Emergency Delivery 101

What to do if you can’t get to the hospital in time during pregnancy and childbirth.

Jeanne Faulkner, EMC’s writer and on-staff labor and delivery nurse offers these tips for DIY deliveries:

• Call 911 and make sure help is on the way.
• Don’t push before help arrives unless there’s such a strong urge you can’t avoid it.
• Get into a comfortable side-lying, hands and knees or kneeling position on your bed or floor.
• Place a waterproof barrier (garbage bag, puppy pad) and plenty of clean towels under your bottom to absorb fluid and create a soft nest for your baby.
• If your partner or someone else is there to help you, have them support your pereneum to prevent tearing as you gently push baby out. Place a towel on the perineum and apply very gentle support as baby’s head emerges.
• As soon as the head is delivered, slide your finger under baby’s chin and check that the umbilical cord is not wrapped around baby’s neck. If it is, stop pushing and gently slide the cord over baby’s head without tugging or pulling. If the cord is coming out before baby’s head delivers, use your fingers to make sure the cord is not compressed by baby’s head during delivery.
• Baby will be very slippery so use an extra towel or blanket to help catch and guide baby from the vagina to Mom’s chest or abdomen.
• Dry baby immediately to prevent him from getting cold. Remove wet towels and cover baby with a blanket and maintain skin-to-skin contact with Mom.
• Baby will almost certainly take a breath on his own, but if he does not, rub him vigorously with a dry towel or flick the bottom of his feet. This will cause him to gasp and begin breathing.
• Check baby’s heart rate by feeling for a pulse at the base of his belly button. Count beats for 6 seconds and multiply by ten. For instance, if you feel 12 beats in 6 seconds, his pulse rate is 120. His heart should beat between 120 and 160 beats per minute. If baby is not breathing or his heart is not beating rapidly enough, make sure an ambulance is on the way and, if necessary, begin infant CPR. Read these guidelines provided by the American Red Cross on when and how to perform infant CPR.
• Once the placenta delivers, massage the uterus by rubbing her abdomen below Mom’s navel to prevent excess bleeding. If an ambulance will be there soon, there’s no need to cut the umbilical cord. Simply wrap the placenta and keep it attached to baby. If an ambulance cannot reach you, call your hospital for guidelines on what to do. Have clean shoelaces, dental floss or embroidery thread and sterilized scissors (washed and wiped with rubbing alcohol) available, in case you do need to cut the cord. Here’s how to do that.
• Tie the umbilical cord in two places — about three inches from baby’s tummy and again at about five inches. Make sure the string is tied tightly.
• Cut in between the two ties.
• Wrap the placenta in a towel and transport it to the hospital when medical help arrives.
• Breastfeed ASAP after delivery to help prevent Mom from bleeding and to keep baby’s blood sugar and body temperature stable.