This document provides information about childbirth and caring for pregnant women and newborns during delivery. It discusses the normal process of pregnancy and birth, potential complications, steps to assist with a vaginal delivery in an emergency situation, newborn care procedures, and key questions to ask a woman in labor. The presentation aims to equip healthcare workers with knowledge to handle routine deliveries and recognize issues that may require additional assistance.

1. A lecture about where babies come from
Richard Beebe MS RN NRP

2. To be able to handle a routine vaginal
delivery in an emergent situation.
To recognize that over 90% of
pregnancies end in a normal term
delivery and that we as healthcare
workers are there to assist something
that has been going on for millions of
years.
To be able to recognize potential
complications of pregnancy and delivery
and be able to administer commonly
accepted measures to alleviate the
complications.

3. Ovulation
Mittelschmerz
Fertilization
Chlamydia
Implantation

4. Placenta
Hormones
Umbilical Cord
Amniotic Sac
Amniotic Fluid
175 - 225 mL - 4 months
PROM

5. 40 weeks in length
37 - 42 Weeks
3 trimesters
Average weight
6.6 to 7.9 pounds
A missed period is the usual first clue
11% of women who say there is “no way” they
could be pregnant actually are..

7. Last
Menstrual
Period
TPAL vs GPA
Primapara
Grandpara
Estimated
Due Date
Abdominal
Assessment

8. As the uterus
grows it rises
up out of the
pelvis.
At approx. 12
weeks the
uterus “clears”
the pelvis
20 weeks =
belly button
37 weeks = just
under xiphoid
process.

9. Are you pregnant?
How far along are you?
How far apart are the contractions?
Any bleeding or discharge? Show?
PROM?
Do you feel pressure between your legs?
How many times have you been pregnant
before?
How fast were your previous babies

10. Placenta Previa
Abruptio Placenta
Eclampsia
Fetal Distress (Meconium)
Breech Presentation
Cephalopelvic Disproportion
Active Herpes

11. Always give high
flow oxygen
Baseline Vital Signs
History and Physical
Put mom on side if
delivery is not
imminent*
Locate the OB
delivery kit

12. The pregnant uterus acts like a tourniquet to
the vena cava and restricts blood from
returning back to the heart.
Treatment: flip them on their side.
(preferably left side with high flow oxygen.

13. Starts out at a
rate of 180 in the
1st trimester
After 12 weeks,
the rate drops to
120-160.
Any rate less than
120 signals
distress.

14. Typical OB Kit

15. A few clean towels,
blankets, shirts, etc.
clean string
clean sturdy scissors
or a knife
a clean trash bag
Some gauze pads to
wipe out the mouth
Prayer

16. check for crowning
Get your already located OB kit/supplies out.
if you have time, place some folded towels
underneath mom’s pelvis with a clean plastic
bag opened up and tucked underneath her
buttocks.
Have your assistant set up another bed/cot near
the mom and prepare for baby care.

27. Position, Dry, Wrap ‘em up. Keep them
warm.
Keep them level with mom’s body. Keep
warm.
Check sugar if lethargic or SGA or LGA.
Repeat suctioning as needed, keep warm.
Note the time of birth and if mobile the
county baby was born in.
Assess the infant, obtain APGAR’s, keep
warm
Stimulate if not perking up.

28. Appearance
(color)
Pulse (> 100)
Grimace
(vigorous and
crying)
Activity (good
motion in
limbs)
Respirations

32. The uterus cannot
“clamp down” to
control bleeding.
Fundal massage is
first choice
treatment to coax
the uterus to firm
up.

33. Explain to mom that this will be uncomfortable,
similar to a bad menstrual cramp, but that it
MUST be done or she can bleed to death.
With your hand flat and perpendicular to the
belly, press down anterior to posterior just
above the umbilicus until you feel a “ridge” rise
up. This “ridge” is the fundus. Begin rubbing the
fundus and moving down toward the pubic
symphysis until it you no longer see clots and
“gushes” from the vagina.

36. Condition where the cord presents through the
birth canal before the head.
Life Threatening to baby.
Requires aggressive interventions.
Knee Chest or ??

44. “Turtle Sign”
High Flow 02
Flex mom’s legs as
far back as possible
firm pressure just
above the pubic
bone