• If possible call ups the emergency ambulance service. Call your neighbour or someone else to help if possible.

• If you are alone, wash your hands and vaginal area. Lie down on a cot and start panting to keep you from bearing down. Spread some newspapers / plastic sheets / clean towels below you. If, inspite of the panting, the head of the baby starts coming out, conduct the delivery as explained.

• If the head is not yet visible and you are pregnant for the first time, you may still have 15 – 20 minutes. If it is possible for you to reach the hospital within that time, do so. If not, stay where you are and contact someone.

• The partner should calm and reassure the  woman in labour all the time.

• Your partner can wash her hands with soap and also the vaginal area.

• If possible, it is better that you lie on the edge of the bed with your legs supported on stools. Now it is easy for your spouse is deliver you.

• If not, lie on the floor with few folded towels / blankets beneath your buttocks the facilitating delivery of the baby.

• As the head appears and stretches the perineum, the labouring woman should stop bearing down and start taking deep breaths. Let the uterus do its job alone. At the same time, the spouse / attendant gives gentle counter pressure to avoid the head coming out suddenly. This will help in preventing excessive tears.

• As the head delivers, stroke the head from forehead to nose and check the nose to expel mucus and amniotic fluid from the mouth and nose. If you have an ear / nose syringe, then use it.

• Once the head is out, do not pull it as it may cause spinal injury. Feel for any loop of umbilical cord around the neck. If present gently slip it off before the rest of the body is delivered.

• You will now see the head turning till the baby faces the mother’s thigh. When this happens, gently push the head downwards (do not pull) so that the upper shoulder comes out. As it comes out hold the head in your hands and gently raise it in the opposite direction i.e. upward, so that the lower shoulder also comes out. The rest of the body will be delivered easily on its own.

• Now quickly complete sucking the mouth and nose of the baby and clean the mucus and amniotic fluid with syringe/cotton swabs /gauze pieces. Once this is done, dry the baby. 

• Feel for the pulsation of the umbilical cord. Once the cord stops pulsating, you can tie the umbilical cord with thread / twine / new shoelaces. (You can also leave the cord untied till the placenta is out. Just take care to place the baby at a lower level than the placenta and the mother).

• If the cord is long enough, you can let the baby feed at the mother’s breast. The suckling will help in expulsion of the placenta.

• If the baby is not suckling, the mother herself or the attendant can stimulate the nipples.

• Do not pull the placenta out. During the expulsion of the placenta, there may be a little bleeding as also from the tears, if any. Do not be alarmed.

• Once the placenta is out, do not throw it. Collect it in a plastic bag to show it to your doctor.

• Feel for the uterus now. If it has contracted and become firm, there won’t be any bleeding.

• If not, give a good massage to the lower abdomen in a circular manner.

• If there are any tears, use the sanitary pads to give pressure on them to stop / reduce the bleeding, till medical aid is obtained.

• Cover the baby in a blanket and keep him/her warm. It is best that the mother nurses the baby till medical help arrives. As this will help in contracting the uterus and reducing the bleeding.

• If the mother is alone, she can try doing all the above measures by herself as much as possible till help arrives.

• These are just the instances of extreme case. Chances are that you will never even be required to do so. But if it does happen, you now know what is to be done. But, like they say “prevention is always better than cure”. Even if you are in doubt, do not hesitate or wait. Report to your doctor immediately let him decide whether you are in labour or not.

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