Illustrated First Aid Guide - Marcia Wendorf [33]
Human infants have the biggest head and shoulders relative to the size of a woman’s pelvis of any species. In order for a baby to pass through the bony ring of the pelvis and be successfully delivered, several distinct steps have to occur:
1. The baby’s head must descend through the bony ring of the pelvis
2. The head should rotate so that the baby’s face is towards the mother’s rectum
3. The head must pass out the birth canal
4. The baby’s head must then turn 45 degrees to align with its shoulders
5. The shoulders repeat the corkscrew movements of the head.
A problem in any of these steps, such as malpresentation of the fetal head, failure of descent of the head through the pelvis, poor uterine contraction strength, or a big baby and a small pelvis, can result in serious complications. Hemorrhage is the biggest killer of birthing mothers, and infection remains a problem especially in developing countries. Risk factors for babies include not receiving sufficient oxygen to the brain and other vital organs during labor, which has been minimized by the use of modern monitoring devices, birth injuries caused by the use of instruments and infection.
The safest way to deliver a baby is by professionals in a hospital. The time to go to the hospital is when the mother feels pain and pressure, and especially when her water breaks. When it is not possible to get to a hospital, or if emergency medical personnel haven’t arrived yet, the steps below describe how to successfully deliver a baby.
Treatment:
1. Lay the mother down on top of a clean sheet on the floor.
2. Place a pillow under her hips. If she’s more comfortable on her side, the mother can lay that way until just before delivery.
3. Have someone sit behind the mother and prop up her back during contractions.
4. Wash your hands before touching the baby and try not to touch anything that will contaminate them.
5. Check for crowning, when the baby’s head becomes visible.
6. If a membrane (the amniotic sac) covers the baby’s head, pinch and twist the membrane to break it and release the amniotic fluid.
7. Never try to hold the baby’s head back, guide it slowly from the birth canal.
8. Allow the baby to turn slowly to the side on its own.
9. Once the baby’s head is entirely out, clean baby’s nose and mouth with a bulb syringe if you have one, or use a clean towel to wipe away fluid and membrane from the baby’s airway.
10. If the umbilical cord is wrapped around the baby’s neck, try to slip it over the baby’s head. If you can’t deliver the baby anyway.
11. Guide the baby’s top shoulder out. The lower shoulder will quickly follow along with the rest of the baby.
12. Wrap the baby in a clean towel or blanket to keep him or her warm.
13. Within ten or fifteen minutes, the placenta will naturally deliver. Do not pull on the umbilical cord.
14. If help is on the way or you plan on taking both mother and newborn to a hospital, do not cut the umbilical cord. Instead, keep the cord and placental level with the baby. If you must cut the cord, clamp it tightly in two places, then make the cut between the two clamps. The remaining umbilical stub remains for up to 2-3 weeks as it dries and then falls off.
Pregnancy Emergencies
If a woman experiences any of the following symptoms during her pregnancy, she should seek medical attention:
• Vaginal bleeding
• Cramps in the lower abdomen
• Swelling of her face or fingers
• Severe continuous headache
• Dizziness or fainting
• Blurring of vision or seeing spots
• Uncontrollable vomiting
Treatment:
1. If a woman is experiencing severe vaginal bleeding or abdominal pain, call 911 immediately.
2. Have the victim lie on her left side, and keep her quiet and warm.
3. Place a sanitary napkin or a clean pad over the opening ov the vagina.
4. Save all blood-soaked pads and any tissues that are passed so they can be examined by a physician.
5. Seek medical attention for any injuries to a