Easter morning of 2009 was a special day for me. If you don’t recall, that was Sunday, April 12th. While most of the world attended church services or spent time with loved ones, I was working a weekend shift at a small ambulance station in Perry County, MS. About the time that most churches were either eating breakfast or listening to their choir cantata, my unit was dispatched to an emergency childbirth. These types of calls are fairly routine and usually just requires monitoring on the way to the hospital. However, after arriving on the scene, I quickly realized that this was no ordinary call. About half way to the hospital, with just myself and the patient, we delivered a new child into the world.
I use the term “we” lightly. I didn’t actually do much during the actual birthing process. Yet, I felt immediately connected to the child and mother alike. There, in the back of an ambulance that was traveling at high speed, I had never felt life slow down as much as it did on that day. In case you were wondering, the child was a healthy boy and, to my knowledge, will celebrate his eighth birthday next year. For as beautiful of an experience as childbirth can be, there probably has not been a pregnancy occur in which one of the parents did not wonder what they would do if they had to deliver the baby away from the hospital. Because of this, it is a great idea to brush up on a few key points and find out exactly what to expect when you weren’t expecting.
The best piece of advice I can give is do not panic. Remain calm and focus on what you need to do for the birth, even if you are alone. Call 911 immediately! Try to identify if there are any signs of what we call imminent delivery, or there is no stopping the baby from coming. The most common sign of imminent delivery is crowning of the head against the vaginal opening. At this point, the mother is probably experiencing contractions every 30-60 seconds with incredible intensity. If you are in a vehicle and crowning occurs, pull over immediately. You simply cannot drive a car and deliver a baby at the same time! Place the palm of your hand against the baby’s head to prevent an explosive delivery.
Remember, you should never pull or push against the head or neck of the child but can gently guide the birth procedure. As the head emerges, gently stroke downward on the baby’s nose to expel any amniotic fluid that could hinder breathing. After completely delivering the head, the shoulders and body of the child should follow on the next push.
After the baby is delivered, place it skin-to-skin with his mother so that the baby’s head is slightly lower that the body of the child. Cover and keep them both warm with dry towels and blankets. Even if not planning to breastfeed, have the mother nurse the newborn. Nursing stimulates the hormone Pitocin which will cause contractions inside the mother to cease and stop any bleeding.
At this time, the baby will still be attached to the umbilical cord. Do not attempt to cut or pull on the cord as this can cause serious issues unless done by a medical professional. Depending on the length of time to get to the hospital or the arrival of an ambulance, the mother might feel a second urge to push. This is normal and is the body attempting to deliver the placenta. If the mother does delivery the placenta, call 911 for instructions on cutting the umbilical cord while saving the placenta for inspection at the hospital. Oh, and please do not slap the child’s bottom. This is a tired movie cliché that simply doesn’t happen in real life. The pressure of the chest wall being released from birth canal is almost always enough to stimulate breathing. If not, simply flick the soles of their feet.
Since that day in 2009, I have birthed two more babies in the back of my ambulances and countless others in hospital Emergency Rooms. Even for a trained professional, it can be out of your comfort zone. Just remember, women have been having babies for a long, long time and the vast majority of births are complication-free and the baby and mother does wonderful despite the panicked people assisting. Also, many area hospitals offer new parenting classes that, in part, instruct what to do in greater detail.
If you or your family are expecting, consider taking one of these classes and have an action plan ready in case your child decides to discover America sooner than expected. Stay safe out there.
M. Eric Williams, MS, NR-P
Emergency Medical Faculty
Jones County Junior College
Questions/Comments: eric.williams@jcjc.edu
