Emergency childbirth at home

I’d like to talk to you about how to handle an emergency childbirth. Of a human. You might be thinking, “Eh, not for me… On to the homesteading stuff.” However, I invite you to keep reading for a moment. A life may depend on it.

Who is This Guide For?

This is NOT meant to be a conclusive guide for a planned home birth. Rather, I want to share the most basic, critical things to assist a birthing woman in an unplanned-for, emergency childbirth situation. I pull from my experiences as a home-birth midwife.

There are many scenarios in which childbirth might fall to the hands of whoever happens to be around: a storm prevents the mother from getting to the hospital, or her midwife from getting to her. A mother goes into labor unexpectedly while visiting your homestead, a hundred miles from nowhere. The economy has collapsed.  A pandemic has driven everyone inside. The Zombie Apocalypse has finally come.

I will, for the duration of this piece, refer to the presumed “emergency” as the Zombie Apocalypse.  This is not to make light of a very serious topic, but, well… it’s to make light of a very serious topic.  Because humor is how you stay sane in survival situations.

If you think it’s even a possibility that this will be you, please get some childbirth and breastfeeding education and take a CPR course.

So, here’s what you need to know in the case of an emergency childbirth.

Make the Mother Feel Safe and Comfortable

You must be cool as a cucumber. The fact that you are reading this publication shows that you have some sense of level-headedness. Forget every TV birth you have ever seen (unless it was from Apocalypto, which is absolutely spot-on). It is very important that she feels in control. Ask permission to assist her and touch her.

Gather Supplies

  • Soap and water
  • A nasal syringe, AKA “booger sucker.”  Make sure it is for an infant’s tiny nostrils, preferably in a sterile wrap
  • Disposable gloves
  • Plastic-backed underpads that protect the bed, sometimes called Chux pads. A new shower curtain or plastic tablecloth is nice if you have one
  • Plenty of very clean towels and washcloths
  • Blankets
  • Sharp scissors
  • New, white shoelace to tie the umbilical cord
  • Adult diapers or a good substitute
  • Diapers for the baby, or a good substitute

Encourage Movement

Most moms want—and need—to move around.  Scope out the area for zombies and take her for a nice, rambling walk.  Many mothers want to rock from side to side, lean on people or furniture, or be on hands and knees. Bathing is fine if the water is very clean, and her water has not broken.  Encourage her to sleep as much as she can (and get some sleep yourself if possible), but do not insist that she stay in bed. Encourage her to go to the bathroom every hour.

Don’t I Have to Boil Water?

It is not necessary to boil water. A very clean blade to cut the cord is sufficient.

Feed Her

Give her all the food that your food storage will allow. Remind her to drink often—birth is extremely thirsty work. If she is vomiting (not uncommon in the late stages of labor), offer her a drink with some electrolytes and calories after every contraction.

Encourage Her Noises

Animal noises, deep breathing, and moaning are important coping mechanisms. If you are very certain she has not been bitten by a zombie and is, in fact, just giving birth, speak to her calmly and offer to moan or breathe with her to a pattern (in, two, three; out, two, three).

What’s Going On In There?

Most of the long, slow work of labor is the opening of the cervix, which is the “door” to the uterus.  The important thing during this stage is to keep the mother relaxed. Steady pressure with the palms of your hands on her lower back is helpful, offering to support her in a slow “dance”, pouring warm water very slowly over her back, or firmly massaging her feet can help.  DO NOT put your fingers inside her, especially if her waters have broken.

She will say she cannot do this, and you must tell her she can.

When her cervix is fully dilated, she will have an uncontrollable urge to push. She might say she feels like she has to poop, and you can tell her to push exactly as she would in that case. Get her over a soft, clean surface with room for you to help guide the baby out. She should try a few positions to see what is comfortable and effective. (It’s fine if she is in water, though tricker for you.)

The Delivery of the Head

Most babies will come head-first, and if you are accustomed to delivering lambs or calves, you may be a little disappointed that human heads do not have handles. Be patient. Pushing a baby out can take a few hours. Help her change positions frequently and offer sugary drinks. If the head is coming fast, tell her to push gently and take it easy.

Do not pull on the head. Check for the umbilical cord around the baby’s neck. This is quite common and it’s not an emergency. Gently lift the cord over the head, or just loosen it as much as you can so that the body can pass through.

If the shoulders do not come easily, as they usually do in a few pushes, try pushing down very gently on the head, toward the mother’s bottom. Help the mother shift positions. Usually, raising her hips onto some pillows and pulling her knees back will do the trick, along with very strong pushes.  Being down on hands and knees often works, too.

Hooray! Baby is Out. Now What?

If possible, designate another person ahead of time to attend to the baby while you attend to the mother.

Immediately place the baby on the mother’s chest, skin-to-skin. This is very important! Forget every movie or TV scene you have seen in which the baby is wrapped in a blanket like an eggroll. Dry the baby with a clean blanket, set that one aside, and cover him with a new, dry one, while maintaining skin-to-skin contact.  A hat is not necessary unless the room is very cold.

If the baby does not appear to be breathing, rub his back vigorously and encourage the mother to talk to the baby. Blue or purple skin is okay at first. It should soon turn pink, though the baby’s hands and feet may continue to be a little blueish for a few days.

Some babies take a minute to come around. Just keep rubbing and stimulating the baby. Place him face-up (on the mother’s chest is preferable—remember, the cord is still attached) and tilt the chin back a little. Use the bulb syringe to clear the airway. (Squeeze, aim the end inside the baby’s cheek, release to cause suction. Remove, and squeeze again to release the fluid away from the face. Repeat with each nostril). If you do not have a bulb syringe, gently place your mouth over the baby’s, suck, and spit out the fluid. Repeat with the nose. If there is still no response, perform CPR as best as you can—remember that those lungs are tiny and need only the breath you can hold in your own cheeks, and that the chest is delicate, needing only gentle pressure to stimulate the heart.

If your own heart is palpitating a little as you read this, please keep in mind that most babies do just fine on their own. However, it would be very wise to learn all you can about handling first-aid emergencies before the event.

When the baby is breathing well, put him to the breast. More on this in a minute.

Delivering the Placenta and Handling Blood Loss

Cutting the cord is not urgent. If you gently touch it, you can feel life-filled blood pumping to the baby. Forget it and focus your attention on the delivery of the placenta. This should happen within 30 minutes of the birth.  Mother will get more contractions soon. DO NOT PULL ON THE CORD. Encourage her to push again, and be prepared to catch.

If the placenta is not delivered within thirty minutes, try externally rubbing her uterus firmly, in a downward direction. Yes, this hurts. If the baby isn’t trying to nurse, help that along. Ask the mother to smell the baby’s head (yes, really).

The placenta will look like a rather round, big piece of meat attached to the cord. If what you are seeing is just jelly-like blobs, you have blood clots, not the placenta.

When it’s time to cut the cord, simply tie one shoelace about three inches from the baby’s tummy, leave a gap of about three inches in the cord, and tie the other shoelace. Cut in between the two laces. Place the placenta in a bowl and set it aside in a place where it will not be disturbed by pets, small children, or zombies. Chill it if you think a skilled caregiver can examine it soon.

FIRMLY rub the mother’s belly under her belly button. You should feel a hard, round mass like a large grapefruit. This is the uterus, and its job is to clamp down. You will see some small gushes of blood, and probably some clots. After this, the bleeding should slow.

Observe her face and actions. If she is pale, confused, or light-headed, put her flat on her back, legs elevated, and resume rubbing her uterus with your fist in a downward direction. KEEP THE BABY ON THE BREAST. Offer the mother sugary drinks.

Breastfeeding is crucial to the health of both mother and baby. Nursing will keep the uterus clamped down, support the mother’s mental health, and provide antibodies to the baby. If the zombies continue their shenanigans for the next couple of years, the baby will have a safe, continuous supply of perfectly designed food.

To initiate breastfeeding, the baby and mother should be tummy-to-tummy. Tickle the baby’s nose with the nipple, and when he opens very wide, aim the nipple toward the roof of his mouth.  Most of the colored part of the breast (areola) should be in his mouth.

A newborn baby’s stomach is just the size of a cherry—he needs to nurse at least every two hours, preferably more. Do not put anything else in his mouth. Do not bathe him. Definitely put a diaper on him.

Within an hour of birth, help the mother go pee. This is important! She must have support when she first tries to stand up. If she gets dizzy, tell her to get on her hands and knees and put her head below her heart. She can crawl if she wants, or you can put another clean Chux or makeshift bedpan under her bottom and see if she can pee in that. Remind her to pee every hour, and rub her uterus to make sure it is firm.

The Following Days

The pair will need round-the-clock care for three days.

Keep her warm. Keep them together. She must only eat, drink, sleep, and feed the baby for three days. If you are unable to find a skilled caregiver, look for an experienced mother or grandmother to come help.

Congratulations! This is an experience you will never forget. You may now resume zombie slaying.

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