Would you know what to do if you got caught short and went into labour early? Registered Medical Practitioner Dermot Mora is an expert in unexpected births in unexpected places
Unexpected births was written and edited by Dermot Mora, a registered medical practitioner who, as a general practitioner, has delivered hundreds of babies both throughout Australia, New Zealand and the Pacific Islands (including one in a henhouse with a rooster perched on his shoulder – but that’s another story).
More latterly, as a specialist, he has ruffled fewer feathers diagnosing countless birth situations of all kinds in impeccably professional surroundings.
Unexpected births fall into two broad groups.
The first arise from VERY RAPID LABOUR, often resulting in delivery on the way to the hospital. Usually there is little to worry about; the outcome for such births is almost uniformly excellent.
The most useful ‘piece of equipment’ is a mobile phone, or a helpful taxi-driver, to call up emergency services for directions.
If help is close by, nothing need be done except to look after the babe. If it’s in a built-up area and traffic is slow, the umbilical cord may be tied if there’s something handy. If this is done, tie the cord at least 20 cm (about eight inches) from the infant’s body. (There is no need to cut the cord when mother and newborn are on the way to nearby sterile help).
If the placenta comes out by itself, well and good.
If help is, say, half an hour away, gentle, steady pulling on the cord, along with gentle pressure on the top of the uterus will help deliver the placenta.
The second situation confronting someone inexperienced is the UNINTENDED, OFTEN PREMATURE labour, in an unplanned or unforeseen situation.
In such a situation, distance or some other factor may mean transport to assistance is not likely to happen before the babe is born. (But call for emergency help anyway).
This is a different kettle of fish as the labour could be long and difficult – and yet, may be over before help arrives. The baby may be small, premature, and/or exhausted and limp.
There will be time for some elementary preparation, which really only means scrubbing hands and boiling up a pair of scissors to cut the cord and tape, or something like it, to tie it afterwards. (In a remote area this makes handling the baby easier).
Help with the placenta may be necessary if it does not push out within ten minutes or so. This means a gentle but steady pull, just enough to put tension on the cord – not enough to cause it to stretch.
Either the head or breech comes out and progress stops. In the city-taxi kind of scenario, keep going for help. Emergency services include police so they may clear the way. In the remote-home or similar situation, maintain steady pulling, not jerking of the baby parallel to the bed will hopefully succeed – but emergency help will be required.
Usually, bleeding from the mother ceases after delivery of the placenta. If it doesn’t, get to the hospital as quickly as possible. Pressing the uterus might help lessen the bleeding.
Reviving The Baby
Most newborns breathe fairly quickly but if breathing doesn’t start within a minute gentle mouth-to-mouth resuscitation is the best method in an emergency. A baby has a lot of built-in immunity from its mother and is unlikely to catch anything.
- Don’t jerk. Any actions need to be firm and gentle at the same time.
- Don’t tie the cord close to the baby.
- Don’t panic. The human race would not exist if we didn’t get it right naturally most of the time!