«My husband and I are curious as to what the authorities could do if we decided at the time not to call the midwife, as I would very much like my husband to deliver my baby and I know that the midwife would not be prepared to take a back seat if we called her. This is something we feel very strongly about and I feel safe and more comfortable having my husband there instead of the midwife — who, incidentally, is still trying to make me go into hospital.»
It is difficult not to feel sympathy with the mother who wrote this. However, do-it-yourself delivery is not recommended because of the slight risk of either you or the baby needing the specialised skill or equipment of the midwife. Moreover you can be prosecuted if it can be proved that you intended to deliver a baby when not qualified as either a midwife or a doctor, although prosecution is intended for those fraudulently claiming to be qualified.
Some midwives suspect that their aid has been dispensed with deliberately when they arrive at the home of a newly-born baby too late, although if the parents are adamant that it arrived without warning there is nothing that the midwife can do. However it does mean that parents whose baby has arrived genuinely without warning are sometimes subject to interrogation, adding to their shock and bewilderment and making them feel very uneasy.
If you are booked for a home birth you will at least be expecting to have your baby at home. But babies can and do arrive before the midwife, so it is important to have some idea of what to do. This is not so much because such a baby will need help — a baby that is born that quickly is generally fine and so is its mother — but in order that you can feel calm about what is happening. Knowing what to do in this situation will not only give you confidence but it can also help you visualise the baby’s progress in labor when the baby arrives more slowly, and means that you can cooperate with your midwife at the time of delivery.
You might realise that your baby was arriving suddenly if you had some contractions and felt an overwhelming desire to push, or felt the baby’s head in the birth canal (a sensation something like a grapefruit in your rectum). Ring the midwife or doctor if you have not already done so.
If you want to delay the birth until help arrives, try lying on the floor with your bottom high in the air and your head on your crossed arms on the floor. If there is anyone with you, get them to put on a heater and get a couple of towels ready to wrap the baby in. Put them on a radiator until needed. (The most common reason for transferring babies to hospital is because they have become too cold; they lose heat very rapidly, especially when they are still wet and are in a temperature below 25 degrees Centigrade.)
What to do
All you need to do is catch the baby and keep it warm.
— Find something soft on which to give birth, and cover it with a towel if possible.
— When you feel the baby’s head coming through your perineum, cup it with your hand.
— Once the head is out, feel for any loops of cord around the neck and bring them forward. The baby’s head will probably emerge facing your anus and then rotate to face your thigh.
— Wipe the baby’s eyes, nose and mouth free of mucus with a clean hanky or your finger.
— Wait for the next contraction and with it, guide the baby’s head down so that the shoulder closest to your front can slide underneath your pubic arch. Once it is free, guide the head upwards towards your abdomen so that the lower shoulder can be freed, and its body will follow.
— Dry the baby with a towet and wrap it in a fresh one. Keep the baby as warm as possible and put it to your breast.
— Do not do anything with the cord.
— The placenta will probably come away within half an hour, especially if you are upright and feeding the baby. If no help has arrived by the time the placenta is delivered, wrap it separately from the baby and keep the two together. Do not attempt to cut or tie the cord.
— Send for help if you have not already done so.
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