Regardless of whether you are a future parent or an unprepared taxi driver, someone may one day call you to help deliver a delivery without professional help around. Don't worry – this situation is more common than you think. Basically, stay focused on helping the pregnant woman relax and letting her body do the main thing. This article has tips on how to ensure everything runs smoothly until medical care is available.
Part 1 of 5: Preparations for childbirth
Step 1. Call 192 (SAMU – Mobile Emergency Care Service) or 193 (fire brigade).
So assistance is already on the way even if you have to deliver it yourself. This way you will have help if complications occur. Another advantage is that the attendant (usually used to this type of occurrence) can guide you until the rescue team arrives at the scene.
Ask the woman if she has a doctor or midwife available to provide emergency care. He or she can guide you by phone or cell phone through the entire procedure
Step 2. Find out where the dilation is
In the first stage of childbirth, the body prepares to dilate the cervix. This process can be quite time consuming, especially if this is the mother's first baby. If she presents a complete dilation, it is because the woman is already in the second stage of childbirth.
- For some women, this stage is not as painful and painful as the following stages.
- If the woman has fully dilated and you can see the baby's head poking out, she is in the second stage. Wash your hands, skip the next step and get ready to pick up the child.
Step 3. Time the contractions
Pay attention to the beginning and end of each one so that you can determine the interval between them. Note the duration as well. The closer the time for giving birth, the more regular and stronger the spasms become. Another sign is when the gap between one and the other decreases. Here's what you need to know about contractions:
- If the difference between them is 10 minutes or less, it means that the pregnant woman has already gone into labor. The doctor's recommendation is that you contact the nearest hospital when the spasms are a matter of 5 minutes apart and last 60 seconds each. Another point to be considered is whether this activity has lasted for an hour. If this is the case and you are close to a health care facility, it is likely that you still have time to get professional help.
- First-time mothers tend to give birth when the interval between contractions is in the range of three to five minutes and the duration of each contraction varies between 40 and 90 seconds, increasing in intensity and frequency for at least an hour.
- If the difference between one spasm and another is already at the mark of two minutes or less, roll up your sleeves and get ready for delivery because the baby is coming. This is even more valid if the mother already has other children and a history of rapid births. Another warning sign is if she feels she is going to have a bowel movement, as this indicates that the baby is making its way into her arms through the birth canal, which results in pressure in the rectum.
Step 4. Wash your hands and arms very well
Take off any jewelry or accessories such as rings, bracelets or watches. Try using an antibacterial soap and warm water. Rub your hands together and continue down your forearms to your elbows. Ideally, this cleaning should last five minutes, but if you don't have time, wash them vigorously for at least a minute.
- Don't forget to rub between your fingers and under your nails. Use a brush. It's even worth using a toothbrush to clean under your nails.
- If possible, wear sterile gloves (the kind used in surgical procedures and can be found at any pharmacy). Do not use models designed for cleaning or washing dishes as they may be loaded with bacteria.
- To complete the hand sterilization process or in case you do not have access to soap and water, use gel or regular alcohol to kill any bacteria and viruses that may be on your skin and come in contact with the baby or mother. This care prevents infections and protects the child and the mother.
Step 5. Prepare the site
Leave all the necessary material at your fingertips and try to create a comfortable environment for the pregnant woman, as much as possible. Know that childbirth will leave many physiological residues. So, if you can, choose a place that is easy to clean or that can handle the procedure without any problems.
- Gather clean towels and sheets. Even better if you have waterproof tablecloths or a vinyl shower curtain. Whichever option is used, everything must be clean. These materials can be the savior to prevent fluids such as blood from staining the car seat, furniture or carpet, for example. As a last resort, you can use newspaper sheets, but be aware that they are not very hygienic.
- Provide a blanket, towel or sweater. The important thing is to have something soft to keep the baby warm and warm as soon as it's born.
- Get some pillows. They can help a lot to support the mother when it comes to pushing the baby. Cover them with clean sheets and towels.
- Prepare a clean basin of warm water, scissors, pieces of string, alcohol, cotton balls, and a rubber nasal aspirator (sold at pharmacies in the baby care sector). You may also need to have pads and paper towels on hand to deal with the bleeding later.
- Another tip is to get a bucket in case the woman feels like throwing up. Another item on the list is a glass of water for mom. Labor is not easy.
Step 6. Help the mother to be calm and comfortable
She may panic, be in a hurry to get it over with, or be ashamed of the situation. Therefore, your moral support at this time is essential for her to be able to relax.
- Ask her to remove her clothing from the waist down. If you can, give her a towel or clean sheet so she can cover herself.
- Help her with breathing. It is necessary to avoid hyperventilation, a condition in which the person starts to breathe too quickly. Try to calm her down by talking softly and giving her instructions for her to inhale through her nose and exhale through her mouth following an even rhythm. If she is still not being able to breathe properly, try holding her hand and breathing deeply and slowly with her.
- Convey confidence. The woman who finds herself in an emergency birth almost always imagined a completely different situation (in the hospital hours before, surrounded by family and medical staff, pampered by the trusted obstetrician, etc.). It's normal for her to be worried about possible complications. Say that help is on the way and that you will do everything in your power to make sure everything goes smoothly in the meantime. Remind her that homebirth used to be the norm for thousands of years in human history. Therefore, it is more than possible to go through this experience without sequelae and with a perfectly healthy baby.
- Show that you are on her side. At such a delicate time, the mother can be scared, nervous, feel angry, dizzy or a mixture of all of this and more. The best thing to do is to agree with what she is feeling without judging or arguing.
Step 7. Help the mother to find a comfortable position
She may feel like walking or squatting during this stage of labor, especially if she is experiencing a contraction. As the birth phase progresses, it can be helpful to keep changing positions until you find one that she is most comfortable with. Let her decide if she wants to try out different positions or if she prefers to settle in one way and stay that way throughout the entire process. What's important is that she finds out what works best for her own body. Below are four of the most common positions, along with the pros and cons of each:
- Squatting. Here gravity works in the mother's favor and can open the birth canal 20 to 30% more than the other positions. If you suspect the baby will be born sitting (feet will come out first), perhaps this might be the best position as it gives the baby more room to turn. To help the woman give birth on a squat, kneel behind her and support her back.
- On four. This option neither favors nor hinders in terms of gravity, but it can alleviate back pain and the mother can decide for this alternative by instinct. There may be pain relief if the mother has hemorrhoids. To help her, stay behind her.
- Lying on its side: This way the baby will go down more slowly through the vaginal canal. On the other hand, this option allows for the gradual expansion of the perineum, decreasing the risk of a vaginal tear. Ask the woman to lie on her side with her knees bent and lift her leg from above. She can also support herself on one of her elbows.
- Lying on your back (lithotomy position). This is most common in hospitals, with the woman lying on her back with her knees bent. In this way, the health professional has maximum access to the birth canal. The downside is the great pressure placed on the mother's back. Therefore, this is not considered the ideal alternative. Another downside is that contractions can become slower and more painful. But if the woman has chosen to be like this, at least try putting some pillows under her back to ease the pain.
Part 2 of 5: Carrying out the delivery
Step 1. Instruct the mother to push through the right stage of labor
If she makes an effort too soon, she will be exhausted to no avail. When women are ready to push the baby, they may feel increased pressure in their lower back, perineum, or rectum. She might even feel like having a bowel movement. When the time comes, be ready to guide her to push the child.
- Ask the mother to lean forward and tuck her chin inward as if looking at her breasts. This position will help the baby to cross the pelvis. When pushing, the mother can grab her knees or legs or pull them back to ease the effort.
- The area around the vagina will be pushed out, making it possible to see the top of the baby's head. Once this happens, the woman should start trying harder by putting pressure on the child to leave.
- Encourage her to push lightly between contractions. The mother may be tempted to push hard at the height of a spasm, but this is not ideal. Instead, ask her to exhale through her mouth when the pain is most intense, and to start pushing as soon as the contraction eases.
- Guide her to focus on her abdominal muscles when pushing down, as if she were trying to urinate faster. This can help prevent exhaustion and direct the effort downwards instead of upwards (ie, when driving the force upwards, it will only tense up in the neck and face, worsening the wear and tear of this already arduous task).
- It is recommended that the mother push three to four times for 6 to 8 seconds per contraction. But that's not a rule, and the important thing is that she does what she feels is right by intuition, by nature.
- Encourage slow, deep breathing throughout the entire process. In this way, the pain can be more or less controlled, depending on the state of mental relaxation and the command over the rhythm of breathing. This attitude is much more productive than panicking or trying to get distracted by everything that's going on around you. Although every woman feels pain and manages it differently, this breathing exercise always helps during childbirth.
- Be ready in case the mother urinates or has a bowel movement during the process. This is normal and not a cause for concern. By the way, pretend that you didn't even notice in order not to leave the mother embarrassed.
Step 2. Support the baby's head as he emerges
This step is not complicated, but it is important. Pay extra attention to the following tips:
- Do not pull on the baby's head or umbilical cord. This can damage the child's nervous system.
- If the cord is wrapped around the baby's neck, lift the cord very carefully to pass it over the head so the child can pass through the gap. Never pull the cord.
- The most natural and desirable position for the baby is for the baby to face the mother's back. Childbirth is easier that way.
- But if the baby is coming out through its feet or butt instead of its head, be prepared, as it will be born sitting. Check out the following precautions to be taken:
Step 3. Get ready to receive the baby's body
When his head swivels to one side (which he'll probably do on his own), brace yourself as he'll come out in full on the next contraction.
- If he cannot turn his head by himself, very carefully help him to turn his head towards his mother's back. That should help one shoulder out with the next little push.
- Help the other shoulder out. Carefully lift the body towards the mother's belly so that the other shoulder can pass. The rest of the body should quickly follow.
- Keep supporting the child's head. The body will be slippery, so it takes a little knack to hold the baby's head, as the baby's neck is not strong enough to support the weight of the head itself.
Step 4. Know how to deal with birth complications
Maybe everything has gone well so far and you have in your arms a perfectly healthy baby and a happy mother in front of you. But if the baby seems to have been “stuck” in the birth canal, here's what to do:
- If the head has come out but the body is still stuck after three pushes by the mother, ask her to lie on her back and place two pillows under her bottom. Guide her so that she hugs her knees to her chest and pushes hard with each contraction.
- If the feet come out first, see the seated babies section later in this article.
Step 5. Hold the baby so that the fluids in his mouth and nose can run off
Use both hands, one of which should support your little head and neck. Tilt your head down slightly at a 45-degree angle to allow the liquid to flow out. The feet should be slightly higher than the head (but don't hold the baby by the feet).
You can also clean mucus or amniotic fluid from the nose and mouth area with a clean and sterilized gauze or cloth
Step 6. Place the baby on the mother's chest
Try to get them in skin-to-skin contact, as this stimulates a hormone called oxytocin, which will help the mother expel the placenta. Cover both with towels or blankets.
The baby should be in a position where the head is at a height just below the rest of the body. This allows fluids to continue flowing. If his little head is on the mother's shoulder and his body is on her chest, even better, as this position will allow liquids to be expelled naturally from the baby's airways
Step 7. Check that the child is breathing
The normal is a discreet cry. Otherwise, you need to take steps to unclog the airway.
- Rub the baby's body. Massage will help your baby to breathe. Stimulate his back with firm strokes and a blanket while he's still on his mother's chest. If that doesn't work, try leaving his little face up. Tilt his little head back a little to get the airway in a position to ease the decongestion. Continue massaging the baby's back throughout this procedure. He may not actually cry, but this technique makes sure he gets the air he needs.
- Drain fluids manually. If baby chokes or turns blue, clean mouth and nose using a clean cloth or blanket. If that doesn't work, use a rubber nasal aspirator. Squeeze the fat part so that air comes out and place the tip in your mouth or one of your nostrils. Then release the bulkier part so that the liquid can be aspirated. Repeat the operation until all the fluid has come out. Don't forget to empty the vacuum between one suction and another. If you don't have a rubber nasal aspirator available, you can improvise and use a plastic drinking straw. Suck the fluid in your mouth and stop before the fluid comes in direct contact with you. Discard the contents of the straw and repeat as needed.
- As a last resort, resort to a pat. If all other options have failed in trying to get the baby to breathe, try patting the soles of her little feet using your fingers. You can also pat his butt lightly.
- If even this technique doesn't work, cardiopulmonary resuscitation will be needed.
Part 3 of 5: Delivering a Sitting Baby
Step 1. Rare are the cases where the baby is born sitting
When this happens, the first part of the body to come out is the feet or buttocks, not the head as usual.
Step 2. Help the mother to be in the right position
Ask her to sit on the edge of the bed or another flat, firm surface. Guide her so that she holds her legs against her chest. To prevent accidents, place pillows or blankets on the floor to prevent the baby from hurting himself if he ends up falling.
Step 3. NO touch the baby until the head comes out of the birth canal. You will be tempted to help the baby when you see that the buttocks and back are hanging down, but resist with all your might. That's because if you pick it up, the child will be encouraged to breathe, which would be dangerous if the head is still submerged in the amniotic fluid.
Try to keep the environment warm, as a drop in temperature can also cause the baby to choke on the fluid
Step 4. The right time to pick up the baby
After the head comes out, take the child in your arms and take him to the mother. But if the head remains in the birth canal even after the arms have come out, ask the mother to squat down and push again.
Part 4 of 5: Expelling the placenta
Step 1. Prepare for embryonic attachment release
This process is the third stage of labor and can take place a few minutes or even an hour after the baby is born. The mother will probably feel an urge to push after a few minutes; this is helpful.
- Place a basin near the vagina. Just before the placenta emerges, there will be bleeding and the umbilical cord will get longer.
- Ask the mother to sit down and push the gestational organ out.
- Firmly rub the mother's belly below the navel to help reduce bleeding. This procedure can be painful for the woman, but it is necessary. Continue massaging until you feel the uterus the size of a large orange at the level of the womb.
Step 2. Let the baby feed
If this doesn't require stretching the umbilical cord too much, encourage the mother to breastfeed as soon as possible. This will help to stimulate a contraction that can expel the placenta, as well as help to slow down bleeding.
If the woman cannot, or decides not to, breastfeed, tell her that stimulation of the nipples can also help stimulate placental delivery
Step 3. Do not pull on the umbilical cord
As the embryonic attachment is being expelled, resist the temptation to pull on the umbilical cord to get the organ out soon. This can have serious consequences for the mother. Let the placenta move on its own as the mother pushes.
Step 4. Save the placenta
Once she is completely out of the woman's body, place her in a garbage bag or container with a lid. The doctor may want to examine the organ to see if there are any abnormalities.
Step 5. Assess whether you should cut the umbilical cord
Only do this if medical attention is already on the way. Otherwise, leave it as is. You only need to give the mother a hand if the cord is stretched too far.
- If for some reason it is necessary to cut the cord, you need to feel its pulse first. Hold it carefully to check his pulse. Then wait about ten minutes, as this is the time it takes for the placenta to finish separating from the baby. Only after the pulse has stopped can you cut the cord.
- If you're worried about causing pain to the mother and baby when it's time to cut the cord, relax. The cord has no nerve endings. Therefore, neither she nor the child will feel the cut. You just have to be careful when handling it, as it will be a bit slippery and difficult to handle.
- Tie a rope or string around the cord about 8 cm away from the baby's navel. Tie securely and secure with a double knot.
- Repeat the operation. But this time, make the double knot about 6 cm away from the first one. The cut will be made between the two string/string ties.
- Use a properly sterilized knife or scissors (boiled for 20 minutes or sanitized with alcohol) to cut between the two strings. Don't be in a hurry as the cord is elastic and difficult to cut.
- Cover the baby again after you finish cutting the cord.
Part 5 of 5: Mother and Baby Care
Step 1. Keep mother and baby warm and comfortable
Cover them with blankets or warm clothing and encourage the mother to keep the baby on her chest. Change any wet or dirty rags and take both to a clean, dry place.
- Help relieve the woman's pain. Place a cold thermal bag in the mother's vagina for the first 24 hours to relieve pain. Offer a pain reliever with acetaminophen (also known as Tylenol) or ibuprofen, but ask her first if she is not allergic to any of these medications.
- Give mom a light snack and a drink. Avoid sodas and foods that are fatty or contain a lot of sugar, as they can make you sick. Go for toast, salted crackers or even a natural sandwich. To drink, it can be coconut water, mineral water or a sports drink like Gatorade to ensure rehydration.
- Put a diaper on the baby. Place it below the height of the umbilical cord. If the cut site starts to smell bad (indicating an infection), clean it with alcohol until the odor disappears. And if there's a hat or cap around, put it on the baby so it doesn't catch a cold.
Step 2. Massage the uterus through the abdomen
Sometimes unexpected births can cause bleeding. They occur in up to 18% of births. To lessen the likelihood of this, massage the uterus firmly. Do the following if you see a lot of blood after the placenta leaves:
- Place a clean hand inside the vagina. Place your other hand on the lower abdomen of the hand. Press the mother's abdomen down while pushing the hand inserted into the vagina against the uterus.
- You can also firmly and repetitively squeeze the mother's lower abdomen without putting your other hand inside the vagina.
Step 3. Prevent infections in the mother when going to the bathroom
Instruct her to wash her vagina with warm water after urinating to keep the area clean. If she's too weak, you can do the cleaning yourself. Use a squeeze bottle (the ones you can squeeze) to splash the water.
- If she needs to have a bowel movement, ask her to place a clean cloth or towel against her vagina while she defecates.
- Help the mother to urinate. It is good for her to empty her bladder, but she may be feeling very weak from the loss of blood. In that case, it might be better to leave a cloth under it that can be used as a kind of diaper and removed after it's soiled. That way she won't have to get up.
Step 4. Get medical attention as soon as possible
Once the delivery is complete and you have taken care of the safety and comfort of the mother and child, go with them to the nearest hospital or wait with the two of the ambulance you called.
- Don't be scared if your baby is a little blue at birth or if he doesn't cry right away. His color will be similar to his mother's when he starts to cry, but his hands and feet may still be blue. Just change the wet towel for a dry one and put a hat or bonnet on your baby's head.
- If you don't have blankets, use clothes, towels or warm clothing to keep mother and baby warm.
- Every mother-to-be or father should consider the possibility that labor will start around the date scheduled by the doctor, even if you have already made plans (such as a trip, for example). In any case, always carry an emergency kit containing sterile soap, gauze and scissors, clean sheets, etc. Leave these materials in a carry-on bag or in a box inside your car. Check out the complete list of materials in the section below.
- To sterilize an instrument that will be used to cut the umbilical cord, clean it with alcohol or heat it very well to kill the microbes.
- If the mother has already gone into labor, never let her go to the bathroom to have a bowel movement. Sometimes, when the baby is changing position to prepare to go out, the woman may feel like pooping because of the pressure the baby puts on her rectum. This is normal. What should be avoided is for her to go to the bathroom, sit on the toilet and end up giving birth there and the child fall into the toilet.
- Do not clean the mother or baby with antiseptic or antibacterial products unless soap and water are available or if there is an external cut.
- This article is not intended to replace medical care by trained professionals nor to serve as a guide for a planned home birth.
- Keep yourself clean as much as possible. This is also true for the mother and the place of birth. This care with hygiene is essential, as the risk of infection is high for both mother and child. Do not sneeze or cough on the spot.