Where There Is No Doctor 2011 267
DIFFICULT BIRTHS
It is important to get medical help as quickly as possible when there is any
serious problem during labor. Many problems or complications may come up, some
more serious than others. Here are a few of the more common ones:
1. LABOR STOPS OR SLOWS DOWN, or lasts a very long time after being
strong or after the waters break. This has several possible causes:
• The woman may be frightened or upset. This can slow down or even stop
contractions. Talk to her. Help her to relax. Try to reassure her. Explain that the
birth is slow, but there are no serious problems. Encourage her to change her
position often and to drink, eat, and urinate. Stimulation (massage or milking
motion) of the nipples can help speed labor.
• The baby may be in an unusual position.
Feel the belly between contractions to see
if the baby is sideways. Sometimes the
midwife can turn the baby through gentle
handling of the woman’s belly. Try to work
the baby around little by little between
contractions, until the head is down. But do
not use force as this could tear the womb
or placenta, or pinch the cord. If the baby
cannot be turned, try to get the mother to
the hospital.
• If the baby is facing forward rather than
backward, you may feel the lumpy arms and
legs rather than the rounded back. This is
usually no big problem, but labor may be
longer and cause the woman more back pain.
She should change positions often, as this
may help turn the baby. Have her try on her
hands and knees.
• The baby’s head may be too large to fit through the woman’s hip bones
(pelvis). This is more likely in a woman with very narrow hips or a young
woman or girl whose body is not fully grown. (It is very unlikely in a woman
who has given normal birth before.) You may feel that the baby does not
move down. If you suspect this problem, try to get the mother to a hospital as
she may need an operation (Cesarean). Women who are of short stature
(dwarfs), have very narrow hips or are especially young should have at
least their first child in or near a hospital.
• If the mother has been vomiting or has not been drinking liquids, she
may be dehydrated. This can slow down or stop contractions. Have her sip
Rehydration Drink or other liquids after each contraction.