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| Home > Complication & Medications > Emergency Delivery
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| | Emergency Delivery
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In case you need to have emergency delivery at home but had planned a hospital delivery you may find it very disturbing to change your plans. Initially, you may panic and temporarily forget all you have learnt about labor, birth and coping techniques. It is far better to stay home, where it is warm and comfortable, when birth is truly imminent, than rushing to the hospital. Usually, babies born without much warning are in excellent condition. The following instructions will help you be in command of an emergency situation and ensure the best possible outcome.
What You Can Do
Signs of an Imminent Birth:
You feel a strong urge to bear down.
You see the baby`s head or presenting part visible at the vagina.
You feel the baby coming.
Call the emergency care number and request an aid car. Paramedics are trained to handle emergency childbirth. Call your physician`s office or the labor and delivery ward of your hospital. Ask for help or emergency instructions.
Call for someone to help you at home-your partner, a relative, a neighbor, or a friend. Even children can help if they know specifically what to do.
Before the Birth:
Bare the lower half of your body.
Lie on your side or in a semi sitting position in a warm, comfortable place (usually in bed) with clean towels or folded linen under your buttocks. A waterproof sheet will protect the mattress.
Stay as relaxed as possible. Let the uterus do the work. Try not to push or bear down with the contractions, but pant or blow through them.
Your partner or attendant needs to quickly, but calmly, gather a clean cloth handkerchief, tissues, clean towels, and receiving blankets. Keep these supplies nearby. If possible, place the receiv-ing blankets in a clothes dryer or warm oven so as to give warmth to the baby.
Your partner should thoroughly scrub his hands and arms up to the elbows.
During the Birth:
The baby`s scalp coming out of the vagina will be wet and somewhat wrinkled, and it may be streaked with blood and vernix in places. Your perineum and anus bulges due to the pressure of the baby`s head. With the contractions, the visibility of the baby`s head increases. The progress being so rapid the need to bear down does not arise. Instead, raise your chin and pant or "puh, puh" as lightly and rapidly as you can. You may excrete sometimes, as your baby`s head descends. In that case, the attendant should remove the feces with tissues and sanitize the area. You should keep your thighs and pelvic floor re-laxed. Gradually, as the head emerges from the vagina and as "crowning" begins, make extra efforts to relax, pant, and do not push. The slow delivery of the head lessens the risk of tearing the perineum.
After the emergence of the head, your partner or attendant should use the clean handkerchief to wipe away excess mucus from around the baby`s nose and mouth. In case the baby`s head is covered with membranes, he should break them with his fingernail and peel them away. He should also wipe the baby`s face.
A baby`s head is usually born facing your back. The baby will turn 90 degrees to face your thigh, so the shoulders can be born. Gentle support to the baby`s head is a must at this time; no force should be applied. If the cord is coiled around the baby`s neck, your attendant should lift it gently over the baby`s head.
The next set of contractions would help you bear down smoothly to deliver the shoulders and the rest of the baby`s body. Your attendant could support the emergent baby. Be very careful as the baby will be wet and slippery.
After the Birth
Care of the baby:
Normally the baby should begin breathing and crying immediately. The baby should be placed on his side with his body slightly higher than his head on your bare abdomen, to drain any mucus remaining in his nose and mouth. The remaining mucus, has to be wiped away and he has to be dried completely, especially his head. The baby needs to be kept warm. You can place him by the side of your bare body and pull a warm blanket over both of you. This will ensure adequate warmth to the baby. Keep his head covered to prevent heat loss.
The cord need not be cut as it will constrict when exposed to air au-tomatically stopping the blood flow. A non pulsating cord implies that the blood flow has stopped.
Care of the mother:
The contractions resume after a slight pause which causes the placenta to detach from the uterine wall and slip down into the vagina. Bear down to deliver it. Cover the placenta in a sheet and place it on the bed. Put on a sanitary napkin, folded diaper, or small towel on your perineum.
Breastfeeding can be started right away. It will stimulate the uterus to contract and reduce bleeding. In case the baby refuses to suck, her nuzzling your breast stimulates your uterus. Your uterus will be at the navel level. It should feel firm, like a large grapefruit. Your fundus needs massaging, If your uterus is not firm (top of the uterus) until it contracts. Stop the massage if the uterus is hard, but keep a check on it from time to time and massage again if necessary.
Possible Problems
Baby does not breathe spontaneously
Place the baby`s head at a slightly lower level than her body and rub her back or chest rapidly but gently. In case she fails to respond within thirty seconds, her feet needs to be held to-gether and the soles spanked sharply. Repeat the procedure several times in case the baby fails to breathe. Now insert your finger in his mouth to check for mucus and then do mouth to mouth resuscitation. Tilt the baby`s head back gently to straighten the airway from face to chest. Encircle your mouth over her nose and mouth and put your fingers on her chest. Blow with only the air in your cheeks gently until you feel or see the chest elevate a little. Do not blow hard. Remove your mouth. Continue this se-quence, one blow every five seconds, until the baby responds or medical help arrives.
Excessive bleeding from the birth canal
Some amount of bleeding after labor and delivery is normal in the third stage. Losing more than two cups of blood would mean that you maybe hemorrhaging. The characteristics of hemorrhage are a steady flow of blood and symptoms of shock (rapid pulse, paleness, trembling, cold, and sweating). Hemorrhage may be reduced by firmly massaging the uterus through the abdominal wall until it contracts and en-couraging the baby to nurse (or stimulate the nipples). The lower half of your body should be elevated to avoid shock.
Padding the perineum with an ice pack and towels will reduce the bleeding coming from the tears at the vaginal open-ing. Apply firm pressure to contain the bleeding. Go to a hospital when the bleeding refuses to stop in spite of the following procedures. The hospital staff should assess you, your baby and the placenta and give you the attention you need, incase the bleeding does not stop.
In an emergency situation, your options are limited. Fortunately for you, aid cars and experienced paramedics are available everywhere. In case of an emergency home birth, do not forget the different techniques you practiced for relaxation, breathing etc. Your knowledge of the whole birth process will help. An emergency birth can be unnerving, but with your proper preparation, calm and wise temperament, the experience will always be precious to you, despite its unconven-tionality.
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