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| Version | User | Scope of changes |
|---|---|---|
| Sep 11 2008, 1:22 PM EDT | 29thDay | 1240 words added |
| Sep 11 2008, 10:09 AM EDT | 29thDay |
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In the event of childbirth, in a Z-World, studying a book of obstetrics might not be an option! Absent of modern medical attention, there's only one way to deliver a baby "in the wild". The old fashioned way.
Now, not every survivor is going to be motivated to want to save or assist a birthing mother. I am going to make the assumption that someone reading this page will be motivated to do so, for personal, moral reasons, or just so a screaming, semi-feral laboring mother won't attract zombies to your location! Lots can go wrong with birth without modern ob/gyn. But, nature is on your side. The womans body is designed to have babies. With a little intervention and some luck, most deliveries should progress to a live birth. But, before you reestablish society, focus on rudimentary med/surg procedures for the population, every labor (emergency or planned) is going to be a bit of a crap shoot. So when I write this procedure, I'm going to assume it will be an unplanned delivery but normal labor. If it is not normal, there really isn't too much you can do about it anyway, proceed as if it is, then wing it.--------------------{PS: I'm an LPN with some OB/GYN and delivery experience & 3 kids of my own, but I'm not an expert and this isn't professional medical advice. Just what I'd do.}
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What to gather, if you can. Obviously improvise if you have to.
*Blankets, towels, linens, washcloths, clothing scraps. Clean if possible.
Reasons: comfort, cleaning, thermoregulation of baby. Tin foil is also an excellent insulator for newborns. Diapering.
*Clean "surfaces": linens, paper, etc. you can keep your materials on.
*First aid kit, basic medical supplies best you can. Most helpful would be clean, preferably sterile: gauze, sterile water, scissors, clamps. Rubber gloves if you have them.
*WATER: Clean, drinkable. Also, boiling hot, clean water for sterilizing instruments when possible.
*Antibacterial soap: to keep hands clean, before, during, after. Super important to avoid infecting mom if you have the luxury.
*A Straw or other small, tubular suction device: for clearing child airways of mucus, meconium (fetal feces in canal). Juice box straw works best (baby=small nares) or infant nasal aspirator=ideal. None, suck out goo with your mouth.
*Clamping device: to clamp off umbilical cord. Surgical clamp, shoe string, plastic tie, wire.
*Scissors: again, preferably sterile, very clean. Or improvise with a knife.
*Large bowl, etc. to catch afterbirth, vomittus (hopefully not yours)
*Food, water for mom after delivery.
*Sanitary pads, real or improvised. Mothers bleed for weeks after birth (called lochia, similar to a heavy period).
*Baby bottle with sugar water, water, in the event the mother suffers a mortality, cannot nurse.
OK, that's the list I would assemble if I had minimal time and resources. Of course, the more desperate your situation, the less likely you'll have all of this. 3 essentials in order are highlighed: a clamping device, a cutting device, suction. The goal is that you have to safely detach the baby from the afterbirth and then to get it to breathe.
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How to Deliver the Baby:
OK, this is the last stage of labor. Very intense, painful, scary for mom. She may or may not comply due to fear, pain. Baby's head is starting to crown (visible in birth canal). First, take a breath and get your mental sh*t together. The first time you see a vagina ready to expel a baby, it can be a little horrifying (especially to a guy). Well, it's gonna get a little worse, so focus. Focus on the task at hand, try to remain somewhat detached. It would be a mistake to humanize the experience, because that's when you could panic, faint, etc. Try not to think about the mom at this point, focus only on the delivery. Have the mom focus on the delivery, too, motivate her to get the baby out, so "all the pain will go away". If you have assistance, let others tend to the mother. You just get the baby out. When the baby is crowning, there's not much else you can do for the mom anyway, so the delivery is the only goal for that moment. It sounds harsh, but this isn't a love-in at this point.
Get the mother comfortable if possible. Have her lie on her back, head elevated, in a slightly sitting position. The more that you can position the body to work with gravity, the better. If you have a second set of hands, have them try to hold her under the arms, supporting her weight in a semi-standing squat. The baby is crowning, instruct the mom to push hard and long, 10 seconds, rest quick, start again with the moms urge to push. Press down into the bottom of vagina and "cup" the top of the head in case it comes popping out. It needs support. Deliver the babies head naturally (don't pull it out). At this point, check to see if the cord is compressed (wrapped around neck, etc.). If so, stop pushing and gently unwrap it around head if possible, then continue. The body comes out much faster than the head, so be ready to CATCH the baby, a towel helps with slipperiness. ALWAYS support the head. Upon birth, keep the baby in alignment best possible with the umbilical cord; holding too high, blood drains from baby to placenta, too low, the reverse, neither good. Immediately clear out the baby's airways with gentle suction. For cord, place a tight clamp 4-6 inches from belly button, then another 8 inches from belly button (so, two clamps at 4/6" & 8"). Cut after 8" clamp. Place baby on the moms skin, vigorously rub his back/body/soles of feet till it breathes on own. If necessary, blow 2 short breaths into nose (not CPR). Don't slap, hold by feet, etc! Lusty crying is good, clears amnio from lungs, baby will picken up. Tend to the delivering the placenta. Most placenta will follow birth (hence afterbirth) and there may be a few painful contractions in the process. Catch in container. Do Not Pull Out Placenta or Pull on Cord. In the event placenta comes out quickly after baby, keep the baby and placenta in alignment and close together while tending to airways and tying off cord (don't rush, not dangerous if aligned). At this point, wrap the baby (blanket, clothes, tin foil), keep it warm and preferably put to breast to nurse. Wrap the baby's tied off cord up in a clean or sterile dressing (don't untie it). Tend to the medical needs of the mother, particularly by cleaning the vaginal area, sanitary pad, etc. I would re-wash my hands before I did this, since it's pretty much full of visible and non-visible tears and it's an expressway to the uterus and bloodstream (infection, peuperal fever). At this point, baby should be nursing or attempting to, keep the baby near the mothers skin and heartbeat as it calms the baby. Diaper the baby! Renourish the mother, provide as much rest as possible. Worst case, should mom not survive the delivery, nurse baby with bottle, dropper, spoon approximately 1 oz sugar water, water or other easily digestable fluid as needed until you can get your hands on some infant formula. And that's about it for normal emergency deliveries. Now, onto your plan for aftercare and childcare in a Z-world!!
Now, not every survivor is going to be motivated to want to save or assist a birthing mother. I am going to make the assumption that someone reading this page will be motivated to do so, for personal, moral reasons, or just so a screaming, semi-feral laboring mother won't attract zombies to your location! Lots can go wrong with birth without modern ob/gyn. But, nature is on your side. The womans body is designed to have babies. With a little intervention and some luck, most deliveries should progress to a live birth. But, before you reestablish society, focus on rudimentary med/surg procedures for the population, every labor (emergency or planned) is going to be a bit of a crap shoot. So when I write this procedure, I'm going to assume it will be an unplanned delivery but normal labor. If it is not normal, there really isn't too much you can do about it anyway, proceed as if it is, then wing it.--------------------{PS: I'm an LPN with some OB/GYN and delivery experience & 3 kids of my own, but I'm not an expert and this isn't professional medical advice. Just what I'd do.}
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
What to gather, if you can. Obviously improvise if you have to.
*Blankets, towels, linens, washcloths, clothing scraps. Clean if possible.
Reasons: comfort, cleaning, thermoregulation of baby. Tin foil is also an excellent insulator for newborns. Diapering.
*Clean "surfaces": linens, paper, etc. you can keep your materials on.
*First aid kit, basic medical supplies best you can. Most helpful would be clean, preferably sterile: gauze, sterile water, scissors, clamps. Rubber gloves if you have them.
*WATER: Clean, drinkable. Also, boiling hot, clean water for sterilizing instruments when possible.
*Antibacterial soap: to keep hands clean, before, during, after. Super important to avoid infecting mom if you have the luxury.
*A Straw or other small, tubular suction device: for clearing child airways of mucus, meconium (fetal feces in canal). Juice box straw works best (baby=small nares) or infant nasal aspirator=ideal. None, suck out goo with your mouth.
*Clamping device: to clamp off umbilical cord. Surgical clamp, shoe string, plastic tie, wire.
*Scissors: again, preferably sterile, very clean. Or improvise with a knife.
*Large bowl, etc. to catch afterbirth, vomittus (hopefully not yours)
*Food, water for mom after delivery.
*Sanitary pads, real or improvised. Mothers bleed for weeks after birth (called lochia, similar to a heavy period).
*Baby bottle with sugar water, water, in the event the mother suffers a mortality, cannot nurse.
OK, that's the list I would assemble if I had minimal time and resources. Of course, the more desperate your situation, the less likely you'll have all of this. 3 essentials in order are highlighed: a clamping device, a cutting device, suction. The goal is that you have to safely detach the baby from the afterbirth and then to get it to breathe.
--------------------------------------------------------------------------------------------------------------------------------------------------------
How to Deliver the Baby:
OK, this is the last stage of labor. Very intense, painful, scary for mom. She may or may not comply due to fear, pain. Baby's head is starting to crown (visible in birth canal). First, take a breath and get your mental sh*t together. The first time you see a vagina ready to expel a baby, it can be a little horrifying (especially to a guy). Well, it's gonna get a little worse, so focus. Focus on the task at hand, try to remain somewhat detached. It would be a mistake to humanize the experience, because that's when you could panic, faint, etc. Try not to think about the mom at this point, focus only on the delivery. Have the mom focus on the delivery, too, motivate her to get the baby out, so "all the pain will go away". If you have assistance, let others tend to the mother. You just get the baby out. When the baby is crowning, there's not much else you can do for the mom anyway, so the delivery is the only goal for that moment. It sounds harsh, but this isn't a love-in at this point.
Get the mother comfortable if possible. Have her lie on her back, head elevated, in a slightly sitting position. The more that you can position the body to work with gravity, the better. If you have a second set of hands, have them try to hold her under the arms, supporting her weight in a semi-standing squat. The baby is crowning, instruct the mom to push hard and long, 10 seconds, rest quick, start again with the moms urge to push. Press down into the bottom of vagina and "cup" the top of the head in case it comes popping out. It needs support. Deliver the babies head naturally (don't pull it out). At this point, check to see if the cord is compressed (wrapped around neck, etc.). If so, stop pushing and gently unwrap it around head if possible, then continue. The body comes out much faster than the head, so be ready to CATCH the baby, a towel helps with slipperiness. ALWAYS support the head. Upon birth, keep the baby in alignment best possible with the umbilical cord; holding too high, blood drains from baby to placenta, too low, the reverse, neither good. Immediately clear out the baby's airways with gentle suction. For cord, place a tight clamp 4-6 inches from belly button, then another 8 inches from belly button (so, two clamps at 4/6" & 8"). Cut after 8" clamp. Place baby on the moms skin, vigorously rub his back/body/soles of feet till it breathes on own. If necessary, blow 2 short breaths into nose (not CPR). Don't slap, hold by feet, etc! Lusty crying is good, clears amnio from lungs, baby will picken up. Tend to the delivering the placenta. Most placenta will follow birth (hence afterbirth) and there may be a few painful contractions in the process. Catch in container. Do Not Pull Out Placenta or Pull on Cord. In the event placenta comes out quickly after baby, keep the baby and placenta in alignment and close together while tending to airways and tying off cord (don't rush, not dangerous if aligned). At this point, wrap the baby (blanket, clothes, tin foil), keep it warm and preferably put to breast to nurse. Wrap the baby's tied off cord up in a clean or sterile dressing (don't untie it). Tend to the medical needs of the mother, particularly by cleaning the vaginal area, sanitary pad, etc. I would re-wash my hands before I did this, since it's pretty much full of visible and non-visible tears and it's an expressway to the uterus and bloodstream (infection, peuperal fever). At this point, baby should be nursing or attempting to, keep the baby near the mothers skin and heartbeat as it calms the baby. Diaper the baby! Renourish the mother, provide as much rest as possible. Worst case, should mom not survive the delivery, nurse baby with bottle, dropper, spoon approximately 1 oz sugar water, water or other easily digestable fluid as needed until you can get your hands on some infant formula. And that's about it for normal emergency deliveries. Now, onto your plan for aftercare and childcare in a Z-world!!
