For everyone's personal knowledge, pulling the baby out directly by the head can be problematic. I'd recommend allowing the baby to pass with minimal pulling. It mostly happens automatically.
Baby will present face down, head first, and rotate during delivery. After delivery, It's important to keep the baby in line with the mother until you cut the unbilicus (or umbilical cord). Ensure baby is warm and wrapped in towels. Cut the unbilicus 1-3 minutes following the delivery. To cut it, simply clamp it in two places and cut in the middle. The placenta will be delivered approximately 30 minutes after baby. Retain it and any other biological materials.
if you see a foot or arm (or both) coming from the vagina do not attempt to deliver on your own
if baby is crowning and appears cyanotic (blue) insert two fingers past the head and attempt to palpate or feel babies neck. If nuchal cord (umbilical cord wrapped around the neck) is found attempt to releave pressure by inserting fingers between babies neck and cord.
if foul discharge is noted in the amniotic fluid (fluid from the water breaking) this is probably meconium (baby pooped inside of mom) and should be reported to the receiving physician.
if baby is lethargic or cool to the touch attempt to warm baby and gently stimulate them with vigorous rubbing.
take the placenta with you. It's important for the physician to inspect it for many reasons including making sure the whole thing came out.
It's been awhile since I've looked at any of this stuff but this is all pretty generic advice. I'm more of a trauma dude and don't deal with obstetrics very often. If anyone has any more specific guidance for a out of hospital emergency delivery I'd appreciate the feedback.
October 08, 2014 at 02:39AM
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