Home Delivery of Babies
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BLEEDING AFTER DELIVERY
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At the time the placenta is expelled from the uterus, what
seems like an amazing amount of blood is also expelled.
This is normal but it's a good idea to have someone on hand
who knows how much bleeding is OK and how much is too much.
Sometimes a fragment of placenta is retained in the uterus
following delivery. When this happens, the uterus does not
flex its muscles to stop bleeding and you will notice
thatinstead of feeling like a firm orange when you massage
it below the belly button—the uterus is large and
flabby. Blood loss from this condition can be rapid.
If the complication develops, the baby should be placed at
the mother's breast and her blood pressure checked
frequently. If the bleeding continues, the mother's pulse
becomes rapid and weak or her blood pressure starts to
fall, you've got a problem. The mother needs qualified help
immediately to evacuate the retained placental fragment and
start a blood transfusion . . . and that means a hospital.
The average amount of blood lost during a normal delivery
is about a cupful. Loss of over two cupfuls is worrisome
and occurs in about one in 20 hospital deliveries.
PREMATURE LABOR
If labor begins a month or more before the baby is due to
arrive, it can be predicted that the child will be small
and weak (a premature infant). Such deliveries are tricky
and should not be conducted at home. Certainly, any baby
which weighs less than four pounds at birth is much more
apt to get seriously sick in the days following delivery
than is a baby of average weight. Low birth-weight babies
also chill rapidly and should be put in a warm place as
soon after birth as possible.
COMPRESSION OF THE UMBILICAL CORD
If the umbilical cord (which carries blood to the baby)
slips past the baby's head and into the vagina, the cord
will be compressed during the passage of the baby. This
causes a shutting off of the baby's blood supply and the
complication is estimated to occur about once in every 300
hospital deliveries.
Although cord compression does not threaten the mother, it
will frequently result in a dead baby unless a rapid
delivery of the child (usually by C-section) can be
performed.
A trained person would feel the cord by doing a vaginal
examination, would place the mother in the knees-to-chest
position (have nurse, midwife or M.D. show you how) to
reduce pressure on the cord and would rush the mother to a
hospital.
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