Early stages of labor can last many hours.  During this time the mother’s contractions open the cervix and the baby begins to move down the birth canal.  Once the cervix if fully dilated, the mother usually feels the urge to push and the baby’s head appears at the vaginal opening.  If this is the first baby, the pushing may last long enough for  medical help to arrive.  But, if it is the second or third baby the head may deliver very quickly. Rapid delivery is most common in women who have had rapid deliveries before, had several births, or gone into premature labor.   

Babies are usually born head first, facing down.  The placenta detaches from the uterus and delivers after the baby.  Rupture of the amniotic sac may indicate the baby will be coming soon.  The fluid in the amniotic sac is referred to as “water” and often when it ruptures is relayed as “my water has broke”.  Other signs to watch for that birth is close at hand, regular contractions that are less than 2 minutes apart, the urge to have a bowel movement, a strong urge to push, bulging vaginal opening, and the mother saying the baby is coming.

The ambulance should have already been called.  Until help arrives, stay calm and reassure the mother. In the rural areas where help can be several minutes away the chances are you may have to deliver the baby before help arrives.  Wash your hands with soap and water.  Here are a few don’ts.  Do not try to delay the delivery in any way.  Crossing or holding the mother’s legs, or pushing the babies head back into the vagina can seriously injure the baby.  Do not allow the mother to go to the bathroom.  The baby could deliver in the stool.  Reassure her the need to have a bowel movement means the baby is coming.  Do not let her push until you see the bulging of the baby’s head in the vagina.  Do not pull the baby out.  Do not pull or cut the umbilical cord.  Keep persons with colds, unwashed hands, or open cuts at a distance.  Do not use chemicals or antiseptic products around mother or baby.

Call 911 and request an ambulance if there is no time to get to the hospital.  Do not attempt to drive the mother to the hospital.  You will have two patients on your hands if she delivers. In case she may deliver at home, keep a few supplies on hand.  A flashlight, pillows, clean sheets and towels, suction bulb, sterile gloves, scissors, and two tie cords. 

As the expected date approaches, think through all the possible scenarios of getting the hospital.  Include arrangements for transportation and supervision of other children.  Prepare an emergency delivery supply kit listed above.

If the baby is born before help arrives, suction the airway and keep the infant warm.  It is an exciting time, but most of all try to remain calm and keep the mother calm.  After all, women have been having babies for centuries without much help.