Figure 2-2. Procedures for normal emergency childbirth

1. Be calm. Reassure the mother that you are there to assist her with the delivery.

2. Provide an environment which is as quiet and private as possible.

3. Position the mother as comfortably as possible and concentrate on helping the mother stay in control

4. DO NOT allow the mother to strain or push during the early stages of labor. This may cause the cervix to become swollen and unable to dilate. Pushing or straining might also cause additional bleeding and distress to the mother.

5. Before or during labor, the amniotic sac should burst. Also, some blood-tinged mucus may appear.

6. Watch for the baby’s head to emerge or “crown” at the vagina.

7. Permit the head to deliver between contractions. This avoids perianal tearing and injury to the baby’s head from the sudden release of pressure.

8. In a normal delivery, when the baby’s head emerges, it faces down and then turns. Check to see if the amniotic sac covers the baby’s face.

9. As soon as the baby’s face is visible, support the head with one hand and wipe the baby’s nose and mouth.

10. Check to see if the umbilical cord is around the baby’s neck. If the cord is around the baby’s neck, use two fingers to slip the cord over the baby’s shoulder. Clamp and cut the cord only if you cannot dislodge it.

11. Normally, the baby’s shoulders will rotate, and the upper shoulder will be born first. To help the shoulder out, support the head in an upward position.

12. As the baby’s body is expelled, support the head and body with both hands. If possible, note and record the time of the baby’s birth and the baby’s Apgar point count.

13. Place the baby on his back with the head slightly lower than the rest of the body. Turn the baby’s head to one side to allow mucus and fluid to drain.

14. Wipe the baby’s face with sterile gauze. Suction the baby’s nose and mouth again

15. Clamp or tie off and cut the umbilical cord after the cord has ceased to pulsate.

16. As soon as the baby is breathing and crying, dry him in a towel. Then, if you have a blanket, wrap the baby in it.

17. Give the baby to the mother to hold and/or nurse, if possible. Massage the mother’s uterus through the abdomen. This aids in the delivery of the placenta and reduces the chances of the mother hemorrhaging.

18. Check the placenta for completeness. Wrap the placenta in a towel and place the towel-wrapped placenta in a plastic bag or container.

19. Place a sterile pad over the mother’s vaginal opening. Remove any drainage soaked linen from under the mother and wrap her warmly.

20. Continue massaging the mother’s uterus through the abdomen to ensure the uterus remains contracted. Monitor and record the mother’s vital signs.

21. Transport the mother and baby carefully to a medical treatment facility. In a normal delivery, it is not necessary for the transporting vehicle to use its light, siren, or to travel very fast.