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EMT in person class- Topic: Childbirth
This week in EMT class we learned about our last two topics: childbirth and the KED. For childbirth, when I got to class there was a mannequin of the bottom half of a pregnant woman’s body. There was a baby mannequin that fit inside of the stomach.
The process of childbirth:
- The first step of childbirth is the dilation of the cervix. The cervix needs to be fully stretched by uterine contractions in order for the opening to be large enough to fit a baby. This usually averages about 16 hours. Signs of the onset of labor include contractions of the uterus or blood streaked mucus and the rupture of the amniotic sac. Initially, these contractions may not occur at regular intervals but as true labor begins, they become more regular and last about 30 to 60 seconds each.
- The second stage is delivery of the fetus. This begins when the fetus enters the birth canal and ends after the baby is born. The uterine contractions become close together and longer because the fetus goes through position changes as it moves through the birth canal. It is common for people giving birth to need to go to the bathroom due to pressure on their rectum. When the top of the fetus’s head begins to appear at the vaginal opening it is called crowning.
- Finally, there is the delivery of the placenta. Contractions will continue and the placenta must separate completely from the uterine wall.
If a woman begins giving birth, it cannot be stopped. As an EMT, my job would be to assist with delivery. I would need to support the baby’s head and body as it emerges. We learned about different complications that can occur during childbirth. For example, if there is an uncultured amniotic sac, if the umbilical cord is wrapped around its neck (AKA a unchallenged cord), if it comes out feet first, etc. After the baby is born, we need to hold onto it firmly (it is very slippery) and make sure the airway is clear. If the mother is able to, it is good to place the newborn baby on the mother’s abdomen with the cord still intact; skin to skin contact allows the newborn to be warm and perfumed. If there is any gurgling, I would need to suction the baby’s mouth. Then we cut the umbilical cord. After the baby is born, we use what is called the Apgar Score. This is a standard scoring system used to assess the status of a newborn. Apgar stands for appearance, pulse, grimace, irritability, activity or muscle tone, respirations. Each category is given a numeric value 0,1 or 2. We then wrap the baby in a blanket (because they’ve gotten used to the heat in their mother’s stomach) and transport them to the hospital.