Month 9 The baby is coming!

The baby is coming. Now. And you are nowhere near a delivery room or doctor! Here is what to do to deliver a baby on your own.

It doesn’t only happen on TV. Although giving birth unassisted is highly unlikely, it does occur. Most labours last between eight to 24 hours – more than enough time to get you to a hospital or get an ambulance or midwife to you. However, there are those few women who do defy the statistics and whose labours are extremely quick – mainly for second or subsequent deliveries, so here is a step-bystep guide to help you cope if you really are going to deliver on your own.

IS THIS REALLY IT?

First you need to establish if you are in true labour. If you are further than 35 weeks and have experienced any of the following, the chances are that this is really it:

• loss of mucous plug

• your waters have broken

• regular lower back pain that becomes more intense

• tightening of your abdomen, hardening and then softening of your belly – contractions.

If you are experiencing contractions – time them. If the time from the beginning to end of one contraction is between 30 and 75 seconds and there are five minutes between contractions, then you may indeed be in real labour. Moving around, emptying your bladder or drinking fluids often makes false labour pains go away – so try these before you step up action in preparation for a birth. Phone your midwife, doctor or a doula, and describe the pains to them, so they can confirm real labour. If you experience these symptoms, and you are not yet 35 weeks pregnant, you may be going into pre-term labour – get to a hospital as you will need emergency medical assistance to deliver and care for your baby.

MAKE THAT CALL

So you are in real labour, now what? Try to remain calm. If you are absolutely alone, rally a passer-by to support you – one may even be a doctor or midwife! Call the emergency services number for your area. Even if medical help will take too long to reach you in time for the birth, you will need an expert on the line to keep you calm and talk you or your partner through the process. Emergency services will also dispatch an ambulance to get to you as soon as possible.

POSITION YOURSELF

Your support partner can help you to sit or lie at the edge of a bed or table, with your hips hanging off and your knees apart. If it is too painful to climb onto a bed or table, lie flat on the floor with a stack of newspapers or clean towels under your hips to raise them. If you are still in early labour but prefer to lie down, lie on or wedge a pillow under your left side. This will stop the full weight of you and baby pressing down and decreasing the blood flow – which will make both of you feel ill. Spread a shower curtain, clean towels or a newspaper under you to protect the area and to absorb the amniotic fluid and blood that will come out. Collect clean blankets and towels for drying the baby and swaddling him after birth. One major complication with an emergency home birth can be hypothermia for the baby, so once born, he must either be placed skin-to-skin on your chest or abdomen and you both should be wrapped with blankets or towels, or swaddled to keep warm.

PANT, DON’T PUSH

During contractions, try to slow down, focus and breathe. If you feel the urge to push, pant or blow rather to concentrate on the contraction rather than pushing. Panting breaths will help to hold off the baby’s arrival until help comes. Don’t, however, close your legs or try to hold the baby’s head in, as this could result in injury. If the urge to push becomes unbearable, wait until the contractions are at their strongest, and only push then. Try to rest in between contractions.

COMING TO A HEAD

The baby’s head needs to come out in a gradual processratherthan “popping” out. To encourage this, you or your support partner can apply gentle pressure – not pushing – to the baby’s head as it begins to crown, this will slow down delivery and help guide the baby out. Going slowly will also help prevent tearing. Never pull the baby’s head out, if the cord is wrapped around its neck, pulling will cause immediate suffocation. Once the head is birthed, check to make sure that the umbilical cord is not wrapped around the baby’s neck. If it is, hook a finger under it and gently work it over the baby’s head. Your support person should wipe the baby’s face with a towel and gently stroke the sides of the baby’s nose downwards and upwards under the chin. This will help get rid of any mucus and amniotic fluid from the nose andmouth.

IF YOU ARE ABSOLUTELY ALONE, RALLY A PASSER-BY TO SUPPORT YOU – ONE MAY EVEN BE A DOCTOR OR MIDWIFE!

KEEP YOURSELF AND BABY WARM UNTIL THE EMERGENCY SERVICES REACH YOU.

SLIP SLIDING AWAY

Your partner can gently take the head in both hands and press it slightly downwards – do not pull. Push at the same time to deliver the shoulders. When the upper arm appears, lift the head and watch for the rear shoulder. Once the shoulders have eased out, the rest of the body should slip out easily. The baby will be really slippery from the amniotic fluid, blood and mucus – so have a towel handy to “catch” him. If you think of it, ask your support partner to note the time of birth.

WRAPPING UP

Use the towel to carefully but vigorously rub your baby to prevent him from getting cold or stressed. This will also get him to cry, which will help to clear the lungs. Do not smack his bottom or back. It is normal for the hands and feet to be bluish, but if he is purple or grey all over he may be having difficulty breathing. Try to startle him into breathing by blowing on his face. If this does not work, seal your mouth over his nose and mouth and give a gentle puff of air. Once he is dry, place him skin-on-skin or swaddled onto your chest or abdomen, depending on how long the umbilical cord is.

BREAST IS BEST

If you feel up to it, try to breastfeed as this is a great way to speed up recovery. Not only does it aid with bonding and encourage a positive breast-baby relationship, but it also helps your uterus to contract. This helps to deliver the placenta and to prevent heavy bleeding.

IT’S NOT OVER YET

It can take anywhere from a few minutes to over an hour after the baby has been born for the placenta to be delivered. Do not tug on the umbilical cord to detach the placenta, it will happen naturally. If it comes out before the ambulance arrives, wrap it in a towel and keep it above baby’s head.

CORD CARE

Do not cut the cord. If you have a clean piece of string, tie the cord, no closer than 10cm from baby’s tummy. Wait to tie the cord until it has stopped pulsing. Keep yourself and baby warm until the emergency services reach you. Try to keep alert until you arrive at the hospital. ●