The Harvard Medical School Family Health Guide Emergencies and First Aid
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Before and After 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.


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