Childbirth and

Gynecologic Emergencies

By Steph Hammond Class-EMS 110/81

This slide show explains:

Key Terms and the stages of birth, along with emergencies and how to take care of them,

and also home-births, and a brief explanation of a Doula.

This well educate you in how labor is and signs to look for in a emergency as a first aider and a

civilian.

Choosing this subject was close to

me, I am 32 weeks pregnant and due to deliver

October 8/16.I wanted to educate my self more on what will

happen with the labor process, and my options and signs to look for in case of a emergency.

I’m having a boy who we are naming Oskar L.J. Hammond and this is our first child :O)

I will tell you now... This has been one crazy adventure so far and life changing for my husband

and I. I hope you all enjoy my slide show :O)

As a first-aider you should know...

Birth Canal-The passage through which babies pass through during birth, formed by the cervix, vagina, and vulva

Cervix -the lower part of the uterus that extends into the vagina.

Placenta -lining of the uterus by the union of the uterine mucous membrane with the membranes of the fetus, that provides for the nourishment of the fetus and the elimination of its waste products.

Umbilical Cord-lining of the uterus by the union of the uterine mucous membrane with the membranes of the fetus, that provides for the nourishment of the fetus and the elimination of its waste products.

Amniotic Sac-A two-layered membrane that surrounds the embryo or fetus in the uterus. The amniotic sac is filled with fluid in which the embryo or fetus is suspended.

Crowning -to reach a stage in delivery where the largest diameter of the fetal head is emerging from the pelvic outlet.

Labor -the process or effort of childbirth or the time during which this takes place.

Bloody Show-The Mucus that and blood that might discharge from the Vagina before the first stages of labor.

Contractions-one of usually a series of rhythmic tightening actions of the uterine muscles (as during menstruation or labor)

Stages Of Birth3D video of the 3 stages of labor http://www.babycenter.com/2_inside-pregnancy-labor-and-birth_3658872.bc

Stage 1: Early/Active Labor•Early Labor is when contractions are coming at relatively regular intervals and the cervix begins to progressively dilate and efface, Meaning labor has started and there is a baby on the way!•Active labor is when things really get rolling! Contractions become more frequent, longer, and stronger for the woman. The cervix begins dilating more quickly, going from about 4 to 10 centimeters.

•Transition-The last part of active labor -- when the cervix dilates from 8 to a full 10 centimeters -- is called the transition period because it marks the shift to the second stage of labor.

Stage 2: PushingOnce the cervix is fully dilated, the work of the second stage of labor begins: the final descent and birth of of a baby. At the beginning of the second stage, contractions may be a little further apart, giving the woman the chance for a much-needed rest between them. This Stage last until the baby is fully born.

Stage 3: Delivery of the PlacentaMinutes after birth, the uterus begins to contract again. The first few contractions usually separate the placenta from the uterine wall. A couple more pushes from the woman and the placenta is delivered, And the Labor process is over.

Gynecologic Emergencies

What to do and what they are.

Placenta Abruption

-Placental abruption occurs when the placenta peels away from the inner wall of the uterus before birth.

Prolapsed Cord

-In a prolapse, the umbilical cord drops (prolapses) through the open cervix into the vagina ahead of the baby.

Prolapsed Cord Emergency

Placenta AbruptionEmergency

In most cases, you'll have some vaginal bleeding, ranging from a small amount to an obvious and sudden gush. Sometimes, though, the blood stays in the uterus behind the placenta, so you might not see any bleeding at all.

Most women will have some uterine tenderness or back pain. And in close to a quarter of cases, an abruption will cause the woman to go into labor prematurely.

IMMEDIATELY TAKE MOTHER TO HOSPITAL!

The cord can be seen before the baby’s head, cord is prolapsed.

1) position the mother with her head down or buttocks raised to use gravity to lesson

in the birth canal.

2)Insert fingers with a gloved hand into vagina, placing fingers on either side of

the prolapsed cord to hold pressure from the presenting part (most often the head) of the fetus away from the pulsating cod. Continue until EMS arrive. DO NOT PUSH

CORD BACK IN!

3) CALL 911 IMMEDIATELY!

Breech & Limb Presentation-if your baby is breech, it means he's poised to come out buttocks or feet first.

In breech position if baby’s head is not delivered within 3 minutes of the body, YOU MUST act to prevent suffocation of the baby. Suffocation will occur when the face is pressed

against the vaginal wall. 1)Place one hand on the vagina, positioning the palm

toward the baby’s face.

2) Form a V with your fingers on either side of the baby’s nose.

3)Push vaginal wall away from baby’s face until head is delivered.

4) Have someone call 911 IMMEDIATELY

4) Have mother continue to push with contractions and attempt to deliver the baby

Meconium Emergency

This emergency is baby’s first feces (bowl movement) and can be present in the amniotic fluid.

It is dangerous for the baby’s to breath it into lungs and is associated with fetal distress.

When recognizing this condition it is greenish/brownish rather than clear and tarry and almost colorless.

1) Keep infant moderately head down position to help with drainage.

2) Suction mouth and nose throughly, to prevent baby from inhaling the meconium.

Try not to stimulate baby to breath before suction.

3)Maintain a open airway.

4) CALL 911!

Other Emergencies

Pre-clampsia- is a serious complication of pregnancy associated with the development of high blood pressure and protein in the

urine.

Cervical Incompetence-is a weakness of the cervix, which may result in a late miscarriage.

Ectopic Pregnancy-a fertilized egg becomes implanted in tissues outside the uterus instead of in the uterine lining.

Placenta Praveia- the placenta is implanted lower down in the uterus and closer to the cervix than is normal.

Immediate Child Birth

Always reassure the mother she and the baby is ok!•Place her on her left side for it prevents drops in blood pressure.•Woman whom have had another pregnancy has shorter labors usually. •Time the contractions... If they are 5 minutes apart or more then there is enough time to get mother to the hospital. •Labor will proceed rapidly after the water has broke (amniotic sac).•Does the Mother feel the need to push? If so that indicates the delivery is immediate.

In any emergency Call a ambulance and/or get the Mother to the Hospital IMMEDIATELY!

If to late and baby is coming sooner, you will need a list of items to perform

a emergency birth.

•Clean sheets, plastic bag (for placenta)•Clean and sterile medical gloves•Sanitary pads •Newspaper or plastic to place under mother during delivery •Rubber sucker to clean babies mouth and nose•Strips of gauze •clean pair of shoe laces•Blankets & towels

Questions to ask in Immediate delivery and others to take into consideration.

Transport mother to the hospital if she is not straining or crowning. ONLY when she is crowning doe's a first aider begin to perform child birth while waiting for the EMT.

If this is the mothers first baby it could possibly take 12 hours to deliver.

(outside the hospital a first aider cannot safely check dilation of the cervix. Dilation is the cervix opening in

go’s from 1-10)

Always ask these questions

•Has the woman had a baby before?-Labor with 1st pregnancy is usually longer.

•How frequent are contractions?-Contractions more the 5 min apart gives you enough time to get to hospital. -Contractions 2 min or less apart is a signal of immediate delivery

•Has the amniotic sac ruptured? -Labor proceeds more rapidly after water has broke.

•Doe's the Mother feel a bowel movement or that she has to push?-Indicates immediate delivery and that the baby is crown or moving down the birth canal.

Home-birthsProsFreedom to control your own birth experience is maintained

Involves no hospital fee, and midwives' fees are usually much lower than physicians

Environment is safe, warm, and inviting, making relaxation easier and labor go smoother

Mother and baby have already developed antibodies to any germs found in the home, so they pose little threat to mother and child

Mother can eat, drink, and move around as she chooses

Infant's birth experience can be enhanced through lowered noise level, lowered lighting, and water birth if desired

Children can be present at birth if desired

No separation of mother from infant

Father or partner can have as active a role as he wants in the birth, can even "catch" the baby

Mother can give birth totally unassisted if she chooses to

Cons

Not all insurance companies pay for home birth expenses

Spirituality of the birth experience can be a priority

Filing for birth certificate is parent's responsibility, although some midwives do this

Complications can result if caregivers do not know what to do in an emergency

Arrangements for hospital care can sometimes be made in advance in case complications

occurIn case of emergency, there may be a delay in receiving care as you transport to the hospital

Responsibility for safe birth rests with parents

Click for short video

http://youtube/4DgLf8hHMgo

Personal thought on Home-births:I have friends that have chosen to have their babies at home and they have all been totally

Fine. Right now, I have another friend who is having her first baby and chose to have him also at

home. Me personally, would of loved to do it at home, BUT I feel safer at the hospital with this being

my first child.The first lady I mentioned above is my Doula :O). A Doula is a person who provides support for

a woman in labor by encouraging her to use techniques learned in childbirth-preparation classes. She is also attending to get her Midwifery degree, to do home births. I think it is

perfectly ok to have babies at home, as long as you know your self, your labors and if the baby is capable of doing a home birth. I think if this is a decision to take into consideration the you as a parent need to research the Midwife, Make sure they have EVERYTHING and ALL knowledge to

perform a home delivery. Also, there is always a birthing center too, which is a very relaxing and you can do water births, and have a baby at your own natural state. Usually birthing

centers are located next, in, or very close to the hospital.

Sources

EMS Class Book

http://pregnancy.doctissimo.com- Information & Images

http://pregnancy.com- Information & Images OB Nurse from Hillsdale Hospital

Google Images

http://www.unhinderedliving.com/home.html

Movie- The business of being born (Homebirth VS Hospital)

My Doula (home births)

And Josh’s Personal Experience.