_The person helping the mother should always let the baby be born by
itself. No attempt should be made to pull the baby out in any way._
Usually the baby's head appears first, the top of the head presenting
and the face downward. Infrequently the baby will be born in a
different position, sometimes buttocks first, occasionally foot or arm
first. In these infrequent situations, patience without interference in
the birth process is most important. The natural process of delivery,
although sometimes slower, will give the child and the mother the best
chance of a safe and successful birth.
The baby does not need to be born in a hurry, but usually about a
minute after the head appears the mother will have another bearing down
feeling and push the shoulders and the rest of the baby out.
As the baby is being expelled, the person helping the mother should
support the baby on her hands and arms so that the baby will avoid
contact with any blood or waste material on the bed.
If there is still a membrane from the water sac over the baby's head
and face at delivery, it should immediately be taken between the
fingers and torn so that the water inside will run out and the baby can
breathe.
If, as sometimes happens, the cord, which attaches the child from its
navel to the placenta in the mother's womb, should be wrapped around
the baby's neck when his head and neck appear, try to slip it quickly
over his head so that he will not strangle.
After the baby is born, wrap a fold of towel around his ankles to
prevent slipping and hold him up by the heels with one hand, taking
care that the cord is slack. To get a good safe grip, insert one finger
between the baby's ankles. Do not swing or spank the baby. Hold him
over the bed so that he cannot fall far if he should slip from your
grasp. The baby's body will be very slippery. Place your other hand
under the baby's forehead and bend its head back slightly so that the
fluid and mucus can run out of its mouth. When the baby begins to cry,
lay him on his side on the bed close enough to the mother to keep the
cord slack.
The baby will usually cry within the first minute. If he does not cry
or breathe within 2 or 3 minutes, use mouth-to-mouth artificial
respiration.
_Very little force should be used in blowing air into the baby's
mouth_. A short puff of breath about every 5 seconds is enough. As soon
as the baby starts to breathe or cry, mouth-to-mouth breathing should
be stopped.