Emergency Delivery - A Unique Birthing Story

Introduction

An emergency of any kind during pregnancy can be life-threatening to pregnant women and babies. A medical emergency can be expected at any time during pregnancy, labor, and delivery. Childbirth takes several hours sometimes. This can give time for patient preparation, operation theater preparation, and arrangements for the gynecologist or midwife. Childbirth occurs in three stages: the first stage which starts from uterine contractions and water breaking, followed by a second stage where the baby is pushed out of the uterus, and the last and final stage where the woman pushes out the placenta.

What Is an Emergency Delivery?

Emergency delivery or childbirth is the sudden precipitation of labor in an unexpected setting. When the delivery is planned, the pregnant woman has the liberty to choose the hospital and the medical team. There are various place choices for giving birth like a multispecialty hospital, a medical facility, at home, or a natural birthing center. In some instances, women give birth on their way to the hospital without a gynecologist or any other medical staff. The percentage of emergency childbirths is low. Emergency delivery needs special care and measures. The procedure is similar to a planned delivery but there are higher chances of complications since the ideal location and medical help are lacking most of the time. The emergency delivery may be natural or cesarean. A cesarean or C-section is a surgery to give birth to a baby.

What Are the Causes of Emergency Delivery?

A pregnant woman is advised for an emergency delivery for the following reason.

• Considering the safety of the mother and the baby.

• To save the mother and baby from a life-threatening condition.

• The labor progression is abnormal.

• In some medical conditions like severe bleeding and pre-eclampsia (high blood pressure during pregnancy).

What Are the Signs and Symptoms of Emergency Delivery?

Most of the pregnancy symptoms are normal and nothing to panic about. But some alarming symptoms need to be addressed by a doctor immediately to prevent any complications post the delivery. If a pregnant woman experiences any of the below-listed symptoms, immediate action has to be taken.

• Stomach pain during the first 3 months of gestation indicating ectopic pregnancy.

• Cramping during the first 3 to 4 months of pregnancy would indicate a miscarriage.

• Stomach pain in the last 3 months of pregnancy can indicate placental abruption.

• Cramps and severe pain in the stomach and abdomen.

• Dizziness.

• Lower back pain.

• Vomiting.

• Headache and fever.

• Sudden hypertension.

• Blurred vision.

• Sudden swelling of face, hands, and feet.

• Strong uterine contractions which increase in intensity before 37 weeks of pregnancy.

• Reduced normal baby movements.

• Sudden gush of watery discharge having a sweet smell.

• Seizures and unconsciousness.

• A feeling to push out the baby.

• Mild bleeding from the vagina.

• If the water breaks in the amniotic sac.

What Measures Are to Be Taken During an Emergency Delivery?

The process of childbirth (labor) is divided into three phases, which are explained in detail.

First Phase of Labor: Dilation of the Cervix

• The duration of this phase is two to eighteen hours, which can extend for more hours during normal pregnancies.

• This phase can be further divided into two phases called the active stage and the latent stage, according to the dilation of the cervix.

• A latent stage is when the cervix is dilated less than three to five centimeters with regular uterine contractions and lasts for up to 20 hours, not being considered prolonged.

• An active stage is when there is cervix dilation of more than three to five centimeters with regular contractions. The active phase can be long and if less than 12 hours, it is considered normal. Other measures to be followed during this labor stage are to evaluate the mother for transition in the stage of labor and to motivate the mother to walk for short distances or sit comfortably.

Second Phase of Labor: Birth of the Baby

• The duration of labor can vary between 20 minutes to 3 hours.

• The mother is in a lithotomy position, that is lying on the back with feet at the same levels of hips and the perineal region at the edge of the bed.

• The perineal area is sterilized with an antiseptic solution or water and soap. Anyone helping the woman should also clean their hands and use sterile gloves.

• The pregnant woman is encouraged to push the baby down.

• Once the head of the baby is delivered, to prevent rapid expulsion, place one hand on the perineum and the other hand to handle the baby’s head.

• The position of the umbilical cord is checked if it is wrapped around the neck of the baby. The cord is carefully clamped at two sites. If the cord is around the neck of the baby, it is loosened and clamped.

• Then the shoulders of the baby come out. A midwife or the partner during emergency birth will guide the baby out and the rest of the baby’s body follows it.

• Hold the baby carefully as they come out easily once their shoulders are out and as their body is slippery to hold.

• Now, the umbilical cord is cut carefully without injuring the mother and the baby with clean and sterilized scissors or a knife.

• The baby is wrapped and dried with clean towels and kept warm. The baby is now kept on the mother’s breasts.

Third Phase of Labor: Delivery of the Placenta

• The baby is connected to the placenta through an umbilical cord. The placenta remains inside the womb after the cord is cut. The placenta gets delivered within two to ten minutes or can take even longer. The expulsion of the placenta is spontaneous but sometimes needs the mother to push it.

• The mother is later taken to a proper hospital setting to check for vaginal injuries that are repaired surgically, stabilize the mother and the baby and provide post-delivery care to the mother and newborn.

What Are the Risks and Complications Associated With Emergency Delivery?

• Infections due to lack of a sterile environment.

• Excessive postpartum bleeding.

• Accidental injury to the newborn.

• Accidental injury to the mother.

• Perineal skin laceration.

• Retained placental tissue.

• Vaginal and uterine lacerations.

• Emotional stress.

• Higher chance of infection in the newborn.

Conclusion

There is a common fear of pregnancy and childbirth among women. And an emergency delivery is an even more fearful thought for every pregnant woman. But they occur very rarely. If someone is experiencing a fear of this, they should be given counseling sessions with the gynecologist, physician, or midwife to reassure them and keep them motivated and relaxed throughout their pregnancy. Pregnant women can be mentally prepared and get familiar with the process which will help them cherish and enjoy the whole pregnancy journey.