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Thursday, January 7, 2010

Emergency Childbirth, or common sense?

This was forwarded to me by another midwife - advice for impromptu birth attendants, straight from the DOD. It would be wonderful if medical practitioners routinely followed this commonsense advice for safe birth! Notice there is no mention of checking for a Cesarean scar first...


Emergency Childbirth Reference Guide Posted at 01:18 AM on January 06, 2010

U.S. Department of Defense

Emergency Childbirth
A Reference Guide for Students
Medical Self-Help Training

Course Lesson No. 11
Emergency Childbirth: What To Do
1. Let nature be your best helper. Childbirth is a very natural act.
2. At first signs of labor assign the best qualified person to remain with mother.
3. Be calm; reassure mother.
4. Place mother and attendant in the most protected place in the shelter.
5. Keep children and others away.
6. Keep hands as clean as possible
7. Keep hands away from birth canal
8. See the baby breathes well.
9. Place the baby face down across the mother's abdomen.
10. Keep baby warm.
11. Wrap afterbirth with baby.
12. Keep baby with mother constantly.
13. Make mother as comfortable as possible.
14. Identify baby.

What Not To Do
1. DO NOT hurry.
2. DO NOT pull on baby, let baby be born naturally.
3. DO NOT pull on the cord, let the placenta (afterbirth) come naturally.
4. DO NOT cut and tie the cord until the baby AND the afterbirth have been delivered.
5. DO NOT give medication.
DO NOT HURRY - LET NATURE TAKE HER COURSE.

{emphasis is not mine - I copied this exactly as written}

This is how I approach attending VBAC as a traditional midwife and it works quite well - just ask the mothers!

3 comments:

heather d said...

WOW! It is amazing that this is what to do in an "emergency", yet nearly completely the opposite of what is done in the hospital. That in an emergency one should remain calm and let nature takes it course, but in a hospital every one should panic and try to force it out against nature should set off alarm bells! That alone should really make one wonder!!!

Thanks so much for posting this!

heather d said...

Ok, I cant resist a little comparison:

Emergency Childbirth: What To Do
VS. HOSPTIAL BIRTH: What To Do

1. Let nature be your best helper. Childbirth is a very natural act.
**Childbirth is VERY DANGEROUS-and a medical condition occurring to a patient—drugs and technology must be used.

2. At first signs of labor assign the best qualified person to remain with mother.
**This is a DOCTOR, though he is only necessary in person at the end when he “delivers” the baby. A nurse who has several other women to watch will do and can talk to the doctor by phone.

3. Be calm; reassure mother.
**Remind mother how dangerous childbirth is and that her pelvis may not even be big enough and any other imminent danger lurking around the corner. Suggest more drugs and machines. Have other nurses look at the EFM readout with concern.

4. Place mother and attendant in the most protected place in the shelter.
**Keep door open to bright hospital room to make it easier to run in and out (as long as she has had her epidural and isn’t too loud). A centrally located room where all the nurses and doctors can easily come in and out is best. Keep it bright so the doctors and nurses can see.

5. Keep children and others away.
**Yes, there should be as little distraction for the doctors and nurses as possible. This is very stressful and difficult for them. Doulas are not recommended either, or mothers for that matter as they can get very frightened when things get dangerous.

6. Keep hands as clean as possible
**Yes, see #7

7. Keep hands away from birth canal
**Check the cervix by putting fingers inside vagina at LEAST once an hour. It is very important that dilation is occurring swiftly or the baby could die. This can be done by any nurse or doctor who is coming around, and whenever they deem it necessary.

8. See the baby breathes well.
**Just suction that baby immediately without checking. There is all sorts of fluid in the lung, especially if it was born by c-section.

9. Place the baby face down across the mother's abdomen.
**Take the baby away IMMEDIATELY to measure and weigh and check apgar and give shots and give oxygen if needed. Tightly wrap up child in blanket and then after deemed safe to do so give back to mother. Check to see if she has any interest in feeding it or wants formula, and offer a pacifier to keep baby quiet

10. Keep baby warm.
**see #9

11. Wrap afterbirth with baby.
**Use Pitocin to speed up birth of placenta, tugging a bit if needed on cord. When out immediately take it away to be destroyed and give the mother a very stern look if she asks to see it or even keep it. This is very frowned upon for obvious reasons.

12. Keep baby with mother constantly.
**Baby should be bathed by staff soon after birth and is recommended to sleep in the nursery, especially after a c-section as mother will be tired and she will have the rest of her life with that baby. Also there are many other tests that must be done away from the family.

13. Make mother as comfortable as possible.
**Hospital beds are very comfortable, and after a c-section she can stay up to 5 days to do nothing but rest!

14. Identify baby.
**Do be sure to keep the hospital security bands on baby and mom due to past attempts at kidnappings of newborns in hospitals.

ENJOY YOUR HOSPITAL BIRTH! We hope you and your baby come out OK!

SheGotHipsLikeCinderella said...

Gee, sounds a little like birth is safe and interfering in the process is risky... Hmmm.... Trust Birth?!?No that cannot be- it's dangerous and deadly, especially outside of the hospital, right?!? big giant eyeroll-> <@@>

Thanks for posting this Vanessa!