DELIVERY CASE ON BOARD

Pregnant or expectant mothers are not accepted on board ‘After 38th weeks of pregnancy but there is always the risk of pre-mature labor or child birth due to physiological or psychological stresses of a long or tiring flight.

Symptoms of Labor Pain:

1 .Low backache 2. “Show” of blood stained discharge

3. Regular contraction 4.Occasional “breaking of water”.

Preparations for the delivery:

a. A quiet and spacious place with privacy should be chosen. Galley area is most suitable.

b. If no bed is available, prepare a clean surface for the mother to lie on.

c. Expecting mother should be asked to pass her urine and stool.

d. Antiseptic dressing of the external gentalia with 10% of Dettol or Savlon solution.

e. A cot should be ready for the baby with blanket or towel ready to keep the baby warm.

f. A sterilized scissors should be ready after boiling for 10 minutes to cut the cord.

g. 3 pieces of strings (thread), each 9 inches long should be boiled for 10 minutes to tie the cord.

h. Jugs of hot water and a plastic bag to throw in soiled cotton swabs should be available.

i. All handling crew should wear masks made of handkerchief.

j. All handling crew’s hands should be washed thoroughly.

First stage of labor:

The uterus contracts every 10 to 20 minutes and may last for several hours. Finally, cramps like pains increase and last up to a minute.

Second stage of Labor:

It may start with “breaking of waters” surrounding the baby and a liter of water gushes out indicating that the baby is on its way.

The mother should be instructed to draw her knees up, holding them with her hands. She should stay near the edge of the bed. She should keep her mouth open and pant for air so that the baby emerges slowly.

The baby’s head commonly emerges first with the face looking back or sometimes, the bottom, arm or foot may appear first.

If the cord is around the baby’s neck, try gently to ease it over the head or over the shoulder. Then support the baby’s head in your palms and wait for the next contraction which will deliver the baby’s shoulder. The baby is then held under the armpits and lifted towards the mother’s abdomen.

The cord is firmly tied in two places, one 4 inches and one 6 inches from the baby’s navel with the two strings kept ready. In between the area (4 inches and 6 inches) the cord is cut. If it is suspected that there is no bleeding after a period of 10 minutes, another tie (ligature) is given 2 inches from the baby’s navel. The cord is then dressed with a sterile bandage.

Note: If the baby’s bottom appears first, do not interfere. Wait for the shoulders to emerge to get the baby’s head after gentle traction.

The baby is then wrapped with a cloth and held by ankles with head downwards to drain out the fluid from the baby’s mouth and nose and the baby will cry out. If the baby does not cry or show any kind of breathing in 2 minutes, start resuscitation process.

Third stage (after delivery):

The Placenta will be expelled by uterine contraction and by the mother’s voluntary efforts.

After 10 minutes of child birth, if there is much bleeding, gently massage the top of the uterus just below the navel which will stimulate the uterus to contract.

Care for the mother:

The mother is then washed with savlon or dettol water and a sanitary towel is fixed. She should be given hot drinks, biscuits, etc. and advised to sleep. Her pulse and respiration rate should be checked.