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Delivery complications
 
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Sudden birth

Sometimes labour is so quick that your baby is born before you can get medical assistance. The following information is not intended to be used as a guide for an out-of-hospital birth without a professional attendant, as this can be very risky. It's reassuring, though, that there are rarely complications in emergency births of this sort.

What to do incase of sudden birth?

Sudden birth
© Jupiter

When you get the urge to push, try to pant or blow for as long as you can to delay your baby's birth. The contractions alone are usually enough to push your baby out when he's coming this fast, so this won't delay things for long, although it may be long enough for your midwife or the ambulance to arrive. Never try to hold your legs together to delay delivery, or allow anyone else to do so: this may cause your baby to suffer brain damage. If you cannot comfortably delay your baby's birth, don't try to interfere. Deliver the head slowly. There's more chance that your vagina and perineum will tear if you push along with the force of your uterus, so pant lightly with each contraction.

Prolapsed cord

If a loop of the umbilical cord washes out when the membranes rupture and your partner says he can see a piece of grey-blue shiny cord bulging out of your vagina, this means that you have a prolapsed cord. You must get help as soon as possible as your baby's oxygen supply is in danger of being cut off. Don't panic; you have time. Get on to the floor on your knees, with your chest to your knees, your head on the floor, and your buttocks in the air. This helps to take the pressure of your baby's head off your cervix. If the cord is still protruding, ask your partner to cover it with a wet, warm, very clean towel before he rings the hospital or goes for help. Don't touch or put any pressure on the cord. Stay in the knee-chest position even on the way to hospital, because it reduces pressure on the cord. A prolapsed cord means you'll have to have a Caesarean delivery, unless the cervix is fully dilated, in which case forceps or ventouse will be used.

What the birth assistant should do incase of sudden birth?

If it looks as if your partner's going to give birth at home without medical assistance, telephone the hospital or your midwife if you haven't done so already. If you haven't got a telephone, on no account leave the mother alone. However anxious and overwhelmed you feel, it's vital for you to stay calm and reassure your partner - she needs to feel confident and relaxed. Encourage her to take up any position she finds comfortable.

Wash your hands thoroughly in soap and water, then fetch lots of clean bath towels. Fold one and put it on the floor to lay your baby on. Then fill several bowls with hand-warm water, and find plenty of clean hand towels, face flannels, and tea towels. They can be soaked in the water and used as wipes during and after delivery.

The birth

Your partner will know when her baby's coming because she'll feel a stinging or burning sensation as the baby stretches her vagina. See if the top of the baby's head is visible in the vaginal outlet. Remind your partner to pant or blow, so that her vagina and perineum have time to thin and stretch, which might help to avoid tearing.

Your baby's head will probably be born in one contraction and the rest of his body in the contraction afterwards. When the head is born, wipe each of your baby's eyes from inside to outside with separate pieces of moist cloth, and then feel round his neck to see if the cord is present. If it is, crook your little finger underneath it and pull it very gently over his head, or lift it so that his body can be born through the loop.

Do not interfere with the cord because it may go into a spasm and deprive your baby of oxygen. If the membranes are still present over your baby's face, gently tear them off with your fingernail so that your baby can breathe. Be careful to hold him firmly, as he'll be slippery with blood, mucus, and vernix. Never pull on his head, his body, or the cord.

Once the baby is born, he'll probably give a couple of gasps, a cry, and then start to cry properly. If he doesn't cry at once, place him across your partner's thigh or abdomen with his head lower than his feet, and then gently rub his back. This helps any mucus to drain away and usually causes a change in blood pressure, which brings about his first breath. Talking to your baby lovingly and calmly will also help.

After the birth

Once your baby's breathing, pass him to your partner so she can put him to her breast and keep him warm against her skin. If the baby's interested in feeding, the nipple stimulation will also release oxytocin, which encourages your partner's uterus to contract again and expel the placenta.

Keep your partner and your baby warm with blankets or towels, especially your baby's head, as most heat is lost from here. Bear in mind that the normal colour of a baby at birth is a bluish-white. He'll gradually become pink in the first minutes as oxygen enters his body. Don't try to wash off the vernix, and never cut the umbilical cord.

On your way to the hospital

If the urge to bear down comes as you're driving to the hospital, use your breathing techniques to avoid pushing; do your best to stay calm.

If the urge becomes too strong for you to control, ask your partner to pull the car over and stop. Cover the back seat and car floor with a thick layer of newspapers or towels if you have them available and get as comfortable as possible. You can then deliver the baby into your partner's hands.

Follow the procedure for the birth in the main text. Once your baby is born, it's important that he's kept warm, so wrap him in a blanket or towel (or in your partner's shirt, jumper, or coat, if there's nothing else) and hold him close against your skin. If the placenta arrives before you reach hospital, wrap it up with your baby as this provides him with much-needed extra warmth. Do not cut the umbilical cord.

The delivery of the placenta

  • never pull on the cord
  • don't cut the cord
  • after the placenta is delivered, massage the mother's uterus firmly, with a deep circular motion, gently pushing downwards 5-7cm (2-3in) below the navel and rubbing. This is important to make sure the uterus contracts and stays hard after the birth so there's no haemorrhage
  • it's normal for a couple of cups of blood to be delivered when the placenta comes out
  • getting your baby to nurse immediately will help the uterus contract and minimize blood loss
  • if your baby won't suck, massage your partner's nipples as another way of releasing oxytocin.

Posted 16.11.2010

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