When baby comes early
NO matter how well you plan, anything can happen when you’re expecting a baby. Just ask 30-year old Kellyann Dwyer, whose water broke while she and her fiancé were making their way across the Portmore toll road earlier this year.
Although her child’s father eventually pulled over and frantically waved down passers-by to assist with the delivery, most of them were of no help and the mother was left to deliver her baby in the back seat of the car by herself.
Eventually, she said two women on their way to work pulled over and helped her wrap the baby and later escorted them to hospital.
Registered nurse and midwife Victoria Melhado said it’s not uncommon for babies in Jamaica to be “born before arrival (BBA)”. She said BBA babies, as they are referred to by health professionals, are especially seen among women who have had multiple pregnancies.
“They are most prone to having a [early] baby, so once they recognise that they are in labour, they shouldn’t wait, they should come in. Sometimes because they have so many children, like five children or seven children, I guess they are embarrassed at times about coming to the hospital. They don’t want people to say ‘Why are you trying to have more children?’ or ‘Why you have so many children?’,” she said.
With the hurricane season now in full swing, Melhado has reiterated the importance of pregnant women moving closer to the hospital so they can go in for delivery when they begin to feel contractions.
“When she knows she is in labour, the contractions come with timing, so she recognises that it was coming at 10 minutes before, then it starts coming at six minutes, five minutes and then three minutes, and once she starts having regular contractions, she is in labour and she needs to start making her way to the hospital,” she explained.
“If the mother has any sort of complications such as hypertension, diabetes, and if the last pregnancy was complicated, or if an ultrasound showed that there is potential for complications, then once it’s the hurricane season and they live far from the hospital, they are advised to either come in for admission or to move closer and stay with some relatives. They mustn’t stay up in ‘Timbuktu’ or up in the hills, because we sort of have a challenge with people who live in Mavis Bank and Above Rocks and those places,” the nurse said.
In the event that a mother has to deliver at home or on the way to the hospital, a caregiver or the child’s father can take the following steps to ensure that she has a safe delivery:
1. Help to calm the mother. You can do so by ensuring that she is in a comfortable position and offer reassurance that everything is going to be okay.
2. Call for help. Call the gynaecologist or the hospital nearest you and provide them with the necessary information. Also, follow the instructions given. You can also call on more mature women in your community or perhaps a nurse or a doctor who lives nearby.
3. Make arrangements to transfer the mother. If you do not have your own vehicle, call on your neighbours or have a reliable taxi service to send someone who can transport you and the mother to the hospital.
4. Get baby’s things together. Remember to ensure that a bag is already packed with the items both mother and baby will need, such as nightgowns, underwear, towels and blankets and clothes for baby.
5. Prepare yourself. If the baby starts to crown, have a towel on hand to provide a safe landing.
6. Do your checks. After the baby’s head is birthed, check to see if there is any cord around the neck. If there is, gently slip your fingers under the cord and ease it over the baby’s head. If it is not loose enough, leave it alone and instead wait until the baby is fully delivered to release it. Melhado advises against cutting the cord at this point. “They shouldn’t cut the cord with any scissors, or with any cord.”
7. Check the baby’s breathing. A sound cry will determine that your baby is breathing OK.
8. Get them warm. Once you have checked to see that the baby is breathing OK, wrap him up in a towel to keep him warm. Also allow the baby to have skin to skin contact with the mother to help calm them both down. You can help to stroke the baby as well to maintain physical contact, but ensure that the baby’s head is covered with the towel at all times.
9. Begin breastfeeding. Assist the child’s mother to guide the baby to the breast so she can begin breastfeeding. “Once the baby is born, they should start breastfeeding, because the breastfeeding helps the contraction of the uterus and that can actually help decrease the amount of blood that you lose,” explained Melhado.
10. Deliver the placenta. The baby’s placenta is usually delivered within a few minutes after the baby. If the mother is still not yet at the hospital within that time and the placenta is delivered, put it in a clean plastic bag and take it to the hospital. Melhado said this is important, because “the placenta gives us important information”.
11. Safely transport the mother to the hospital. See to it that the doctors are informed that she has just given birth.
— Nadine Wilson
