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Dear Editor:
There are a few errors in J.C.’s article posted 5/19/12. I am a registered nurse that has delivered many babies in hospital and in home and other emergency locations. My comments are in bold type.

J.C. wrote:
 
Make sure to never pull on the baby’s head. Do apply gentle downward traction while someone pushes firmly down superior to mother’s pubic bone.

This counter pressure is usually only done if there is a problem delivering the shoulders not as a routine intervention.

Once the baby delivers the top shoulder, then release all pressure by everyone and tell mom to push.

It is much easier on Mom and baby to have the mother get on her hands and knees which opens the pelvic area significantly and allows the baby to proceed with the process of being born without interventions.
 
Some items that I would like to touch on would be minor complications. One such issue is that the “water never broke” or the placenta has not ruptured.

These are two separate conditions that the writer is treating as the same thing and it is not. Placentas should not rupture. Placentas are embedded into the uterine wall at the beginning of the pregnancy and supply via a cord (the umbilical cord) all the nutrients and oxygen that the baby needs during life in the womb. The writer is referring to two different structures that develop throughout the pregnancy, the amniotic fluid sac also called the bag of waters, holds the amniotic fluid within which the infant is cushioned and the placenta which is attached to the uterine wall and provides all the nutrients and oxygen a baby requires. A ruptured placenta is not what the writer means.

“If this is the case, you will have to rupture the placenta”.

You cannot nor should not rupture a placenta which is usually attached higher up the sides of the uterine walls.

Be careful that you do not hurt baby. Try to pull the membrane away from the baby and make a small puncture or incision. Then pull it apart with your fingers.

This statement is a “how- to- do” direction on rupturing the membranes of the amniotic sac, which really should only be done by a professional but it does not relate to the previous statement about the placenta. You want the placenta to be delivered ” intact” or all in one piece if not, retained pieces of placenta will cause problems that even in this day and age can result in the loss of a mother’s life if not addressed quickly.

I am an RN of 38+ years of experience  and have taught graduate nursing school for years so I fee confident in commenting on this subject from both a professional and personal point of view. I have another grandchild to deliver at home in December.

With My Regards, – P.C.

JWR Replies: Thanks for your sharing your expertise. I have already made immediate corrections to J.C.’s article, and re-posted it.

I never intended to be a homebirthing dad.  Our first child was born in the “normal” American way – in a hospital.  Physically, mom and baby came out fine.  But the scars from that experience still throb in our hearts many years later. 

The impersonal way hospital staff treated us; the overactive use of clinical equipment, terms, and technology; the fact that I had to keep briefing incoming personnel on our birth plan (since apparently they didn’t take the time to actually talk to read the copies I had provided, or talk to one another); the fact that they ordered my wife to lay on her back, which made the process excruciatingly slow and painful; the fact that the first thing my baby saw was a doctor dressed in a haz-mat suit; the way they whisked the baby away from mom as if the child were public property; the way they treated me like a useless observer and not the head, protector, and provider of my family; the forced hospital stay in a shared room, an uncomfortable bed, and with nothing to eat but sub-par food…the whole experience definitely convinced us that there had to be a better way to do this.

Unfortunately, our second birth did not allow for that.  Due to medical complications in the pregnancy, my wife had to get a non-emergency C-section.  It wasn’t that bad.  Our second hospital experience was better than the first — but only by degrees.  Still present were the lack of communication by hospital staff, the impersonal way my wife, our baby, and I were treated by that staff, the way I was shoved aside, the way my wife was given orders, and so on.  Not to mention the price tag.  If it hadn’t been for our excellent health coverage at the time I’d still be paying for that birth years later.  Also notable was how after each hospital birth some designated staff member would come talk to us about how to use contraception to prevent another pregnancy — as if pregnancy were an undesirable medical condition.  The hospitals sure make a lot of money off of parents’ love for their babies, but they do treat all of the parties as ignorant, blundering, or unwelcome troublemakers. 

When we found out the happy news that we were expecting our third, we once again wanted to do things differently.  We really didn’t want to go the hospital route because every time we dealt with an OB/GYN she treated my wife like a semi-idiot and treated me worse — or simply ignored me.  We hoped that this time we wouldn’t be shoved around and have to make more unpleasant memories. 

We wanted to use a midwife and try for a normal birth, called a VBAC (vaginal birth after Cesarean).  The bad news was that in our state, it was illegal for a mom to have a VBAC with a midwife or doula after having a C-section.  She had to be with an OB/GYN.  Few OB/GYNs in the area would even consider letting a woman attempt a VBAC, and then they would still insist on doing all the pre-operative procedures as if she had scheduled a C-section.  Invasive procedures and cold, clinical environments like hospital rooms work against a woman’s body and make it harder for her to relax and have her baby.  It was no surprise to learn that many of these moms had “failed” VBACs – meaning that sometime during labor they asked to go ahead and have a C-section.  To top it off, doctors are extremely unlikely to help a woman try for a VBAC if she has had more than one C-section.  My wife had already gotten one C-section; if we went to a hospital and got cornered into having another one, it seemed very likely that my wife and I would face a future of choosing between getting her repeatedly cut or not having more children.  I didn’t want my wife to be put under the knife – and in harm’s way from surgical complications – if it was unnecessary.

We learned a lot about the reasoning behind this law, and concluded that it was designed to prevent a tiny number of uterine ruptures – which happens 0.4% of the time in a VBAC .  We were more concerned about the 99% likelihood of having another bad birthing experience, and a bleak reproductive future.  Therefore, we used a loophole to prepare for the worst case scenario as well as the best case scenario.  Worst case, we’d have to get another C-section.  Fine.  So we got an OB/GYN and did our mandatory prenatal visits.  We were set if that was what circumstances called for.  But there was a loophole in the law.  While it prohibited midwives and doulas from assisting with VBACs, it didn’t outlaw unassisted childbirths (childbirths with no medical professionals present).  Since a UC would allow us to have maximum freedom in our birthing experience, we decided to try to have a baby on our own. 

This would take some serious training.  We had already read books on birth — but that had not seemed to be of much help.  We needed more than book learning; we needed experience.  But the birth classes we had attended prior to our first birth had not helped at all.  We needed an intensive, hands-on, birth training course.  We wanted to be ready this time.  So we signed up for a Bradley method class. 

I was totally unfamiliar with the Bradley method prior to this time, and given that many readers may also be unaware of its origins, philosophy, and distinctives, I’ll take some time to explain.

Decades ago, a few Californians decided that the hospitalized birth experience I’ve described above — and which tens of millions of Americans have gone through — was not something they wanted to keep experiencing.  In fact, they believed that some if not most of the things about it — its impersonality; marginalization of the mother, father, and child; overuse of drugs, et al — were downright harmful to people.  So through research, experience, and training, they developed what is now known as the Bradley Method of Husband-Coached Childbirth.  Like the name suggests, its philosophy and technique of childbirth is centered around the husband-wife relationship.  What happy news that was to me as a hugely-engaged and devoted husband and father!  The American Academy of Husband-Coached Childbirth is headquartered in California and operated by the same family that founded it, the Hathaways.  Their web site is www.bradleybirth.com, and it offers links to find a class in your area, buy books, and much more. 

What we signed up for was a 12-week course that involved a workbook, weekly meetings, hands-on practice of birthing techniques, personal interaction with a certified instructor, and the opportunity to make like-minded friends in our area.  It cost $360, or $30 per class.  It turned out to be a bargain — and the expense gave me an incentive to make sure we didn’t miss class unnecessarily!

I’d summarize the goal of the class as this: to teach expectant mothers and fathers how to enjoy a healthy, low-pain, natural childbirth together without the use of drugs and unnecessary medical intervention. 

We met for a few hours each week at a local birthing center.  Six expectant couples were part of the class, taught by a Bradley-certified instructor who had given birth herself without drugs (and yes, it had been a positive experience!).  Her husband was also on-hand occasionally to help.  He had been the one who “caught” their babies.  Contrary to popular belief, an everyday father is fully qualified to do that!

Every week, we did floor exercises, practiced relaxing using visualization, learned a lot about the physiology and psychology of women in pregnancy and labor, and overall built our relationship as couples.  The husband-wife bond is strengthened by the husband’s involvement in the pregnancy and birth.  The Bradley method strengthens the marriage even further by placing the husband and wife right in the center of the birthing experience.  No doctors, midwives, nurses, or anesthesiologists can do for a woman in normal labor what her tuned-in, trained husband can do for her.  The Bradley method classes taught me how to listen to my wife better, recognize her physical and emotional cues, soothe her, encourage her, and support her while she does the amazing work of giving birth to a baby — the way God intended it to be. 

The act of giving birth involves every part of a lady: her mind, her emotions, and yes, her body.   Mom needs to pay attention to what she’s eating.  She needs to keep harmful toxins (alcohol, nicotine, caffeine, paint fumes, etc) out of her body during the entire pregnancy if for no other reason than to protect the baby from developing birth defects.  She also needs to make sure that she eats appropriate foods so that the baby can get the building blocks he needs to grow.  She should also eat well to help herself.  If she doesn’t eat enough calcium to provide for her and the baby’s needs, for example, the baby will draw calcium from her teeth and bones and she’ll develop a deficit that could lead to osteoporosis.

Birth is a physical feat that demands more strength, endurance, and cardiovascular health than many sports full-grown men play.  Mom should do whatever possible before and during pregnancy to improve her health through appropriate exercise.

The Bradley method classes teach a number of birth-specific exercises to strengthen the muscles mom will be using during birth.  As a dad, I found it helpful to do these exercises with mom to encourage her and to also strengthen these oft-neglected parts of my own body.

Years ago I learned about the physics of flight while in a civilian aeronautics group.  It made dealing with turbulence during commercial flights so much more bearable because I understood that what was happening was not life-threatening.  It was normal. 

Mom should know that pregnancy and childbirth are normal.  They’re probably not what she’s used to, but they are normal.  Her body was made for it the way a man’s body was made strong for work and for protecting the family.  The Bradley method classes and literature are good sources of information for moms and dads preparing for childbirth.  A little bit of knowledge can calm many unneeded anxieties.

Dad should also remember that what is happening is normal.  Nothing in my life has scared me as much as the sight of my wife going through great pain – and being ignorant of how to make it stop.  That was during our first birth when we were woefully unprepared.  But in subsequent natural childbirths, I have seen her go through the same stages of childbirth faster and with much less pain simply because she and I knew what was happening in her body, and what to do about it. 

Please note that the Bradley method does not disparage the medical profession, but rather seeks to put medical professionals in their proper place in the hierarchy of a birth team — as supporting cast members, not the stars of the show.  Mom and dad are star and co-star of this performance, and ought to seek the expertise and resources of trained medical professionals when conditions necessitate them.

As a father of a C-section baby, I had a good appreciation for these medical professionals.  I had experienced the blessing of modern medicine.  But again, I had also experienced the heartache that comes from being treated like a number and not a person by the same medical professionals.  In an emergency, I still look for a doctor.  When things are going fine though, a doctor is overkill at best and a hazard at worst. 

I consider self-education, appropriate exercise, and proper nutrition fundamental to any mom and dad preparing for childbirth.  But the one thing I value above all else – the thing that I think made the crucial difference between an unhappy, painful, and prolonged childbirth and two peaceful, quick ones – is the practice of husband-coached visualization and relaxation.

We learned about and practiced one new technique each week in our Bradley method classes.  Our homework for the week largely consisted of spending 20 minutes twice each day practicing the technique.  I’d say we got in about half as many practice sessions as we should have prior to our third birth.  (Compare that to about one or two sessions total prior to our first birth.) 

Man, oh man, what a difference it made!  Mom’s muscle memory remained intact several years later when she gave birth to number four after only a few weeks of refresher practice sessions. 

Again, this isn’t rocket science.  The techniques aren’t mystical or complicated.  It’s stuff like visualizing a rainbow and thinking about each color, one at a time, while dad helps mom focus on relaxing each body part, one at a time.  The hardest and most important thing about it, in my opinion, is making the time and space to practice and focusing on what you’re doing.  Getting good at these techniques is a lot like getting good at prayer, or the violin, or being a good listener.  Thinking about it or reading about it is no substitute for doing it – and you get out of it only what you put into it.

The science behind it is simple: like other living creatures, a woman in birth does best when she is in a near-sleep state – muscles relaxed, mind calm, not distracted, and alone (or nearly alone).  God made her body know what to do – her primary task is to let go, give in, give up, and let it happen.  Dad helps by gently reminding her (“coaching,” in Bradley-speak) of this.  I never felt like I did my job all that well, but my wife always tells me afterwards “I couldn’t have done it without you.  You knew just what to say and just what to do.”  Men, the opportunity to be your wife’s rock during childbirth is a gift of God and I strongly encourage you to take up your swords and shields, carve out the time necessary to prepare for this, and be your wife’s coach/champion.

Weeks before the anticipated due date, we picked out a location where my wife could give birth.  We have other children in our home, so we wanted to pick a location that had the following characteristics:

• a door that locks
• as far away as possible from where the other kids sleep and play
• has access to a toilet, sink and tub
• can be warmed via electric or other heater

We thoroughly cleaned and sanitized the space weeks ahead of time, and stashed our gear nearby in boxes or bags so that things would be easy to get to once mom began active labor.  Scissors and other things used on the umbilical cord had been sanitized and stored in new Ziploc bags.  Cloth diapers, towels, and other laundry had been washed and dried in baby-friendly Dreft laundry detergent, and stored in new, clean plastic or paper bags.

We had babysitters on-call if labor occurred during the day or evening, but thankfully our home births have begun and concluded during the wee hours when everybody is usually asleep.

When mom and I saw that active labor had begun (indicated by things such as a broken water bag, loss of mucus plug, contractions at regular intervals, etc) we got things situated, made mom comfortable, and began to do what we had rehearsed so many times before: we relaxed.

I kept track of how long her contractions lasted so that we could have an idea of how things were going.  I shuttled back and forth between the kitchen and birthing space when needed to get drinks or wet down a cool washcloth for her forehead.  I kept my eyes wide open to check for any hint of distress in her or the baby.  Primarily though I was there next to her, holding her, massaging her, and encouraging her with reassuring words such as, “you’re doing a great job.”  I helped her relax her muscles and went through visualization techniques during contractions.

Then, when she felt the urge to push, I kept encouraging her and communicating with her, watching for anything unusual, and getting her what she needed.  Mom sometimes changed positions, and I helped to steady her when needed.  Finally, she passed through the “ring of fire” that occurs when the baby’s head stretches the perineum to the max, and our child began to enter the world.

As with everything else, I let my wife set the pace for this phase of the birth.  Sometimes she caught her breath and paused; at other times she wanted to get it over with and bore down.  I was ready.  I’ve caught many a football and had no problem cradling our baby’s head in one hand while catching his body between my arm and chest.  He was safe, sound, and ours! 

After getting the mucous out of his airway, I gave our baby to my wife, who held him to her skin.  She was amazed.  She kept saying, “I can’t believe we did it,” and then, “I could do that again.”  She oohed and aahed over the baby. 

Because our third childbirth was such a positive experience, it redeemed the act of birth for us.  No doctors scared the baby into screaming with a slap; I held our baby while mom got situated.  No nurses whisked the baby away for measurements, drugs, and shots; I wrapped him up and handed him to mom.  We had done our homework and knew to make sure the cord wasn’t wrapped around his neck, and to make sure the mucous was out of his airway so he could breathe.  We had sterilized our equipment for cutting the umbilical cord.  All that went as smooth as silk.  The bottom line was that mom got to hold her baby without anybody telling her what to do, dad was the first person who held the baby, and that baby was healthy, safe, and loved. 

Mom’s labor was one-third the length of her first labor.  To me, it was miraculous.  And it was all possible because God had made a way for women and their husbands to give birth naturally, safely, and happily.  That is so typical of God!  Man comes along and tries to improve upon God’s procedures and what happens?  Things get complicated, upsetting, dangerous, invasive, expensive, and tragic.  I know it’s not possible in all cases, given complications that do occur (such as the ones that necessitated our C-section).  But we don’t make rules based on exceptions; we make exceptions to the rule.  And the rule is, “If God made it, it ain’t broke — so don’t go trying to fix it!”

Mom’s postpartum recovery was the best she had experienced thus far.  She slid into her own bed, snuggled in her own sheets, and had her own husband waiting on her hand and foot while she slept next to her newborn baby.  We had all the necessary postpartum supplies on-hand.  It sure isn’t rocket science.  Anybody can do it with a little education and a few dollars of supplies. (see the list below)

As an added bonus to any fathers out there who might be considering doing what we did, consider this: the cost of our unassisted childbirth was less than $200.  Compare that to $2500 per day charges for a hospitalized childbirth, and $10,000 and up for a C-section.  As preppers living on a budget, unassisted childbirth is a no-brainer.

And in later years, it got better.  We recently had another UC.  This time, labor was even shorter, and mom and baby are once again happy, healthy, and home.  Mom would never go back to the hospital route and I am so blessed to have played a central role in the birth of my children.  There’s no place I’d rather be than protecting my wife, guiding her, and supporting her while she performs the penultimate act of womanhood: childbirth.  I am proud of her and grateful to God for the privilege.

I am also grateful to brave men and women such as Dr. Robert Bradley and Marjie and Jay Hathaway who fought medical and political bureaucrats to give everyday folks the right to experience birth free of state interference and corporate control.

Below is a gear list of things we used for our unassisted childbirths, with links to online merchants for reference and convenience.

For preparing the birthing space:

• Whatever mom wants to make her comfortable, and nothing that she doesn’t!

• Food (if mom is hungry, she can eat; if she’s not, she shouldn’t)

• Drinks (water, Gatorade, etc)

• Movies, music, audiobooks – very gentle, quiet stuff – only if mom wants

• Candles (unscented or scented, depending on mom’s preference) – only if mom wants

• Pillows, blankets, mats, anything to make the area soft and comfortable for the birthing mom

• Large bowl in case mom vomits during labor

• Mainstays shower curtains to waterproof the floor, mats, etc. – $11.47 at Walmart.com

• Dark colored Mainstays flat sheet to cover the shower curtains (they’re more pleasant to the touch than shower curtains) – $5 at Walmart.com

• Dark colored Mainstays pillowcases – $5.50 at Walmart.com

• Plastic garbage bags for covering pillows (inside pillowcases) and for collecting trash afterwards – $4.16 at 365OfficeSupplies.com

• Puppy pads for absorbing lots of fluids – $9.99 at Petco.com

For the laboring mom (if she’s using a birthing pool/bathtub):

• Dark towels – $3.99-5.99 at Target.com

For delivering the placenta:

• Large bowl for catching the placenta

• Garbage bag for storage or disposal

For cleaning up mom and baby immediately after birth:

• Cloth diapers – $1.00 at Cotton Babies.com

• Peri-bottle – $1.00 at Midwifery Mercantile

For keeping baby warm and snuggly:

• Receiving blankets – $10 for five at Walmart.com

• Newborn infant cap – $2.25 at Midwifery Mercantile

• Newborn disposable diapers – $7.90 for 36 at Walmart.com

• Baby wipes – $8.97 for 360 hypoallergenic wipes at Walmart.com

One of the following to clamp the umbilical cord:

• Two 8” lengths of yarn or thick string

• Sterile umbilical cord clamps – $1.65 at Midwifery Mercantile

• Stainless steel umbilical cord clamps – $7.50 at Midwifery Mercantile

For cutting the cord:

• Cramer bandage scissors – $13.88 at Walmart.com

For keeping the cord-cutting gear sterile:

• Ziploc plastic bags – $2.98 for 100 at Walmart.com

For weighing the baby:

• Mustad 50 lb. digital scale – $19.96 at Walmart.com

• D-ring sling for newborn hanging scale – $21.95 at Midwifery Mercantile

For mom, postpartum:

• Perineal cold packs – $3.10 each at Midwifery Mercantile

• Mesh panties – $1.95 at Midwifery Mercantile

• OB pads – $2.99 for 12 at Midwifery Mercantile

• A change of comfortable clothes

• Ibuprofen to reduce postpartum swelling – $4.00 for 200 tablets at Walmart.com

This article is not intended to be a complete guide to childbirth.  We highly recommend enrolling in a Bradley method class in your area.  To find a local instructor, go to www.bradleybirth.com/Directory.aspx.

Our favorite books and web sites where you can learn more about the Bradley Method of Husband-Coached Childbirth, or to learn about unassisted childbirth. 

• Husband-Coached Childbirth: The Bradley Method of Natural Childbirth by Robert Bradley, M.D., Fifth Edition

• Unassisted Homebirth: An Act of Love by Lynn Griesemer – $19.95 at Amazon.com

• Unassisted Childbirth by Laura Kaplan Shanley

• www.bradleybirth.com

• www.unassistedhomebirth.com

• www.christianuc.com

• www.unassistedchildbirth.com

Disclaimer: The information included in the preceding article is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.  Interested parties should thoroughly consult professionals and literature to be aware of possible complications and to determine the appropriate type of childbirth for their situation.

Other Useful Links:

http://vbacfacts.com/quick-facts/

http://www.askdrsears.com/topics/pregnancy-childbirth/pregnancy-concerns/creating-healthy-womb-environment/avoid-alcohol

http://www.askdrsears.com/topics/child-rearing-and-development/bringing-baby-home/how-smoking-harms-babies/how

http://www.askdrsears.com/topics/pregnancy-childbirth/pregnancy-concerns/creating-healthy-womb-environment/cut-back-caffeine

http://www.babycenter.com/404_is-it-safe-to-paint-or-be-around-paint-fumes-during-pregnanc_9484.bc?startIndex=10&questionId=9484

http://www.mayoclinic.com/health/pregnancy-nutrition/PR00108

http://www.niams.nih.gov/health_info/bone/Bone_Health/Pregnancy/default.asp

http://www.babycenter.com/pregnancy-exercises

http://www.askdrsears.com/topics/pregnancy-childbirth/seventh-month/growing-concerns/kegels/kegel-exercises

http://www.webmd.com/baby/guide/pregnancy-safe-exercises

http://www.amazon.com/Husband-Coached-Childbirth-Fifth-Edition-Bradley/dp/055338516X/ref=pd_bxgy_b_text_b

http://en.wikipedia.org/wiki/Bradley_method_of_natural_childbirth

http://www.webmd.com/baby/labor-signs

http://www.whattoexpect.com/pregnancy/eating-well/week-40/eating-well.aspx

http://www.webmd.com/baby/news/20100120/eating-drinking-may-be-ok-during-labor

http://www.babycentre.co.uk/pregnancy/labourandbirth/labour/eatinganddrinking/

Our society today views childbirth as a sickness that can only be managed by “professionals” in the hospital.  Babies that might come out blue and unresponsive, possible hemorrhaging, and babies that get stuck in the birth canal are all things that deter families from having births at home.  These are real issues and should not be ignored, but they make up only a small percentage of birth outcomes.  The vast majority of women in the world can and do give birth safely at home.   As fellow survivalists, we understand that the government and media either hide statistics or distort them.  The fact is that the U.S. is ranked 24th in infant mortality following such countries as Cuba, Portugal, and Singapore.  When one looks at the countries with the lowest mortality rates, at least 70% of the births are attended by midwives.  At the turn of the 20th century, that same statistic was true for our country.  Now home births account for less than 3% of all births.  In fact, in some of our major cities, nearly 50% of births are performed by a major surgical procedure known as Caesarean. When one investigates the facts concerning the safety and reasons for home birth, it is not hard to see that it is a better way to birth.  Regardless of opinion and inclinations during normal and peaceful times, in a survival situation caused by economic collapse or natural disaster, childbirth will have to be dealt in possibly less than ideal conditions.  I believe that in such a situation, midwives will be an invaluable and precious asset.  In preparing your family for a TEOTWAWKI situation, you might consider making contacts with midwives in your area if you are expecting a child or plan to have some in the future. There is no substitute for experience and knowledge, so please consider the care of a midwife if you are pregnant. If your situation does not allow you to have a midwife, then here are some good suggestions to ease the process of labor and birth.

If you and your family have had children before, then you know something about the process and how things progress.  Still, having a baby at home can be intimidating when traveling is dangerous and help is miles away.  One thing to remember is that the mother knows her body and will, almost unconsciously, facilitate an easy entrance for the baby if she is left to herself.  Once labor has started, you should contact any help you planned on having, whether it is an ambulance or a midwife.  The best way to help Mom is to encourage her in her efforts and provide as much food and drink as she wants; labor is a very strenuous activity.  Help her to go to the bathroom often, as this will help relax her muscles and speeds the descent of the baby.  Childbirth can be painful, but the pain is most often caused by a poor position of the mother that forces the baby on the pelvis or against the spine.  A good overall position is standing up or squatting.    

Squatting opens the pelvic cavity 30% more than lying down.  If the mother is lying on her back, her body weight is compressing an artery in the back and preventing good blood flow to the baby; it is also a very uncomfortable position.  When the mother wishes to lie down, she may prefer laying on her side or sitting up part way.  A hands and knees position may also be preferable, especially when a baby is posterior (its back bone is against the mother’s spine). This position drops the baby off Mom’s spine and gives some relief.

We know that Mom can push this baby out, but what do Dad/ Sister/Friend do as the baby comes out?  You may want to gather some supplies for the birth.  This would include a bowl to catch the placenta, plenty of towels or other absorbent material to clean up blood and amniotic fluid, sterile scissors (boil for 10 min.), and towels for baby (warm in low oven, dryer, or over a wood stove).  As the newborn arrives, have Mom pant through her contractions to slow the descent of the baby and prevent tears in the perineum.  Supporting the head as it comes out will also minimize tears.  Also, the infant has been in the mother’s belly for approximately 40 weeks, floating in warm, cozy liquid.  Unless careful consideration is taken to keep the temperature slightly warmer than body temperature, the baby arrives into a colder environment.  You might think that the baby should immediately be wrapped in a towel, but the best place for a newborn is on the mother’s bare chest with a blanket on top.  God designed the mother to be able to adjust her body temperature to warm or cool the baby.  Fathers are also able to warm up a baby. Placing the infant on Mom’s chest also allows it to smell her and the nipple area so the baby will be calm and ready to nurse.

As the baby comes out, careful checking of the umbilical cord should assure the birth partner that it is not wrapped around the infant’s neck and cutting off blood flow.  If it is wrapped around the neck, it can usually be slipped off easily.  In the instance where it is too tight to free the neck, tie two strings or shoelaces to the cord and cut between them, otherwise the baby could lose a lot of blood.  In a preferable situation, the cord is left intact and is only cut after it has stopped pulsing.  This allows a maximum amount of blood and nutrients to flow into the baby that will help the baby prepare for life outside the womb.  Before cutting the cord, be sure to sterilize your string and scissors in boiling water.

As well as checking the cord, the father/birth partner should check the baby for breathing and responsiveness.  Obviously, if it is crying, there’s no worry.  But sometimes fluid or meconium (baby’s first bowel movement) can get into the nasal and mouth area and possibly aspirate into the lungs, causing breathing problems.  This is usually not a serious problem, as the baby’s crying and coughing will bring it out; suctioning the mouth and nose with a bulb syringe will help.  If the baby is unresponsive, place on Mom’s chest and rub vigorously with a towel and this will usually trigger a response. If the baby is still not coming around, try giving it oxygen through a face mask, otherwise start CPR immediately.  As part of preparedness, CPR training would be good knowledge to have.

When the baby is born, everyone is absorbed with the infant and the extraordinary event that just took place.  However, there is still a placenta that has been providing nutrients and blood flow to the baby.  At no time should the umbilical cord be tugged on to facilitate its release from the uterine wall, which will cause hemorrhaging.  During the birth process, hormones and chemicals are telling the body what to do and when.  If the baby is born naturally with no drug inhibition (always the situation in home birth), the body will usually tell the placenta to detach. The mother may or may not feel some more contractions and the placenta will be pushed out; standing will help this process.  Remember that the best place for the newborn was the mother’s chest.  When a baby starts to nurse, it causes oxytocin in the mother which produces contractions and helps to release the placenta from the womb.  If the baby will not suck, manual stimulation of the nipple will suffice.  Be sure to watch for excess bleeding, in which case, more stimulation of the nipple is needed and/or vigorous massage of the abdominal area to cause the uterus to shrink up and stop the bleeding.

Another situation that may be cause for concern is if the baby becomes stuck in the pelvis.  The pelvis is shaped somewhat like an oval with the narrow portion extending from side to side of the woman.  As the baby is being born it rotates slightly to pass this narrow part so the shoulders can come out.  Sometimes this does not happen; maybe the baby is very large, its arm has come out with the head, or some other similar situation. Whatever the cause, its shoulders cannot get past the narrow part.  If the mother is lying down or only slightly sitting up, help her get on her hands and knees to help open the pelvic cavity.  This may drop the baby down and back in slightly and get it in a better position to come out.  In a very difficult situation, the dad may have to reach a couple fingers in alongside the baby’s head to the shoulders and try to pull one shoulder past the ischial spines (the narrow part of pelvis).  The important thing to remember if a baby gets stuck is that the umbilical cord may be getting pinched as the infant comes out.  If the baby’s head is out, it may start to breath on its own, but acting quickly is very important.  Encourage the mother to help pull her baby out, move, and swing her hips to get the baby to move down. This will solve most problems instantly.

Again, knowledge is power and researching the means and/or possibility of a home birth will give both parents some ease about the process and confidence in a TEOTWAWKI situation.

A few recommended books to have on hand would be:
• “Spiritual Midwifery” by Ina May Gaskin (wonderful collection of home birth stories, very focused on spiritual and emotional care of woman, as well as info regarding medical care of labor and birth),
• “The Birth Partner” by Penny Simkin (more for father/birth partner, gives info on best birthing positions, encouraging mother, hospital practices, items to have on hand for birth, stages of labor),
• and “Heart and Hands” by Elizabeth Davis (midwifery-oriented, lots of info for midwife on care for pregnancy and birth).
These books offer a wonderful collection of knowledge for both mother and father and would be invaluable for the birth at home.

About The Author: “No Place Like Home” is the pen name of a doula who is pursuing DONA-certification. She is an advocate for home birth and believes that women are strong enough to birth on their own and should be given that opportunity.