Emergency childbirth

Most babies are born safely without help, and your job is mainly to keep mother and baby warm, calm and clean. Call your local emergency number (112 in Europe and many other countries, 911 in North America) as soon as labour starts, or get someone to, and keep the line open if you can. Call urgently if the baby is coming early, feet or bottom first, or there is heavy bleeding.

Signs birth is close

Contractions every two minutes or less, a strong urge to push, or the baby's head showing at the vaginal opening. If so, it is usually safer to prepare for birth where you are than to travel.

Get ready

Wash your hands well and wear gloves if you have them.
Gather clean towels, blankets, a bowl for the afterbirth and plastic sheeting or bin bags to lie on.
Make the space as warm and private as you can.
Let the mother choose a comfortable position — on her back propped up, on her side, or on all fours.

The birth

Let her push when she feels the urge. Encourage short breaths or panting as the head comes out, so it emerges slowly.
Support the baby's head gently as it appears. Never pull on the baby or the head.
If the cord is around the neck, feel for it and gently slip it over the head if it is loose. If it is tight, don't force it — the baby can usually be born through it.
The shoulders and body usually follow with the next contraction. Babies are slippery, so hold firmly but gently.

Straight after birth

Note the time of birth.
Dry the baby straight away with a towel, rubbing the back and head. This helps them start breathing.
Put the baby skin to skin on the mother's chest and cover them both, including the baby's head.
If the baby isn't breathing or crying after drying and rubbing, clear the mouth and nose gently, tilt the head to a neutral position and start baby CPR, beginning with 5 rescue breaths.

The cord and afterbirth

There is no need to cut the cord if help is on the way.
If help is many hours away, wait until the cord stops pulsing, then tie it tightly with clean string or a shoelace in two places, about 10 cm and 15 cm from the baby. Cut between the ties with a clean, sterilised blade.
The afterbirth (placenta) usually comes out within 30 minutes. Don't pull on the cord. Put it in a bowl or bag and keep it for medical staff to check.

After the birth

Encourage breastfeeding — it helps the womb contract and reduces bleeding.
Some bleeding is normal. If it is heavy, firmly rub the mother's lower belly below the navel in circles to help the womb contract, and get help urgently.
Keep both warm and give the mother water to drink.

Mother and baby both need checking by a doctor or midwife as soon as possible.

This guide does not replace a first-aid course. A few hours of hands-on practice will make you far more confident when it matters.

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