If you find yourself having to assist in childbirth without the presence of a qualified nurse or doctor, this is what to do: The mother needs confidence and encouragement, so take a deep breath and keep calm, reminding yourself that birth is a natural event and that a mother is able to deliver herself without assistance , especially if the process is quick.
Your job is to look after the baby immediately afterwards,
and then the mother. lf the birth appears imminent get the mother onto a bed or the floor so that the baby cannot fall when it is born. Remove her clothes from the waist down, putting a covering over her stomach if it is cold.
After the baby has been born and is lying between the mother's legs, look to see if the cord is wound round the neck. If it is, gently unwind it, trying not to pull on it, because it is attached to the afterbirth which is still inside the mother.
Remove any membrane which may be over the baby's face and with a clean handkerchief wipe away any mucus which may be in his mouth. lf there is a lot of this and it is affecting the breathing, try to suck it out through a straw or a length of tubing, if handy. If there is nothing handy, tilt the baby's head down, still doing your best not to pull on the cord, so that the mucus can drain out, and slap the baby's back.
When the baby is breathing normally cover him up as he lies between his mother's legs, and place a shallow bowl or baking tin to catch the bleeding from the mother and the afterbirth, which will soon be expelled (usually 20-30 minutes after the baby). Make the mother as comfortable as you can; and put on the kettle. Some of the water can be used in a saucepan to boil scissors and string to make them sterile and the rest to supply sterile water to clean up the mother afterwards. There is no great hurry to tie and cut the cord, but you will be able to wrap the baby and place him in a more comfortable position after the separation.
First scrub your hands very thoroughly. Fish out the string from the water and let it drip. Then tie the cord tightly twice, about 6 ins. and 8 ins. from the baby and carefully cut between these points with the sterile scissors. If you notice the slightest bleeding from the cord attached to the baby, tie it again nearer his body, otherwise he could bleed dangerously.
Once the baby is warmly wrapped and is breathing well, begin to clean up the mother, removing all sodden linen from under her. After the placenta (after- birth) has been expelled, clean up the opening, using sterile water, and apply a pad or folded towel. Then make her some tea, unless she is bleeding heavily.
If there is heavy bleeding, you can try one of two ways to stimulate the uterus (womb) to contract and ease off the bleeding. One is to feel for the uterus through the abdominal wall at about the level of the navel, or a little higher, then cup the top of it in your hands and rub it gently, at this point it should tighten up. The other way is to put the baby to the breast which often has a reflex action on the uterus.
If the birth is not so precipitate and you have time, spread a waterproof sheet or lots of newspaper over the bed and the surrounding floor, collect what clothes and coverings the mother has prepared for the baby (if it is a cold day put some to warm) and put on the kettle.
Encourage the mother as much as you can, letting her take up whatever position she feels like, even squatting on the bed if she wants to. But once the contractions get very strong, get her to lie on her back supported by pillows, and she will probably find it comforting to hold on to her bent-up knees, which are widely separated. Once the baby's head is seen at the outlet, get her to stop her pushing efforts and pant gently instead. The slower the progress at this stage the less the likelihood of a tear at the outlet as the head is born, but don't worry yourself or her unduly about this.
Finally, keep the placenta for inspection by the nurse or doctor later.
