Sudden Birth

Sometimes labor is so quick that the your baby is born before you can get medical assistance, whether at home or on the way to the hospital. If this should happen, the following information will help you and your partner deliver your baby safely. This is not intended to be used as a guide for an out-of-hospital birth without a professional attendant being present, because this can be very risky indeed. It's reassuring, though, that there are rarely any complications in emergency births of this kind.

What To Do

When you get the urge to push, try to pant or blow for as long as you can to delay your baby's birth. The contractions alone are usually enough to push your baby out when he's coming this fast, so this won't delay things for long, although it may be long enough for the ambulance to arrive. Never try to hold your legs together to delay delivery, or allow anyone else to do so: this may cause your baby to be injured. If you cannot comfortably delay your baby's birth, don't try to interfere. Deliver the head slowly. There's more chance that your vagina and perineum will tear if you push along with the force of your uterus, so pant lightly with each contraction.

Prolapsed cord - If a loop of the umbilical cord washes out when the membranes rupture and your partner can see a piece of gray­blue shiny cord bulging out of your vagina, this means that you have a prolapsed cord. You must get help as soon as possible because your baby's oxygen supply is in danger of being cut off. Don't panic; you have time. Get onto the floor on your knees, with your chest to your knees, your head on the floor, and your buttocks in the air. This will help to take the pressure of your baby's head off your cervix. If the cord is still protruding, your partner should cover it with a wet, warm, very clean towel after he calls the hospital or goes for help. Don't touch or put any pressure on the cord. Stay in the knee-chest position even on the way to the hospital, because it reduces pressure on the cord. A prolapsed cord means you'll have to have a cesarean delivery, unless the cervix is fully dilated, in which case forceps or vacuum extraction will be used.

What The Birth Assistant Should Do

If it looks as if your partner is going to give birth at home, call 911, then call the hospital, followed by your doctor or midwife. If you're not near a telephone, on no account leave the mother alone. However anxious and overwhelmed you feel, it's vital for you to stay calm and reassure your partner-she needs to feel confident and relaxed. Bear in mind that the vast majority of sudden births are uncomplicated. Encourage your partner to take up any position she finds comfortable and to eat and drink if she feels like it. Speak quietly and keep other people away. Between contractions, turn up the heat in the room. Wash your hands thoroughly in soap and water, then gather up as many clean bath towels as you have. Fold one and put it on the floor so that you have something soft on which your baby can be laid.

Then fill several bowls with lukewarm water, and collect as many clean hand towels, washcloths, and dish towels as you can. They can be soaked in the water and used as wipes for the baby and mother during and after delivery.

The birth - Your partner will know when her baby is coming because she'll feel a stinging or burning sensation as the baby stretches her vagina. Look to see if you can see the top of the baby's head in the vaginal outlet. Remind your partner to pant or blow, so that her vagina and perineum have time to thin and stretch, which might help to avoid tearing.

Your baby's head will probably emerge in one contraction and the rest of his body in the next. When the head emerges, wipe each of your baby's eyes from inside to outside with separate pieces of moist cloth, and then feel around his neck to see if the cord is present. If it is, crook your little finger underneath it and pull it very gently over his head, or lift it so that his body can be born through the loop.

Do not interfere with the cord because it may go into a spasm and deprive your baby of oxygen. If the membranes are still present over your baby's face, gently tear them off with your fingernail so that your baby can breathe. Be careful to hold him firmly as he is born, since he'll be slippery with blood, mucus, and vernix caseosa. Never pull on his head, his body, or his cord.

Once he's born, he'll probably give a couple of gasps, a cry, and then start to wail. If he doesn't cry right away, place him across your partner's thigh or abdomen, with his head lower than his feet, and then gently rub his back while you dry him off. This helps any mucus to drain away and usually causes a change in blood pressure, which brings about his first breath. Talking to your baby lovingly will also help.

After the birth - Once your baby is breathing, pass him to your partner so she can put him to her breast, and keep him warm against her skin. If he's interested in feeding, the nipple stimulation will release oxytocin, which will encourage your partner's uterus to contract and expel the placenta.

Keep your partner and your baby warm with blankets or towels, especially your baby's head, since most heat is lost from here. Bear in mind that the normal color of a baby at birth is a bluish­white. He'll gradually become pink in the first minutes as oxygen enters his body; his hands and feet will take a little longer. Don't try to wash off the vernix, and never cut the umbilical cord.