Episode Transcript
Interviewer: Have you ever watched those movies or TV shows where there's a woman in an elevator about to give birth and the elevator is stuck and you're stuck in there with her and you're panicking and you don't know what to do? We're going to tell you next on The Scope.
Announcer: Covering all aspects of women's health. This is the Seven Domains of Women's Health with Dr. Kirtly Jones on The Scope.
Interviewer: We're talking today with Dr. Kirtly Parker Jones. Dr. Jones, I've never been in the situation and I hope I never have to be. But in case I ever do come across it, if I'm stuck in an elevator with a woman about to go into labor or if we're stuck on the highway and the ambulance isn't coming in time and I'm a bystander and I want to help, what are things I need to be doing? What advice do you have for somebody that's just standing there, panicking?
Dr. Jones: First of all don't panic.
Interviewer: Don't panic.
Dr. Jones: Don't panic. Well I'll tell you a story. Some years ago and it was probably late in night. I was on labor and delivery as the attending physician and the elevator door actually opens and it's an orthopedic resident and a woman who actually has given birth in the elevator. So she walked into the front door of the hospital, which is not really close to labor and delivery and was close to delivering. And she didn't know where to go and he took her, as he should, to the elevator and things then happened pretty quickly.
So he was strutting around. He was so proud that he had delivered the baby. But when we actually got to the woman her panties weren't really even off, so I don't think he did anything. So when he said, "I delivered this baby." I said "I think she delivered this baby." And in fact that's what you need to remember. If the baby's coming that fast you just stand back.
So you stand back, you can make sure that the mom maybe is on the ground so the baby isn't going to fall and you want to make sure that the baby if anything, if the baby comes out that the baby's put next to the moms chest. The baby needs to be warm.
Interviewer: Okay.
Dr. Jones: You do not have to cut the cord. Somebody else can do that. If you're in the elevator you can wait for that but mostly . . .
Interviewer: It's not an emergency.
Dr. Jones: It's not an emergency. You keep your hands off.
Interviewer: Keep your hands to yourself.
Dr. Jones: Keep your hands to yourself.
Interviewer: Got you. Okay.
Dr. Jones: If the baby's coming that fast and the woman is on the ground so the baby's not going to fall. Then all you do is you wait. If you have something that's relatively clean so that you can wipe off the baby's face and mouth and then put the baby on the mom's bare chest so that skin to skin so the baby can stay warm. Cover them up. Don't feel like you have to cut anything. You can just wait.
Interviewer: And the mom will be okay.
Dr. Jones: Yeah. The mom's going to be okay. Now the biggest risk to the mom who's having birth that fast is not the baby coming out, because the baby's coming out, it's, is the placenta going to come out. And normally the placenta comes out on its own. The uterus continues to contract after the birth and usually then it's expelled.
But if it doesn't come all the way out then the placenta separates and the mom can hemorrhage. That's where you need to make sure that you're getting help. So if the mom is hemorrhaging and you just see blood everywhere, the best thing you can do is put your hand on her tummy, below her belly button and try to massage this lump that's there and that's the uterus, so that the uterus will contract well.
Most people aren't going to feel comfortable doing that because they don't know what a uterus is. But after baby is born if the placenta isn't out yet, the uterus is still moderately big. It's below the belly button. It maybe just feel like a chubby tummy until you rub on it and then it should contract and become a hard ball-like melon size ball and keep massaging it so the uterus can contract. But hopefully someone's called for some help.
Interviewer: Right.
Dr. Jones: But remember women all over the world deliver their baby's by themselves. If it's coming that fast you don't need to put your hands in anywhere.
Now there is the baby coming that fast and its feet first and that's going to be difficult. My guess is if you have absolutely no experience, you should probably let things go and not tug on the feet.
Interviewer: Okay.
Dr. Jones: But if the head comes out first, that's the way it's supposed to and that's the biggest part of the body so if the head can fit, everything else is going to fit. If the feet come out first then the head may not come out and that can be a problem. But an inexperienced person should not be pulling.
Interviewer: So the rule of . . . Keep your hands to yourself still applies?
Dr. Jones: Right. So it's not like pulling a calf. Just put the baby skin to skin next to the mom and hopefully somebody will get in there who knows what they're doing.
Interviewer: So the takeaway is if you are bystander to a delivery, a birth delivery, keep your hands to yourself.
Dr. Jones: Right. Get the mom down on the ground. You can support her shoulders or head. She will push. If it's coming that fast her body will do the right thing. You don't know what size the baby is.
Interviewer: Stay above her head pretty much.
Dr. Jones: So stay above her head and then if someone can keep an eye so that when the baby does come all the way out that you wipe the baby's face a little, you can blow into the baby's face and make sure it takes a little breath. But then put the baby skin to skin next to the mom. The umbilical chord is still attached. Hopefully everything will go okay with the umbilical cord because that's the next risky time. But don't put your hands in there if you don't know what you're doing.
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