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rhythmical breathing helps to relieve annoying
now feel a stretching, burning sensation.
symptions. The discomfort seldom lasts for
She must now no longer push during the
more than a dozen contractions.
contractions, and to avoid this, should pant
When the womb is almost fully opened the baby
(like a dog on a hot day). This will allow the
will soon enter the birth canal, and there will be
baby's head to slide gently and painlessly
a vocalized catch in the mother s breathing
out of the canal. If possible allow the head
when she has a contraction. The will signal the
to emerge between contractions. This will
onset of the second stage.
prevent the mother's skin from tearing and
will minimize trauma to the baby's head. It
is important that the mother pant instead of
Second Stage
pushing until both of the baby's shoulders
The contractions of the second stage are often have emerged.
of a different kind. They may come further
apart and the mother usually fells inclined to
Delivery of the Baby
bear down (push) with them. When she gets
this feeling she should take a deep breath as
As the baby is coming down the birth canal,
each contraction comes, hold her breath and
keep the perineum red or pink by massaging
gently push. There is no hurry here. The
with warm olive oil (if none is available simply
mother should feel no need to exert great force
massage the area with your hand). Any place
as she pushes. She may want to push with
that gets white will tear more easily so keep
several breaths during each contraction. After it
massaging and keep all areas red. Use olive oil
passes, a deep sigh will help her recover her
on the inside too and pay special attention to the
breath. She should then rest until the next
46
Emergency Childbirth
area at the bottom, as that is the most common and mouth. Be very careful as newborn babies
place to tear. Do this massage during a are very slippery.
contraction when it will not be noticed or it may
The baby will probably breathe and cry almost
irritate some women.
immediately.
You can support under the perineum with your
If the baby doesn't breathe spontaneously, very
hand on top of a sterile gauze pad or washcloth.
gently clear the mouth of mucous with your
Do not hold it together, just support it so the
finger. Stimulate crying by gently rubbing its
baby's head can ease out. The other hand can
back. IF all this fails, give extremely gentle
gently press with the fingers around the baby's
mouth-to-mouth resuscitation. Gently pull the
head so it won't pop out too fast causing tearing.
lower jaw back and breathe gently with small
As the baby's head is born, support it with your
puffs--20 puffs a minute. If there seems to be
hand so the face doesn't sit in a puddle of
excess mucous, use your finger to gently clear
amniotic fluid. Gently wipe the face with a clean
the baby's mouth.
or sterile washcloth. Check quickly around the
neck for the cord. If you feel it, just hook it with
The mother will probably want to hold the baby.
your finger and pull it around the baby's head.
This is desirable. If the umbilical cord is long
Check again. Some are wrapped more than
enough, let her hold the baby in her arms. If the
once. If the cord is so tight it cannot be slipped
cord is short, support the baby on the mother's
over the baby's head, just wait until the baby is
abdomen and help her hold it there.
born to untangle it. Most cords are long enough
It is of benefit to the baby and makes the
to permit this. IF the cord is too short to permit
afterbirth come with less bleeding if the baby
the baby to be born, it has to be cut and
can be allowed to suckle at the breast as soon
clamped and the baby delivered rapidly. In this
as it is born. The cord should not be cut until
situation the baby may be in distress because
the afterbirth has completely emerged.
the oxygen supply was cut off prematurely.
With the next contraction, one of the shoulders
comes and then the whole body slips quickly Third Stage.
out. IF several contractions have passed
The placenta delivery or afterbirth is expelled by
without a shoulder coming, you may have to slip
the womb in a period of a few minutes to
two fingers in and try to find an armpit. With
several hours after the baby is born. No attempt
one or two fingers hooked under the armpit, try
should be made to pull it out using the cord.
to rotate the shoulder counterclockwise while
Immediately following the afterbirth, there may
pulling out. Usually this does it.
be additional bleeding and a few blood clots.
As the baby's head emerges, it is usually face
The womb should feel like a firm grapefruit just
down. It then turns, so that the nose is turned
below the mother's navel. If it is soft, the baby
towards he mother's thigh. Support the baby's
should be encouraged to nurse, and the mother
head by cradling it in your hands. Do not pull or
may be encouraged to gently massage the
exert any pressure. Help the shoulders out. For
womb. These actions will cause it to contract
the lower shoulder, support the head in an
and lessen the chances of bleeding.
upward position. As the shoulders emerge, be
If hemorrhaging occurs, do the following:
prepared for the rest of the body to come
1. The uterus should be gently massaged to
quickly. Use the cleanest cloth or item available
to receive the baby. keep it hard.
Make a record of the time and approximate 2. The woman should lie flat, and the bottom
location of the birth of the baby. of the bed should be elevated.
With one hand, grasp the baby at the ankles,
3. Put a cold pack (such as a small towel
slipping a finger between the ankles. With the
dipped in cold water and wrung out) on
other hand, support the shoulders with the
the lower tummy to irritate the uterus to
thumb and middle finger around its neck and the
contract.
forefinger on the head. (Support but do not
4. Put pressure on the perineum with several
choke). Do not pull on the umbilical cord when
sanitary napkins and the pressure of your
picking the baby up. Raise the baby's body
hand.
slightly higher than the head in order to allow
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