A newly delivered baby Whether you're an expectant father or an unsuspecting cabbie, the time may come when you are called upon to help deliver a baby with no medical professional or midwife in sight. Maybe you're in that situation now. Follow these steps to help the childbirth go as smoothly and safely as possible.


Steps

1. Remain calm. People have to do this all the time; you'll do just fine. Birth is totally natural and most of what you need to do is help the mother relax and let her body do the work.
2. Assess the situation. Labor (the first part of childbirth, where the body is getting ready to deliver) can take a long time. To determine how far along the labor is, first ask the mother if she feels the baby coming or if she feels a strong urge to push. Now time the contractions from the beginning of one to the beginning of the next. Regular contractions less than 2 minutes apart indicate that the baby is ready, as does bulging of the vaginal opening during contractions. If you've still got time, try to get to a hospital, doctor's office or midwife.
3. Call for help if possible. If you've decided you don't have time to get to a childbirth professional, call 911 for an ambulance. That way, help will arrive soon if you experience complications. The dispatcher should also be able to either talk you through the delivery or connect you to someone who can.
4. Clean your hands and arms well with soap (preferably antibacterial) and water. If soap and water is not available, you can use an alcohol-based hand sanitizing product or rubbing alcohol. Whatever you can do, try to get your hands as clean as possible to prevent giving the mother or baby an infection. Wear sterile nitrile gloves if available.
5. Find and prepare a birthing area.
   • A mother birthing in a standing or vertical position is far more effective and comfortable than on her back, but this sometimes requires a third person to help hold her. While vertical there is the benefit of gravity, less likelihood of a perineum tear, and an increase in the flow of blood since the baby is not putting pressure on an artery. She may not want to labor in this position, but it is superior for pushing and the actual birth. Make sure the floor/surface is clean and as soft as possible, and someone is positioned to catch the baby.
   • If you are the only assistant available, it may be easiest to have the mother deliver while lying on her back or side. Again, find a clean, flat surface for her to lie on, and make it as comfortable as you can. Cover it with a clean sheet or sheets if possible because there will be bodily fluids involved. If it is slightly higher at the mother's head than at her feet, gravity will help the delivery.
6. Have the mother remove lower clothing. If she needs to lie down to give birth, have her lie on her side. Support her head and back with pillows, if possible.
7. When delivery begins, have the mother move to the birthing position, either on her back with her legs spread and bent at the knees, or in a supported, vertical, squatting position. Or whatever position "feels right" to the mother. Remember that nature has control here and women usually just "know" what to do if they remain calm.
8. Instruct the mother to take deep, slow breaths. Pain can be controlled to different extents through mental relaxation and by concentrating on deep breathing instead of panicking or being distracted by everything that is going on. Different people have different levels of mental control, but deep, slow breathing is always a benefit during childbirth. Remind the woman that her body knows what to do and to just relax and go with it. This can help her breathe more easily and deeply if she feels more relaxed.
9. Tell the mother to push when the baby's head arrives at the vaginal opening during contractions. When a contraction starts, the mother should take a deep breath, hold it, and steadily push for 10 seconds. The mother should stop pushing between contractions so she can rest. Or instruct her to just push when she feels the urge and to rest when the urge goes away. You may not want to count the seconds she is pushing because it can raise the womans anxiety level and you may accidentally encourage her to push when it's not the best time. Do not tell a woman to push if she has no urge of her own to do so.
10. Apply gentle pressure with one hand to the area below the vaginal opening as the baby's head starts to come out. This prevents the baby from coming out too fast.
11. Support the baby's head when you see it, but do not pull on its head or its body. Allow it to come out slowly; it should turn to the side naturally.
12. Clean the baby's head and nose as soon as the head is out. Use a suction bulb if possible. If a suction bulb is not available, use a clean towel to gently stroke downwards over its mouth and nose. If the umbilical cord is wrapped around the baby's neck, insert a finger between the cord and the neck and gently try to slip the cord over the head. If you cannot easily do this, proceed with the delivery. Do not cut the umbilical cord.
13. Guide the first shoulder out. Gently placing your hands on the baby's head, guide it downward as the mother pushes until the top shoulder is out. If the baby appears stuck, see the Tips section below immediately.
14. Guide the rest of the body out. Gently support the baby's head and body as it emerges and guide it up out of the vaginal opening. Hold the baby with a towel so that it does not slip out of your hands. This could happen slowly or quickly, so be prepared.
15. Hold the delivered baby with two hands, keeping its head down (about 45 degree angle) to allow fluids to drain. Its feet should be above its head, but do not hold the baby by the feet. Hold it so that its head is at about the same height as the vaginal opening. When the baby starts crying, wipe or suction its nose and mouth again. If the baby does not start crying, see the Tips section below immediately.
16. Dry the baby and wrap it in clean, dry towels or clothes. Cover the baby's entire body--including the head--except for the face.
17. Lay the baby on the mother's abdomen or chest, being careful not to pull the umbilical cord, and encourage the mother to nurse the baby, as this will help stimulate the contractions necessary to expel the placenta. Placing the baby skin-to-skin with the mother will help keep the infant warm.
18. Do not tie off or cut the umbilical cord.
19. The placenta Massage the mother's abdomen to help her expel the placenta. When the placenta emerges, do not pull on it. Let it come out slowly and then carefully place it in a large plastic bag or clean towel and lay it near the baby so as not to sever or pull the umbilical cord. Do not worry about cutting or even tying off the cord. A distressed baby can benefit from the nutrients and oxygen still in the placenta. Never try to pull out a placenta.
20. Attend to the mother. If the mother is bleeding from an external tear, apply gentle pressure to the tear with sterile gauze, a fresh sanitary napkin, or a clean washcloth. During the first two hours after delivery, periodically massage the mother's abdomen to help stop uterine bleeding. Clean the mother well with soap and water.
21. Get medical attention as quickly as possible. Once delivery is complete, proceed to the nearest hospital or await the ambulance you called. If help is still a long time away (an hour or more) and mother and baby are doing well, make sure that the mother eats and drinks to refuel and try to get the baby to nurse. It is good for the mother to empty her bladder but due to blood loss it may be best to have her urinate in a pan or on a cloth you can move from under her so she does not have to get up.
22. Tie off and cut the umbilical cord if you cannot get medical attention soon. There is typically no need to hurry to cut the umbilical cord, but if you are stranded in the wilderness or medical attention is very slow in coming you may choose to do so. Use a clean, thick string (such as a shoestring) or piece of cloth, and tie off the umbilical cord about 4-6 inches from the baby's navel (belly button). Tie a second string or cloth around the umbilical cord about 8 inches from the baby's navel (and thus 2-4 inches further down from the first string). Cut the cord with a sterile knife, scissors, or razor blade, then wrap the severed ends of the cord in a sterile dressing or clean cloth.

Tips

• If the baby's shoulder appears to be stuck, have the mother push hard while you press down on her abdomen just above her pubic hair. You may also try raising her legs toward her chest, making sure she keeps her knees bent and apart or have the woman get up and get into a hands and knees position. Sometimes this movement and position can dislodge the stuck shoulder. . Do not pull on the baby if it seems stuck.
• If the baby doesn't start breathing or crying immediately after delivery slap the soles of its feet while you are holding the baby with its head lower than its feet, and gently but vigorously rub the baby's back. If this doesn't work blow two quick puffs of air into the baby's nose and mouth.
• The baby may be blueish when you deliver it but should quickly gain a normal flesh color as long as it is breathing all right. The feet and hands may stay a little bluish and that is OK.
• If you don't have anything at hand, use shirts or towels to warm up the mother and baby.
• You may want to massage (pushing downward from about an inch or two just inside the vagina only with very clean hands or gloves toward the anus) or place a warm washcloth over the mother's vagina before the baby comes out. This can comfort her and help with the pain.
• To sterilize a tool for cutting the umbilical cord, wipe it with rubbing alcohol or heat it thoroughly.
• As an expectant mother or father, be sure to consider the possibility of going into labor when you make travel plans or do activities near the due date. Also, be sure to carry emergency supplies, such as soap, sterile gauze, sterile scissors, clean sheets, etc., with you in your car. Print out this article and carry it with you, too.

Warnings

• These instructions are not intended as a substitute for trained medical professionals. If at all possible, take the mother to a hospital where she can deliver the baby under professional medical care.
• Do not try to stall delivery. When it's time, it's time, and any delay can cause injury or death to the baby.
• If the baby comes out feet or bottom first (a breech presentation), you may want to place your hand up the birth canal and put your pointer and middle finger on either side of the baby's nose. Then pull the wall away from the baby's face so it can breathe. Breech presentations occur in less that 5% of pregnancies, but they may be impossible to deliver vaginally so it is imperative to get medical help as quickly as possible.
• Do not have the mother push hard unless you can see the vaginal opening bulging.
• If the mother is in labor, do not allow her to try to have a bowel movement. She may feel as though she needs to do this, but this feeling is most likely caused by the baby shifting and putting pressure on her rectum. It is normal to feel this urge as the baby moves through the birth canal just prior to delivery.
• Do not pull the baby or try to force it out of the vagina. Do not sever or pull the umbilical cord.
• Keep yourself, the mother, and the birthing area as clean and sterile as possible. The risk of infection is high for both mother and child. Do not sneeze or cough near the birthing area.
• Do not clean the mother or baby with antiseptic or antibacterial products unless soap and water are not available and there is an external cut.