Assisting in childbirth -- First Aid Guide

A woman may go into labor unexpectedly. As a first aider, you may be expected to help with the birth. Remember that the birth of a child is a natural process and occurs around the world thousands of times a day with no complications. Hence the role of the first aider is to assist and support the woman throughout the birth process.

You will need:

• A clean sharp blade (such as a razor blade or scissors).
• Three clean pieces of thick thread to tie the cord.
• Clean clothes to put under the woman during delivery (as many as you can get).
• Clean soft clothes, one to dry the baby and the other to wrap the baby.

FIRST STAGE (Pre delivery)

• Stage one begins with the contractions of the uterus “cramp like pain” in her abdomen
• Contraction can occur every 10 to 20 minutes at first and then gradually become closer together. This can last up to 16-18 hours for the first birth and the time may reduce for subsequent births.
• The “Water breaking” or a “show of blood” can also occur with fluid coming from the vagina.
• This means the baby is coming and the first aider needs to prepare for the delivery.

SECOND STAGE (During delivery)

• Send for the help of a midwife or a doctor.
• Stay calm and gather the equipment needed to assist the birth.
• Wash your hands and put on sterile gloves.
• Help the woman to wash particularly around the area of the birth canal. (Ask another woman to help).
• Help the woman in labor to move around to find a comfortable position for delivery.
• Place the woman on her back with her legs spread apart with her knees bent and feet on the bed.
• Place clean towels on her thighs and on the area beneath her birth canal.
• Help the woman into the most comfortable position of her.
• Place the clean cloths under mother and watch for stools, cover them before the birth of the child.
• You will see the baby’s head “crowning”.
• If the mother has previously given birth, the baby may come out quickly. You need to be ready to catch the baby gently as it is slippery.
• Support the head gently with one hand as the baby comes out.
• The baby’s head will rotate to face the side to let the shoulders and the body to emerge. Allow this to happen naturally whilst gently supporting the baby.

Immediate care of the Baby

• Wrap the baby in a clean warm cloth.
• Listen for the baby’s first cry.
• If the baby does not respond, start resuscitation immediately.

THIRD STAGE (Post-delivery):

• Contractions will occur until the placenta is delivered. The mother will need to deliver the placenta.
• After the delivery the placenta there will be some bleeding continuing. Place a pad over the birth canal to help collect the blood.
• Place the baby on the mother’s abdomen if the cord is long enough. Let the mother start breastfeeding the child.
• If bleeding continues from the mother, firmly massage the lower abdomen until you can feel a small ball. Continue gentle massage until bleeding is controlled.
• Wrap the baby and prepare the mother and transfer to hospital.

Urgent transfer to hospital if:

• Part of the umbilical cord comes out before the baby.
• If the baby’s foot or arm comes out first.
• Strong labor pains for more than a day and a night (as the baby may be stuck).