Emergency measures at an unattended birth

These suggestions have been gleaned from a variety of midwifery and obstetric sources. You can find some online resources, including a downloadable manual of emergency childbirth care, in the Links section. What should I do if...?

Shoulder Dystocia

If the head has been born, but the shoulders are not born with the next contraction, then the baby's shoulders may be stuck.

DO NOT PULL ON THE HEAD. Pulling on the head can cause serious nerve damage, and it won't help.
Change your position. Frequently movement of your pelvis releases the trapped shoulder.
If you are lying on your back, or sitting, roll over onto all-fours.
If the shoulders are still not born, try a different movement - roll back onto your back, and pull both knees up as high as possible towards your armpits (McRoberts' Maneouvre). If someone else is with you, they can help by pushing your knees up for you.
If you are in a birth pool, get out. Midwives say that the hip-hitching action of climbing out of the pool frequently frees a trapped shoulder. Moreoever, after shoulders are stuck the baby may be deprived of oxygen and therefore may gasp immediately after birth, so water birth may be an additional risk.
Keep trying different movements and positions. As time goes on this becomes a dire emergency, so don't stop.

The cord is around the neck

Don't try to cut or break the cord. Support the baby's head close to your vagina while its body is born, then try to loosen the cord. It's important not to cut the cord in this situation, as a great deal of the baby's blood supply can be trapped in the cord and placenta. Once the cord is untangled, the baby will get a transfusion of oxygenated blood exactly where he needs it.

Links on Emergency Unattended Childbirth

Emergency Childbirth manual - http://www.umbrellanoize.com/stuff/Emergency%20Childbirth.pdf Infant CPR videos
Search www.youtube.com and you will find plenty.

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