256 Where There Is No Doctor 2011
PREPARING FOR BIRTH
Birth is a natural event. When the mother is healthy and everything goes well,
the baby can be born without help from anyone. In a normal birth, the less the
midwife or birth attendant does, the more likely everything will go well.
Difficulties in childbirth do occur, and sometimes the life of the mother or child
may be in danger. If there is any reason to think that a birth may be difficult or
dangerous, a skilled midwife or experienced doctor should be present.
CAUTION: If you have a fever, cough, sore throat, or sores or infections on your
skin at the time of the birth, it would be better for someone else to deliver the baby.
Signs of Special Risk that Make it Important that a Doctor or
Skilled Midwife Attend the Birth—if Possible in a Hospital:
• If regular labor pains begin more than 3 weeks before the baby
is expected.
• If the woman begins to bleed before labor.
• If there are signs of pre-eclampsia (see p. 249).
• If the woman is suffering from a chronic or acute illness.
• If the woman is very anemic or if her blood does not clot normally
(when she cuts herself).
• If she is under 15, over 40, or over 35 at her first pregnancy.
• If she has had more than 5 or 6 babies.
• If she is especially short or has narrow hips (p. 267).
• If she has had serious trouble or severe bleeding with other births.
• If she has diabetes or heart trouble.
• If she has a hernia.
• If it looks like she will have twins (see p. 269).
• If it seems the baby is not in a good position (head down) in the womb.
• If the bag of waters breaks and labor does not begin within a few hours.
(The danger is even greater if there is fever.)
• If the baby is still not born 2 weeks after 9 months of pregnancy.
THE BIRTHS WITH THE GREATEST CHANCE OF PROBLEMS ARE:
the first birth
and
the last births after having many
children