In one recent episode of "Oprah," the show featured an 11-year old boy, named Schneider Mettelus, who helped his mother give birth to his baby brother by cutting the latter’s umbilical cord. I have heard of other similar stories and some even concern friends and people I personally know.
When a baby arrives before the mother reaches hospital, experts in obstetrics say that there are usually few complications although the situation can be frightening and stressful. Labor has three stages: first, the birth canal stretches and the uterus contracts every few minutes in preparation for pushing the baby out – this usually lasts for at least 12 hours for a first baby, but may be only two to three hours for a subsequent baby; second, the baby is born; and third, the placenta (afterbirth) is delivered.
When faced with such a situation, remember to call for an ambulance as soon as possible. And here’s what experts advise you to do:
1) Help the mother to lie down on a bed or on the floor if necessary. Provide support for her head and shoulders with pillows, blankets, or rolled-up clothing. Find some clean towels or old cotton sheeting to place under the mother during the birth.
2) Although the mother will want to "push" with each contraction, advise her instead to "pant like a dog." This is to avoid damage to the birth canal if it is not fully ready to expel the baby. When the mother cannot pant any more and is pushing with every contraction, encourage her to rest between contractions and breathe quietly to regain her strength for the next one.
3) When the baby’s head appears, support it lightly on your hands until the next contraction comes and expels the body. The head will rotate slightly on your hands as the shoulders turn sideways ready to be born. Do not interfere with the natural movement of the baby because any resistance can be harmful.
4) Check that the mouth and nose are clear of the birth membrane and remove any remnants which might interfere with the baby’s first breath. Check for a loop of cord around the baby’s neck and if one is felt, quickly slip it over the baby’s head to avoid it tightening on the neck as the baby is born.
5) Be ready for the start of the next contraction when the shoulders will suddenly appear, one at a time. Do not pull on the baby but instead let the mother’s contractions do the work and allow the baby to be born naturally.
6) When the baby slips out of the birth canal, quickly place on one side between the mother’s legs. Immediately check that the mouth is clear of mucus. Cover the baby in a towel to maintain warmth and keep the head covered to conserve heat.
7) Once the baby is breathing, watch the umbilical cord until it stops pulsating. Then tie off the cord with two ties made of string (or strips of pantyhose). Avoid fine string which can cut into the cord. Apply the first tie about 15 centimeters from the navel and the second about 20 centimeters from the navel. Do not cut the ends of the ties too short as they may loosen. Try to avoid pulling on the cord while tying the knots.
8) If an ambulance is due shortly, cover the cord with a clean or sterile dressing and leave it attached to the baby and the afterbirth. If the ambulance is likely to be more than half an hour, the cord should be cut. Use clean, sharp scissors to cut between the two ties. Then apply a third tie only 10 centimeters from the baby’s navel in case the first tie becomes loose as the cord shrinks. Cover the cut end with a sterile dressing and watch for any sign of bleeding.
9) Let the mother nurse her new baby and breast-feed if she wishes to do so. The placenta will be delivered with a mild contraction which the mother may not feel, especially if she is feeding the baby. Do not pull on the cord to speed up the expulsion of the placenta. Save it in a bowl for the doctor to examine later. Keep mother and baby warm together until the ambulance or the doctor arrives.
Experts caution about certain complications in childbirth. For example, if the baby has turned around inside the womb, it may arrive in a position that is not "head first." Without any pressure from the baby’s head, the birth process will be longer and more complicated and will usually need medical help. In a "breech" position, the baby emerges buttocks first, which can delay the second stage of labor. Warn the mother to stop pushing at this stage, and to puff hard to make the contractions ineffective. If the baby’s buttocks and trunk are delivered before trained help arrives, do not try to help the head out, because brain damage could occur. Keep the baby warmly wrapped, half in and half out of the birth canal, to avoid the risk of cold air on the chest stimulating breathing before the head is free.
Sometimes a foot, arm or the baby’s face will arrive first. If the top of the head cannot be seen, always try to slow down the birth process (as above).