The Family Health Guide

Emergencies and First Aid - Childbirth

Birth of the Placenta

If you are called on to help deliver a baby, remember that childbirth is a natural process and that your role is to assist the woman and offer encouragement. If a woman's contractions are very strong and 2 to 3 minutes apart or the water bag (amniotic sac) has broken, birth is very near. If the woman tells you that the birth will happen very soon, believe her.

You will see quite a bit of blood, which is normal. You may see bloody fluid coming from the vagina before and during the birth; this is also normal.

Immediate care
Call 911 or have someone else call. Put down a large plastic sheet or plastic shower curtain and place sheets and towels or newspapers on top of the plastic to absorb fluids. Help the woman lie down with her legs apart and her back supported by a pillow. Wash your hands. Use disposable surgical gloves if you have them.

During the birth, the woman may wish to lean forward and grab her knees, or she may want to squat or lie on her side. Let her decide which position is most comfortable. When the baby's head is visible in the vaginal opening, the birth is about to occur. Do not try to hurry the birth by pulling on the baby's head. Let the woman push the baby out. Usually, as the baby is born, the face will appear straight down or straight up.

As soon as the head is outside the vagina, put two fingers along the top side of the head and feel around the neck area for a loop of the umbilical cord. It will be about the thickness of your little finger. If you can feel it, hook the loop of cord with your two fingers and slide it gently over the baby's head.

The baby's head should then turn toward one side and the shoulders should come out. Assist the birth by supporting the baby’'s head and shoulders, but remember not to pull. Be careful —the baby will be slippery. If there is a membrane covering the baby's mouth and nose, gently wipe it off with a clean cloth. Do not remove the whitish coating on the body.

ITEMS TO GATHER:

  • Towels, plastic sheet, and newspapers
  • Soft blanket for the baby
  • Gloves (ideally disposable surgical gloves), if available
  • Thick string, clean shoelace, or sterile tape to tie off umbilical cord
  • Plastic bag for placenta

REMEMBER TO…

  • Note the time of birth.
  • Congratulate the mother!

AFTER DELIVERY

After delivery, hold the baby with his or her head slightly lower than the feet to drain fluid from the nose and throat. Do not hold the baby upside down or slap him or her. Gently dry off the baby and wrap him or her in a dry towel or blanket. The baby should start breathing and his or her color should improve as oxygen is breathed in. If the baby does not start breathing, place the baby on his or her back and gently rub the chest or tap the bottoms of the feet. If the baby still does not begin breathing, start mouth-to-mouth-and-nose resuscitation.



CUTTING THE UMBILICAL CORD

The umbilical cord will pulsate during the birth and afterward, indicating that the baby is still receiving blood from the mother. Do not cut the cord until it stops pulsating. After it has stopped pulsating, tie off the cord tightly with heavy string, a clean shoelace, or sterile tape about 4 inches from the baby; tie it again 2 to 4 inches from the first string. Cut between the two ties. Wrap the baby in a soft blanket and place him or her on the mother’s stomach.