Watch for warning signs
While you are traveling, help the mother stop pushing (see page 207). Put her
in the knee-chest position (or some other position with her hips up) to take some
of the pressure off the baby’s head.
W A R NI NG ! Never push on the mother’s belly to hurry
the birth. Pushing on the belly can make the placenta separate
from the womb, or tear the womb. This can kill the baby or
Watch for bleeding during pushing
A small amount of blood from the vagina, especially bloody mucus, is normal
during stage 2. It is a sign that the baby is moving down. But a gush of fresh
blood can be a sign of a detached placenta or a torn womb (see page 184).
Detached placenta (abruption)
If the mother has signs of detached placenta (a sudden gush of blood from the
vagina, very fast or very slow baby’s heartbeat, tense or sore womb, shock) go to a
hospital or medical center right away.
If the birth is near and you cannot get to a medical
center, have the mother push as long and as hard as
she can. Get the baby out fast — you may have only
a few minutes. If necessary, cut the mother’s birth
opening to make it larger so the baby can come
out faster (see page 354). If the baby takes too
long to be born, he and the mother can both
The baby must
Be ready! This baby may need extra
help to start breathing (see page 241),
and the mother may bleed heavily after
birth (see page 224). Get help so that
someone can care for the baby while
you care for the mother.
If the mother has a torn womb, her contractions will stop and she may feel very
strong, constant pain. The baby’s heartbeat will get very slow and then stop.
If you think the womb may have torn, treat the mother for shock (see page 239).
Get medical help immediately, even if it is far away.
A Book for Midwives (2010)