The arrival of a baby before the mother is able to get to the hospital is an emergency that can hopefully be avoided.

Newborn(42196)Credit: jmwilding

As the projected date of delivery nears, the mother-to-be should remain as close to home, the hospital, and her doctor as possible.  Even remaining close to home does not always prevent children from being born before the reach medical facilities!  Occasionally a mother may deliver quicker than is anticipated.

If circumstances prevent the trip to the hospital and the contractions (labor pains) are less than two minutes apart, prepare for an unexpected and impromptu delivery!  If the mother feels certain that the baby is coming and feels like “pushing,” birth is imminent.

Make every effort to obtain professional medical assistance.  Try to find a neighbor, relative or someone nearby who has might have some experience in childbirth such as a nurse or EMT (Emergency Medical Technician).  This might sound funny, but a veterinarian or a woman who has given birth several times can also lend valuable assistance if they are available. 

If you must proceed with the birth, use these tips:

Make cleanliness and the prevention of infection your most primary important concern.  If possible, wash your hands thoroughly.  If you can’t wash, use a hand sanitizer or wipes to sanitize your hands.  Make sure that any materials you use are clean and if you have time, boil any water that may be needed.  The water can be used for washing and cleaning as needed throughout the delivery and after the birth.

Place the mother on a clean sheet (newspapers may have to be substituted) with her knees over her chest and her legs spread apart.  Allow the natural child delivery processes of the mother to happen.  The baby should emerge with the natural contractions of the birth canal.

As the infant’s head emerges, hold one hand gently against it in order to prevent an explosive emergence.  Ease the infant’s head and shoulders out slowly as the mother pushes.  Support the baby with one hand in the back of the neck until it has fully emerged.  Place the newborn on the mother’s stomach.

The most important part of delivering a newborn infant is helping the baby start to breathe.  In most cases, the baby will emerge gasping or crying out, and breathing will start automatically.

In the rare event that the baby’s head is enclosed in the water sac, it must be broken on the front of its face to allow the infant to catch a breath.  This occurrence is rare as usually the “bag of water” will have already ruptured.

Do not slap the infant’s back.  In the event that the baby does not start to breath, press gently on its chest.  If breathing still hasn’t started proceed with infant CPR (cardio-pulmonary resuscitation).

When the infant has fully emerged, it is not harmful to leave the baby attached by the umbilical cord until medical help arrives and can take care of it.  Just hold the infant securely by the ankles over the mother’s abdomen to allow mucous to drain from its mouth.  With one finger wipe out any remaining mucous.  It may be necessary to suck out excess material in both the baby’s nose and mouth in order for it to start breathing and functioning.

In the event that the infant’s feet appear first, called a breech birth, or any part other than the head first, do not attempt to continue the delivery.  At this point, professional medical assistance is imperative and must be obtained at whatever the cost.  Cover the mother and try to get her to a medical facility immediately. 

The umbilical cord can be left attached without danger of harming either the mother or the infant.  In rare cases, the baby may emerge with the cord wrapped around its neck.  Carefully attempt to unwind the cord over the infant’s head.

If you cannot do this, and the cord appears to be creating a situation of strangling the baby, it must be cut.  In professional deliveries, before the cord it cut, it is tied or clamped off in two places, several inches from the infant and an equal distance from the uterus.  In an emergency, carefully tie a string around the cord in two places and carefully cut the cord in between the two ties.  The cord should be tied off a few inches from both the mother and the baby.

The placenta, or afterbirth, is usually delivered with the contractions of the birth canal from 10 to 15 minutes following the birth of the baby.  Preserve it in clean wrapping and at the level of the baby.  The placenta should go with the mother and baby to the hospital.

Gently massage the lower abdomen of the mother in order to retain the uterus in place and to help reduce any bleeding.  This procedure should be repeated every few minutes until the mother arrives at a medical facility for care.  The mother should hold her thighs together tightly.  Breast feeding at this point can be helpful in both controlling the bleeding and in contracting the uterus.  It will also calm the infant and mother.  Try to clean the breast area if possible or use hand sanitizer or wipes. 

Bleeding from lesions, or stretch tears, of the perineal tissues at the opening of the vagina, usually is not a serious issue and can be treated when the mother reaches the medical facilities.  Place a clean compress over the area while transporting to the hospital and again, have the mother hold her legs closed tightly to control the bleeding.    

The baby should be dried off with clean towels or cloths but don’t worry overly much about cleaning it completely.  Making sure the infant is breathing on its own is of paramount importance at this time.  Once breathing and partially cleaned, the infant should remain cradled on the mother’s abdomen.  Cover both mother and infant well to retain body warmth until you reach a medical facility.  If you are in a warm climate, cover with a light sheet to help prevent infection. 

Once you have arrived at the medical facility, your duties are finished.  Hopefully the mother will name her infant after you!