenario, it's important to keep the following points in mind:

Remain calm. It will be more helpful for the mother-to-be if she doesn't see fear or panic, but instead feels reassured that she can rely on those around her.

Remember that the birth process comes naturally. Those who are assisting mostly just need to allow the baby to come.

To keep the baby from being born too quickly, laboring mothers generally should be encouraged to push only between contractions, not at their peak. Blowing through her mouth at the height of each contraction might help her resist the urge to push. When the baby's head becomes visible (crowns), it is often possible to just let it ease on out. The baby's head should be supported as it makes its way out of the birth canal.

After the baby's head is completely out, dry him off with a clean towel and wipe his nose and mouth to clear away any mucus and blood.

Assuming that the rest of the body has not yet made its way out, the baby's head should then be guided gently downward toward the floor to deliver the top shoulder. Then, to deliver the baby's bottom shoulder, gently lift his body toward the ceiling.

Once the shoulders are delivered, the rest of the body will be born fairly quickly. It is very important to be aware that the baby will be extremely slippery, so use extra caution in holding him.

If the baby is not breathing or crying at this point, stimulate him to take his first breaths by firmly rubbing his back or by gently slapping the soles of his feet. Drying him off with a towel also can stimulate him and will prevent him from getting cold.

If the baby continues to not breathe, he may require rescue breathing and possibly even infant CPR. Obviously, someone who has taken infant CPR classes, such as those provided by the American Red Cross, is best suited to do this.

Dry off the baby as much as possible with clean, dry towels. Once he is dry, place him skin-to-skin on his mother's abdomen so that he can benefit from his mother's body heat. If a clean, dry blanket is handy, lay it on top of the mother and her newborn.

Do not cut the cord! It's best to let emergency personnel or the hospital staff clamp it and cut it with sterile instruments. If the cord is long enough, encourage the new mother to breastfeed her baby if she is willing. This will trigger additional uterine contractions, which will help to expel the placenta and reduce postpartum bleeding.

Once the placenta is expelled, which can take anywhere from a few minutes to a half hour, it should be placed next to the newborn. You still do not want to cut the cord.

Mom and baby should be kept together and warm until help arrives.


RELATED INFORMATION

			Preparation for Rapid Labor
			The Birth of Your Baby
			The Emotional Stages of Labor
			Childbirth Preparation
			Events of Birth
			Birth Procedures

Created September 04, 2001
Reviewed August 12, 2004

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