The newborn baby needs immediate care once the cord has been divided. He or she should be wrapped in warm dry blankets, and the head gently covered. A small cap made of stockinette helps to prevent heat loss from the scalp as well as the baby’s body. Prompt breathing and rapid delivery of oxygen to the tissues are enhanced when the newborn is kept warm. If the home is unusually cold, the child should be placed “skin-to-skin” upon the mother. Then, both should be wrapped in a blanket. The use of insulating “aluminum foil” may be helpful, but in such cases monitor the child’s temperature frequently with a thermometer to prevent overheating. Some newborns enjoy the experience of suckling, and will lay at their mother’s side to nurse for several minutes. A newborn baby who has been delivered with minimal trauma will have its eyes open, looking around. He or she may recognize the mother and “imprint” her image in their mind within hours after birth. This “bonding” is very important for the mother-and-child interaction, often conditioned by the immediate experience of the postpartum period.
Several emergency situations should be kept in mind. Their possibility, although rare, may require immediate intervention. The prolapse of the umbilical cord is one urgent complication. If the umbilical cord appears before the baby has been delivered, emergency rescue measures may help to save the infant’ s life. The head should be firmly pushed back into the birth canal, to prevent its pressing tightly against the cord, and thus obstructing the flow of blood to the baby. Usually a Cesarean section is indicated in such cases. If performed soon enough, surgery may save the life of the child.
Breech delivery sometimes presents unexpectedly. Either a foot, both feet, or the rump of the baby will appear at the opening of the birth canal. If this was the first pregnancy, the baby is particularly in danger. Ignorance concerning the size of the “aftercoming” head leads most physicians in a hospital setting to do a Cesarean section on the mother whose firstborn baby is a breech presentation. However, if the mother has delivered previous children, this baby could be delivered with the feet grasped and held by an assistant, elevated above the mother’s abdomen. Then, the baby is rotated so that the head can be delivered face down. Exert a gentle pulling with a finger in the baby’s mouth. When its chin appears at the entrance of the birth canal, help to deliver the head with minimal trauma. At times, premature babies come unanticipated in the home. They are particularly sensitive to heat loss, and should be kept very warm and close to the mother. Usually the tiniest ones are unable to suck well and must be tube fed. With practiced skill, this small feeding tube can be placed in the baby’ s stomach with each feeding. Give a small amount of breast milk for nourishment every two or three hours. Most premature infants should be cared for in a hospital with facilities for newborn intensive care.
Hemorrhage involving the mother is a serious emergency. Usually, this will occur immediately after the birth of the baby or within the first few hours. When the blood flow is bright red, there exists the possibility of an overlooked laceration. Look for it carefully. Pressure may help stop the bleeding until the patient can be transported to an emergency room. If there is no laceration, then the bleeding usually originates from the uterus. Firmly massage the softened dome of the uterus immediately, while applying an ice pack to the lower abdomen. This may help the uterus to contract. Place the infant at her breast to nurse and stimulate the release of oxytocin. This hormone aids in uterine contraction and shrinkage (involution). However, if bleeding is not immediately controlled, the mother should quickly be taken for emergency care. Blood transfusions and medications designed to contract the womb may be lifesaving.
Fever occurring immediately before or after childbirth may be ominous. It may indicate infection in the bladder, particularly if a catheter has been used. Occasionally, fever may be due to unrelated conditions, such as influenza or respiratory illness. However, it could emanate from infection of the womb itself. Urgent treatment may help to prevent blood poisoning and serious complications. Cooling measures, such as the hot blanket pack, will open the pores. On the other hand, a dripping wet sheet for evaporative cooling may be beneficial. Maintain careful records of the delivery, including the weight of the newborn, and the time and date of birth. Birth certificates may in most states be filed and signed by the individual who attended at the delivery, whether they are husband, friend, nurse-midwife, or physician. A drop of antibiotic ointment or 1% silver nitrate solution should be put in each eye of the newborn baby, required by state law to prevent gonorrhea infection.
After a brief rest the mother should walk, go to the bathroom, and take a shower if she feels able. Early physical activity after the delivery of a baby will enable her to gain strength as soon as possible. Exercise also helps to prevent complication such as venous clots (thrombosis), that formerly were common with prolonged bed rest. Textbooks of maternity nursing and midwifery describe in more detail the equipment needed for a home delivery and the most efficient setup of the bedroom.
Several emergency situations should be kept in mind. Their possibility, although rare, may require immediate intervention. The prolapse of the umbilical cord is one urgent complication. If the umbilical cord appears before the baby has been delivered, emergency rescue measures may help to save the infant’ s life. The head should be firmly pushed back into the birth canal, to prevent its pressing tightly against the cord, and thus obstructing the flow of blood to the baby. Usually a Cesarean section is indicated in such cases. If performed soon enough, surgery may save the life of the child.
Breech delivery sometimes presents unexpectedly. Either a foot, both feet, or the rump of the baby will appear at the opening of the birth canal. If this was the first pregnancy, the baby is particularly in danger. Ignorance concerning the size of the “aftercoming” head leads most physicians in a hospital setting to do a Cesarean section on the mother whose firstborn baby is a breech presentation. However, if the mother has delivered previous children, this baby could be delivered with the feet grasped and held by an assistant, elevated above the mother’s abdomen. Then, the baby is rotated so that the head can be delivered face down. Exert a gentle pulling with a finger in the baby’s mouth. When its chin appears at the entrance of the birth canal, help to deliver the head with minimal trauma. At times, premature babies come unanticipated in the home. They are particularly sensitive to heat loss, and should be kept very warm and close to the mother. Usually the tiniest ones are unable to suck well and must be tube fed. With practiced skill, this small feeding tube can be placed in the baby’ s stomach with each feeding. Give a small amount of breast milk for nourishment every two or three hours. Most premature infants should be cared for in a hospital with facilities for newborn intensive care.
Hemorrhage involving the mother is a serious emergency. Usually, this will occur immediately after the birth of the baby or within the first few hours. When the blood flow is bright red, there exists the possibility of an overlooked laceration. Look for it carefully. Pressure may help stop the bleeding until the patient can be transported to an emergency room. If there is no laceration, then the bleeding usually originates from the uterus. Firmly massage the softened dome of the uterus immediately, while applying an ice pack to the lower abdomen. This may help the uterus to contract. Place the infant at her breast to nurse and stimulate the release of oxytocin. This hormone aids in uterine contraction and shrinkage (involution). However, if bleeding is not immediately controlled, the mother should quickly be taken for emergency care. Blood transfusions and medications designed to contract the womb may be lifesaving.
Fever occurring immediately before or after childbirth may be ominous. It may indicate infection in the bladder, particularly if a catheter has been used. Occasionally, fever may be due to unrelated conditions, such as influenza or respiratory illness. However, it could emanate from infection of the womb itself. Urgent treatment may help to prevent blood poisoning and serious complications. Cooling measures, such as the hot blanket pack, will open the pores. On the other hand, a dripping wet sheet for evaporative cooling may be beneficial. Maintain careful records of the delivery, including the weight of the newborn, and the time and date of birth. Birth certificates may in most states be filed and signed by the individual who attended at the delivery, whether they are husband, friend, nurse-midwife, or physician. A drop of antibiotic ointment or 1% silver nitrate solution should be put in each eye of the newborn baby, required by state law to prevent gonorrhea infection.
After a brief rest the mother should walk, go to the bathroom, and take a shower if she feels able. Early physical activity after the delivery of a baby will enable her to gain strength as soon as possible. Exercise also helps to prevent complication such as venous clots (thrombosis), that formerly were common with prolonged bed rest. Textbooks of maternity nursing and midwifery describe in more detail the equipment needed for a home delivery and the most efficient setup of the bedroom.
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