We know that the baby will be coming soon, but we don’t know exactly when. The new mother to be will have a plan of how to get to the hospital or, if she’s planning a home birth, there will likely be a plan in place to have a doctor or midwife present. Well, life doesn’t always go according to our plan. Especially when it comes to the birth of a baby. It’s best to be prepared for any situation that may come and to be flexible knowing that we may have to make some adjustments to our plan along the way.
When I was pregnant with my second child I went nine days past my due date. I was scheduled for an induction at 10 a.m. the morning of September 12, 2014. I woke up feeling labor pains. I knew I would be going to the hospital soon so I went about my morning getting ready for the day of the induction. My bags were ready, I showered and I turned the television on trying to pass the time. My husband and our 3 year old son were still in bed.
At 7:15 a.m. I called for my husband and he came running down the stairs. I told him I couldn’t wait until 10 to go to the hospital. My contractions were getting stronger and we had to leave NOW! We waited for a contraction to pass and then we headed towards the car. I made it outside on our porch and I had to stop as another contraction was coming.
My husband was in shock when I yelled to him, “Take my pants off!”
“WHAT!?” he replied.
My brain was saying walk to the car but my body knew better. It’s like my natural instincts took over and I just laid down on my back. My husband still in shock called 9-1-1. They were ten minutes away. There we were - my pregnant self about to give birth on the porch, my husband, our 3 year old son and our dog. Somewhere in the middle of the chaos my husband grabbed clean bath towels. And placed one under my bottom, one under my head, and kept some clean for the baby.
As soon as I heard him tell the 9-1-1 operator he could see the head I pushed. It was the first and only push and out came our baby! Lucky for me my husband is an Intensive Care Unit RN/BSN. He knew what to do plus he had help on the phone reassuring him. We are also very fortunate there were no complications. Emergency medical services arrived four minutes after the baby was born. They cut the cord on my porch and I delivered the placenta in the ambulance in my driveway. By the time we got to the hospital everything was over. It was the most surreal experience our family has ever been though.
Speaking from experience, we have put together a guide to deliver a baby in 15 steps. Just in case!
15 Call For Help
No matter how qualified we think we are, call for help if a laboring mother is about to give birth. A 9-1-1 dispatcher can talk us through delivery if necessary. An ambulance will be dispatched and come to the mother as soon as possible. If the mother was planning on a home birth anyways, the midwife or doctor should be notified. Hopefully help will arrive before the baby comes. If they do not arrive before the baby comes then they should arrive shortly after. It’s important to notify help first, so if there are any unexpected complications during or after the birth they will be there quickly.
A cool side note. When my husband delivered our baby he was on the phone with the 9-1-1 dispatcher the whole time. I was in a daze and didn’t really know what had happened. A week after the baby was born we got a recording of the tape and we were able to listen to the whole thing!
14 Stay Calm
The first rule to delivering a baby is to stay calm! It won’t help anyone in this situation if we are running around having a freak out moment. The mother to be is already under enough stress so it’s important that we do not add any extra hassle. It okay – and totally expected – to panic on the inside but it needs to stay inside of us and remain totally undetected by the mother.
Assure the mother that everything is going to be alright to help her relax. She is about to give birth unexpectedly so there is no way she will be completely relaxed, but it will help to put her mine at ease if we appear confident. Talking out loud to the mother can also help us soothe ourselves at the same time.
This is important - validate the mother’s feelings! She may be feeling scared, angry, happy, or sad. Whatever her feelings are agree with her and don’t try to correct her or argue with her. If she is scared, agree that this is a scary situation but then reassure that you are there to help and everything is going to be alright.
13 Assess The Situation
The next step it to determine how far along labor has progressed. The early stages of labor start when the contractions are coming at regular intervals. There should be enough time to seek medical help before the baby comes if the mother is in the early stages of labor. The contractions will gradually become stronger, longer, and closer together. Sometimes early labor contractions can be very painful, even though they may be dilating the cervix slowly. If the mother is in early labor she should be able to slowly walk around and talk through the contractions.
Eventually, the contractions will come every five minutes lasting 40 to 60 seconds each. This is the end of early labor and the transition into active labor. During active labor things will become intense. The mother will no longer be able to talk through her contractions. Once there are regular, painful contractions, lasting about 60 seconds, every five minutes for an hour, it’s time to get the mother undressed from the waist down. Don’t try to check her cervix for dilation (unless you are a medical professional). If you can see the head when the mother undresses, skip to step 8; Watch and Catch.
12 Make Mom Comfortable
There is only so much we can do to make a laboring woman feel comfortable. We should let the mom to be lead us in helping find a comfortable position. If she is laying down on her back get her some pillows and place them under her head. The mother may want to switch positions between contractions. All-fours is a common comfortable position. It can help ease back pain. If this is the position she chooses stand behind her and rub her back gently. Fair warning some women DO NOT want to be touched during labor while others might enjoy the distraction of a back rub.
If mom cannot find a comfortable position on her own we can suggest lying on her left side. According to Baby Center, lying on your left side is preferable for blood flow. It can also can lead to a gentler stretching of the perineum and may reduce tearing.
11 Grab Supplies
Delivering a baby is a messy process. If we only have time to grab one thing before the baby comes out it should be a towel, sheet, or blanket. If there is access to a clean plastic table cloth or a clean shower curtain (do NOT use the one that is currently hanging in the shower) those would be ideal. It will keep the furniture or carpet from getting stained and will make the clean up afterwards much easier. If we are really in a bind we can always lay down newspapers however that is not nearly as sanitary.
We want something to place underneath the mother to help catch the mess. Depending on where you are and how modest the mother is, she might want a towel or sheet draped over her so she doesn’t feel so exposed. We also want something clean and soft to wrap the baby in. An infant must be kept warm after it is born. Sanitary napkins and paper towels can be helpful to stop the bleeding afterwards.
10 A Quick Clean
We don’t want to risk giving mom or the new baby an infection. We need to sanitize our hands and arms with soap and hot water, don’t forget to scrub between the fingers and under the nails. Anti-bacterial hand sanitizer will be better than nothing if there is no hot water available. If there are clean sterile gloves available that is ideal. Don’t use any kind of dishwashing gloves as they are loaded with bacteria. Clean bare hands would be better than dirty gloves.
We talked about placing something clean under the mother to catch the mess. Placing a clean towel or sheet under the mother will also help keep her clean and reduce the risk of infection. According to US AID, infections are the leading cause of neonatal deaths, accounting for nearly 30% of the total. Infections can also be serious and even deadly to the mother. Bacteria is definitely something we don’t want to mess around with when trying to deliver a baby.
9 Guide Mom Through Pushing
We don’t need to encourage the mother to start pushing. She will feel an unbelievable amount of pressure to do so when it’s time. She might feel like she is going to have a bowel movement – and she might so be prepared for that. When she is ready we need to help guide her through pushing.
Encourage slow deep breathing throughout the process of pushing. Ask the mother to curl forward and tuck her chin. The curved position will help the baby through the pelvis. If the mom has chosen to push while she is lying on her back ask her to pull her legs up towards her chest. We can help her get her legs up but make sure we stay down below and keep our eyes on the baby maker for crowing.
When you can see the top of the baby’s head she is crowing. Now is the time to encourage mom to push with everything she has.
8 Watch And Catch
Ready or not here it comes - we can see the baby’s head! Do not, I repeat, do not try to pull the baby out. Pulling on the head or umbilical cord can cause nerve damage. Simply watch and catch. No, the baby isn’t going to come out full force as if someone is throwing us a baseball. The head should slide out first. When it does support the head with your hands and wait for the next push. It’s common for the cord to be wrapped around the baby’s neck. If this happens gently lift the cord and untangle it off the neck without pulling it.
The baby should naturally turn to one side once the head is out. This means it’s time for the body to come out. If the baby doesn’t rotate with the next push gently rotate it to one side. However, don’t push it if there is resistance. When the baby rotates to one side this should get one shoulder out. With the next push the other shoulder should come out followed by the rest of the body. Be careful – the baby will be slippery!
In the unlikely event of a breech birth do not touch the baby until the head comes out. If we see the feet or butt we might feel the urge to pull them out – DON’T! According to Kids Health, touching the feet before the head is out could cause the baby to gasp and inhale amniotic fluid. If the mother is having trouble getting the head out try helping her into a squatting position to push, but be ready to catch!
7 Clean Out The Baby’s Nose/Mouth
Immediately after the baby is born we want to wipe away any mucus or amniotic fluid around the nose and mouth. Use something clean and as sterile as possible like a towel, gloves, or even a paper napkin. This is going to be important to help the baby breath. We can hold the baby so the fluids in the nose and mouth drain. Hold the baby with two hands – one supporting the head and neck – and tilt the head down. The baby’s feet should be above its’ head at about a 45 degree angle, but don’t hold the baby by their feet like you may have seen in the movies.
Most of the time babies are able to bring the amniotic fluid out of their lungs on their own. However, sometimes they need some assistance in clearing the airway. If there is a bulb syringe – or any kind of clean syringe - available it will be very helpful to suction both the nose and the mouth. We could even use a clean straw.
6 Start Stimulating The Baby
We need to make sure the baby is breathing after the airways have been cleared. The baby should start crying. If the baby does not start to cry begin rubbing the body. Physical touch can help stimulate breathing. In the movies we always see the doctor giving the baby a nice hard smack on the bottom. Well, we don’t want or need to smack the baby but tickling the bottom of the baby’s feet or a gentle tap on the bottom can alert the baby and it will begin to cry.
We want to rub the baby with a towel or blanket to continue stimulation and to help clean some of the fluid and blood off. Hopefully there are no complications. Stimulation should happen fairly quickly. If the airways are clean and the baby isn’t responding to any of our stimulation then we will need to perform cardiopulmonary resuscitation or CPR.
5 Lay The Baby On Mom
Ask the mother to lie on her back if she isn’t already, and then lay the baby on the mother’s chest. Make sure there is skin to skin contact. This will again stimulate breathing and it will also be the beginning of mom and baby bonding. We should put the baby’s head on moms shoulder and the body on her breasts. This will allow the baby’s feet to be slightly above its head to continue the draining of fluids. Cover mom and baby with a towel or blanket to keep them warm.
According to Very Well, skin to skin with baby is good for all types of births assuming the baby is stable. There are numerous benefits that come from skin to skin contact between mom and baby. It will keep the baby warmer, normalize the baby’s breathing and the baby will likely cry less. When the baby can hear mom’s heartbeat – a familiar sound – it will help the baby to have a normal heart rate.
4 The Umbilical Cord
If we know that help is on the way and will arrive shortly, don’t cut the cord. It’s best to wait for a medical professional. Leave it alone and make sure it is not pulled tight. Actually, waiting to clamp or cut the umbilical cord can be beneficial. According to Baby Center, recent research shows that waiting a few minutes before clamping the umbilical cord allows extra blood flow from the placenta to the baby. This may lower the risk of newborn anemia and iron deficiency for the baby. Some parents chose to hold off on cutting the cord until it stops pulsing. This means the placenta is done doing its job.
If medical attention is hours away and we find ourselves in a situation where the cord will need to be cut, here are a few tips. Tightly tie a string or lace around the cord about three inches away from the baby. Move two inches down and tie another string making sure it is secure. Using a sterile knife or scissors cut between the two strings. Don’t worry about the pain. Mom and baby won’t feel a thing.
3 Deliver The Placenta
The skin to skin contact releases a hormone called oxytocin which helps the mother deliver the placenta. While mom and baby are bonding, we need to prepare to deliver the placenta. It might arrive a few minutes after the baby or it could be up to an hour. The mother should feel an urge to push and she can let us know when it is time.
We will see the cord getting longer, remember not to pull on it. Right before the placenta comes out we will see blood coming out, this is normal. Grab a bag or a bowl and place it below the mother. Have her sit up and give one big push when she feels ready and catch the placenta. Vigorously rub the mother’s stomach below her belly button. It is uncomfortable but it is necessary to slow down and stop the bleeding. Breastfeeding can also help stop the bleeding. If mom is feeling up to it, it’s never too early and it will only benefit mom and baby.
2 Seek Medical Attention ASAP
Assuming there were no complications for the mother or the baby during the birth, if help is not on its way to us then now would be the time to get the new mom and baby to the nearest hospital or doctors off. Even if everything seems fine it’s still important to get both mom and baby checked out by a doctor.
The medical staff will want to ensure that the mother did not tear during the delivery. If she did then they will give her a few stitches to help stop the bleeding. They will also check to make sure the uterus is contracting which will again slow down the bleeding. Excess bleeding and post-delivery fainting are common so new moms will need to be monitored after delivery. A pediatrician will need to examine the baby. They will give the baby an Apgar score, which is a simple assessment of how a baby is doing at birth. They will also perform blood tests and also do a hearing screening.
1 Take A Breath
Wow! What just happened? We just delivered a baby! When it’s all over we can finally take a deep breath and relax. That may have been one of the most intense situations of our lives and we need a minute to unwind and think about everything that just happened.
My little guy is two now and sometimes when I close my eyes I still have flashbacks to the day he was born on the porch. It was such a surreal experience for our whole family. You may have just delivered your own child, grandchild, niece/nephew, a friend or a complete stranger. No matter who you were to that baby before the birth, you are so much more now that you have been the one to deliver them. You are the first one to place your hands under their head and the first one to hand off the baby to the mother. You will always have a special intimate bond with this baby – So take a breath and enjoy that thought.