Section IV. ABNORMAL DELIVERIES
2-17. BREECH PRESENTATION
In a breech delivery, the baby's buttocks appear first instead of the head. Make
every effort to get the mother to a hospital if it appears the baby will be a breech
delivery. If there is no time to do this, follow these steps given below.
a. Make the same preparations as for a normal delivery.
b. Allow the baby's buttocks and trunk to deliver spontaneously.
c. When the infant's legs are clear, support the baby's legs and trunk.
d. Allow the baby's head to deliver spontaneously.
e. After the head delivers, continue as a normal birth.
If the head does not deliver in three minutes, create an air passage by
inserting your gloved hand in the vagina. Form a V with your fingers on either
side of the baby's nose. Push the vaginal wall away from the baby's face,
maintaining the airway you have created until the baby's head is delivered.
If the head does not deliver in three minutes of establishing the airway,
transport the mother to a hospital immediately. Have the mother's buttocks
elevated on pillows or blankets and maintain the airway you have created for
DO NOT allow the head to be delivered forcefully.
DO NOT pull the baby out.
2-18. PROLAPSED UMBILICAL CORD
Prolapse of the umbilical cord is a rare occurrence, but it does happen. A
prolapsed umbilical cord is one which delivers before the presenting part of the baby.
This places the baby in danger of suffocating. The baby's head is pressing against the
cord in the birth canal, cutting off the baby's oxygen supply. Perform emergency care.
a. Put the mother either in a knee-chest position or supine position with her hips
elevated on a pillow.
b. Administer oxygen to the mother and keep her warm.
c. With your sterile gloved hand, push the baby's head off of the cord.