Giving Birth At Home

Babies may be small ... but they come with large demands. There's a lot to consider to care for them, in an emergency situation. Before their birth, pregnant moms have a lot to consider in advanced preparations.
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Giving Birth At Home

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Home Birth-Emergency Prep

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Giving Birth "In Place" A Guide to Emergency Preparedness for Childbirth
American College of Nurse-Midwives

https://static.squarespace.com/static/505ca0a4e4b08da3b4046e42/50784a3ee4b02a8ed67b7a1c/50784a40e4b02a8ed67b896f/1334682523078/

EDITOR'S NOTE
What can midwives do to help women who are at risk of giving birth without a trained attendant? The following document from the American College of Nurse-Midwives is available on the ACNM web site at http://www.midwife.org/focus/inplace.cfm, and although written for families in developed countries, the content can be adapted to any setting. This document can be used as a patient handout or it can be used by health care providers who are not
experienced in attending births.


While most women do not go into labor during emergencies and most of those who do can get to a hospital or birth center, women and their families should know what to do if travel is not possible. Being prepared can help. The information here includes a list of supplies and directions for managing a normal labor and delivery while taking shelter in place.

This is not a "do-it-yourself" guide for a planned home birth, nor is it all the information you need for every emergency. It is not meant to replace the knowledge and skills of a doctor or midwife. The information is a basic guide for parents-to-be who wish to be ready in case they have to give birth before they can get to a hospital or birth center.
... continued at link above ....
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Experts to set out advice for women pregnant in a flu pandemic

Helen Branswell, Medical Reporter, THE CANADIAN PRESS
http://www.thecanadianpress.com/english/online/OnlineFullStory.aspx?filename=x040208A&newsitemid=36618022&languageid=1SS

TORONTO - Women who are pregnant when the next flu pandemic strikes will find themselves with special needs, concerns and risks - and very little science to help decide things like whether it's safe to take flu drugs or necessary to wear medical masks in public.

Recognizing this group's vulnerability, the U.S. Centers for Disease Control is gathering experts with backgrounds varying from drug metabolism in pregnancy to baby delivery to come up with special pandemic guidelines for pregnant women.

The nearly 70 experts convene in Atlanta on Thursday and Friday to go over what little data exists. In the process, they will try to figure out what to recommend on issues such as antiviral drug use in pregnant woman and how to try to ensure continuity of obstetrical care for mothers-to-be during what is expected to be a medical emergency.

An expert from the University of British Columbia who will be attending the meeting acknowledges at least some of the recommendations will not be typical evidence-based guidance, but rather advice "couched in the language of ignorance."

"I think we will explicitly state that ... we're dealing with very, very limited data," says Dr. Jan Friedman, a medical geneticist and clinical teratologist. Teratology is the study of abnormal fetal development and congenital malformations.

He expects the group will come up with some advice, for instance weighing the evidence on how flu drugs like Tamiflu work in non-pregnant people against the fact pregnant women are at higher risk of complications and death from pandemic and even seasonal influenza.

"But we will say at the same time that the quality of data is very poor and these are the information gaps that we have. And we should try to fill as many of these gaps as possible before there is a pandemic situation so that we can make better informed recommendations," Friedman explains.

Flu pandemics are rare and not well documented events. The most recent was 40 years ago. So the picture of what it's like for pregnant women when a new flu strain spreads across the globe is murky. But a recent review of available data, published in the journal Emerging Infectious Diseases, cited figures that are cause for concern.

In the 1918 Spanish Flu pandemic, one study reported on 1,350 pregnant women who became infected; 27 per cent died from the flu. In the milder Asian Flu pandemic in 1957, half the women of reproductive age who died from flu in Minnesota were pregnant.

"From the limited information that we have from previous pandemics, it looks like pregnant women are expected to be a vulnerable population for future pandemics," says Dr. Sonja Rasmussen of the CDC's National Center on Birth Defects and Developmental Disabilities, the lead author of the review article and one of the organizers of this meeting.

Doctors know there is something about pregnancy - the carrying of a foreign body - that renders women in that state more susceptible. The normal protections of the mother's immune system have to be altered to allow the fetus to grow.

"And that alteration can make her at an increased risk of infection or increased morbidity (illness) or mortality with different infections," Rasmussen explains.

Little is known about the impact on a developing fetus of a bout of influenza in the mother. But one of the hallmarks of flu is fever. Fever in pregnancy has been linked to an increased rate of neural tube defects such as spina bifida.

Friedman says there is good evidence to urge that caregivers try to bring down a fever in a pregnant woman with influenza. "And there are safe, relatively well-studied medicines to do that."

Likewise there is evidence that regular flu vaccine is safe for pregnant women. But vaccines against novel strains of influenza such as H5N1 avian flu haven't been tested in this population. Nor have the immune boosting additives, called adjuvants, that will almost certainly be used to stretch limited global supplies of vaccine when the next pandemic hits.

As for antiviral drugs, "we just don't have data on them," says Dr. Tina Chambers, a teratologist at the University of California at San Diego who will also be attending the meeting.

"There's the animal data and ... limited or no information on human pregnancy. So you're just, like with so many other things, you're kind of going into it blind."

Dr. Richard Beigi is developing guidelines for care of pregnant women during disasters and bioterrorism events for Magee-Women's Hospital, in Pittsburgh, Pa. He says the scientific literature contains little on drug therapies for pregnant women.

"The whole field is very understudied," says Beigi, another attendee. "As a general rule, therapeutic and preventative agents in pregnancy are understudied, if they're studied at all."

One of the big questions is how to safely provide care to pregnant women at a time when hospitals will be both taxed to the limit and epicentres of contagion.

"That's one of the things which is worrying us," Dr. Matthews Mathai, of the World Health Organization's Department of Making Pregnancy Safer, says of the question of who will care for pregnant women. Mathai is representing the WHO at the meeting.

The Geneva-based global health agency recommends that babies be delivered by skilled attendants. In some parts of the world, those attendants work in hospitals.

"But the hospital, in a pandemic, would be full of people with infection. That's certainly not the place for a pregnant woman to be. . . . So it requires a lot of thinking, a lot of forward planning," Mathai says.

It also will require advance work on the communications front, another thrust of this meeting.

"If you are planning to divert a lot of women away from a hospital when they would otherwise go then there has to be very effective communication to get that message out," Beigi says. "Otherwise people are going to show up."

Despite the paucity of evidence on which to base their recommendations, participants believe starting this process in advance of a pandemic is the only way to go.

"Trying to make those decisions in the midst of this thing is sort of a dumb time to do it. You're better off to think about it ahead of time," Chambers insists.
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Re: Giving Birth At Home

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Home Birth-Supplies Needed

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Wilderness Medicine and Disaster Preparedness

Delivering Babies: So Grizzled
http://disastermedicine-christine.blogspot.com/2009/11/delivering-babies-so-grizzled.html

First, in this post I am going to discuss the things that you should have on hand in order to perform an emergent delivery. (Emergent delivery: if you are in a situation where in you can't contact 911 or are unable to get the laboring mother to a hospital in time.) (Continued at link, above)
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Home Birth

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Wilderness Medicine and Disaster Preparedness
http://disastermedicine-christine.blogspot.com/2010/01/incoming-eminent-delivery-part-1.html

Incoming: Eminent Delivery, Part 1

Excerpt: The following is just a snip from this article. Please go to link, above to read in it's entirety:

::::::WARNING: Due to the graphic nature of some of the images and videos of, there is some medical and anatomical details that may be not appropriate for children.:::::::::::

Go to link, above for a GREAT blog on home delivery, which includes a video. A 'must have' for your medical binder!
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Re: Giving Birth At Home

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US Marines - Resource

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Normal Labor and Delivery
http://www.brooksidepress.org/Products/Military_OBGYN/Textbook/LaborandDelivery/LaborandDelivery.htm

Includes:
  • *Labor
    *Delivery
    *Initial Evaluation
    *Fetal Presentation
    *Fetal Position
    *Managing Early Labor
    *Electronic Fetal Heart Monitoring
    *Pain Relief
    *Second Stage Labor
    *Episiotomy
    *Delivery of the baby
    *Delivery of the Placenta
    *Post Partum Care
Videos include:
  • Vaginal Delivery Video

    Episiotomy Video

    Circumcision Video
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Newborn Care

MORE US Marine Information. This item details the procedure for caring for the baby immediately after birth, including
  • * Drying the Baby
    *Position the Baby
    *Suction the Airway
    *Evaluate the Baby
    *Color
    *Ventilate if Necessary
    *Check the Heartbeat
    *Keep the Baby Warm
    vAssign Apgar Score
    *Breast-feeding
    *Vernix
    *Meconium
    *Eye Prophylaxis
    *Vitamin K
    *Umbilical Cord Care


Care of the Newborn

http://www.brooksidepress.org/Products/Military_OBGYN/Textbook/Newborn/Newborn.htm

Dry the Baby
Immediately after delivery, the baby should be dried. Ideally, this is with a warm, soft towel, but don't delay in drying the baby while searching for a warm, soft towel.

In an emergency, any dry, absorbing material will work well for this purpose. This would include:
  • *Shirts
    *T-shirts
    *Gloves
    *Jackets
    * Socks
----- continued at link, above ----
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:!: GRAPHIC IMAGES :!:

More US Marine Corps Resource

Military Obstetrics and Gynecology
http://www.brooksidepress.org/Products/Military_OBGYN/Textbook/LaborandDelivery/delivery_of_the_baby.htm

Delivery is also known as the second stage of labor, or part of the second stage of labor. It begins with complete dilatation and ends when the baby is completely out of the mother.

The exact time of delivery is normally taken at the moment the baby's anterior shoulder (the shoulder delivering closest to the mother's pubic bone) is out. --- continued at link, above ---

MORE
http://www.brooksidepress.org/Products/ ... edures.htm

Detailed topics include:
Obstetrics
  • * Deliver a Baby
    * Episiotomy
    * Repair Episiotomy
    * Deliver the Placenta
    * Cesarean Section
    * Retained Placenta
    * Shoulder Dystocia
    * Breech Delivery
    * Twin Delivery
    * Circumcision
    * Fetal Heart Monitoring
    * Amniotomy
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Re: Giving Birth At Home

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Giving Birth

Emergency Childbirth
http://www.fas.org/irp/doddir/milmed/childbirth.pdf

13 page PDF

A Joint publication of the Department of Defense, Office of Civil Defense and the US Department of Health, Education and Welfare
Reprinted December, 1970

EMERGENCY CHILDBIRTH

What to Do
  • 1. Let nature be your best helper. Childbirth is a very natural act.
    2. At first signs of labor assign the best qualified person to remain with mother.
    3. Be calm; reassure mother.
    4. Place mother and attendant in the most protected place in the shelter.
    5. Keep children and others away.
    6. have hands as clean as possible.
    7. Keep hands away from birth canal.
    8. See that baby breathes well.
    9. Place baby face down across mother's abdomen.
    10. Keep baby warm
    11. Wrap afterbirth with baby.
    12. Keep baby with mother constantly.
    13. Make mother as comfortable as possible.
    14. identify baby.
What NOT to Do

1. DO NOT hurry.
2. DO NOT pull on baby, let baby be born naturally.
3. DO NOT pull on cord, let the placenta (afterbirth) come naturally.
4. DO NOT cut and tie the cord until baby AND afterbirth have been delivered.
5. DO NOT give medication.
DO NOT HURRY -- LET NATURE TAKE HER COURSE> If it becomes necessary for families to take refuge in fallout shelters, there will undoubtedly be a number of babies born under difficult conditions and without medical assistance. Every expectant mother and the members of her family should do all they n to prepare for emergency births. They will need to know what to do and what to have ready. (See" Expectant Mothers Emergency Childbirth Kit.") ---- Continued at link above ----

Including:
  • Special Safeguards
    Preparations
    Stages of labor
    Change of Feeling
    Moment of Birth
    Cutting the Cord
    Third Stage of Labor
    Miscarriage
    Expectant Mothers Emergency Childbirth Kit
    Identification Tapes
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Video: Birth Kit

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How to make a SHTF/ Disaster Birth Kit
http://www.youtube.com/watch?v=Vy5TZlxt3do&feature=player_embedded

Video info:

We discuss how to construct a birth kit for disaster scenarios
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