Section III. MANAGEMENT OF MOTHER AND NEWBORN DURING
NORMAL DELIVERY IN AN EMERGENCY SETTING
2-10. TIME TO TRANSPORT THE MOTHER TO A HOSPITAL
To determine whether there is enough time to transport a woman having a
normal delivery to the hospital, find out the following information.
a. Has the patient had a baby before? Labor during a first pregnancy will
usually be slower than in subsequent pregnancies.
b. How frequent are the patient's contractions? If the contractions are more than
five minutes apart, there is generally enough time to get to a hospital. If the
contractions are less than two minutes apart, the baby will probably be born soon,
especially if this is not the first pregnancy.
c. Has the patient's amniotic sac ruptured? If so, when did it rupture? If the
rupture occurred many hours ago, delivery may be more difficult. Also, the risk of fetal
infection is increased.
d. Does the patient feel an urge to move her bowels? This sensation during
labor is caused by the baby's head in the mother's vagina pushing against the female's
rectum. This sensation is another sign that delivery is about to take place.
e. Is the baby crowning? Examine the mother externally for crowning (whether
the presenting part of the baby is bulging out of the vagina). If crowning is taking place,
the baby is about to be born and there is no time to get to the hospital.
2-11. TIME TO REACH THE HOSPITAL
If there is time to reach the hospital, place the mother in a lateral recumbent
position. Remove any underclothing that might obstruct delivery. DO NOT allow the
mother to go to the toilet. NEVER, attempt to delay or restrain delivery in any fashion.
2-12. IMMINENT DELIVERY
If all the signs are that the baby is about to be born and there is no time to get the
mother to the hospital, proceed in the following manner.
a. Preparation for Delivery.
(1)
Try to find an area of maximum privacy and cleanliness.
(2)
Allow another woman or the patient's husband to be present to reassure
the patient.
MD0584
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