A baby arriving before medical help is available. Most straightforward births can be safely guided with calm, clear steps.
Stay calm and reassure the mother. Tell her she is not alone and you will help her through this.
Call for help immediately — send someone for a nurse, midwife, or doctor. Keep trying to reach help throughout.
Wash your hands thoroughly with soap and water. Use gloves if available.
Help the mother find a comfortable position — lying on her back with knees bent, or on her side. Place clean cloths or towels beneath her.
Do not try to stop or delay the birth. Do not tell her to hold the baby in.
As the baby's head appears, support it gently with clean hands. Do not pull — let the baby come naturally with contractions.
If a membrane (bag of water) covers the baby's face, carefully break it and pull it away from the face immediately.
Check if the umbilical cord is around the baby's neck. If it is, gently and quickly slip it over the baby's head.
Once the head is out, the body usually follows quickly. Support the baby's body as it emerges — babies are slippery.
Hold the baby face down at the level of the mother's belly to help drain fluid from the airways. Wipe the mouth and nose gently.
The baby should cry and breathe within seconds. If not, rub the back firmly, flick the soles of the feet gently.
Place the baby on the mother's chest, skin to skin. Cover them both with a clean cloth to keep warm.
Do not cut the umbilical cord unless you have sterile scissors or a blade and sterile ties. If you must tie it: tie firmly 4 finger-widths from the baby's belly, tie again 2 finger-widths further away, cut between the two ties with the cleanest instrument available.
The placenta will deliver 5 to 30 minutes after the baby. Let it come naturally. Do not pull the cord.
Baby's buttocks or feet are coming first, not the head — breech birth, needs urgent medical help.
The cord is coming out before the baby — this is a cord prolapse, life-threatening. Get help immediately.
Heavy bright red bleeding from the mother before the baby is born.
Baby is not breathing after 1 minute of stimulation.
Mother loses consciousness.
Placenta has not delivered after 1 hour.
Do not pull on the baby's head or body to speed up delivery.
Do not cut the cord with an unclean instrument — infection risk is severe.
Do not leave the mother and baby alone after delivery — bleeding and complications can occur.
If the baby's bottom or feet appear first (breech) — this is high risk. Do not pull. Get medical help urgently.
✓ What Helps
· Clean cloths or towels for warmth and hygiene
· Sterile gloves if available
✗ What To Avoid
· Do not give the mother pain medication that could sedate her during pushing
· Do not use traditional herbs or substances to speed up labour
→ Ask The Pharmacist For
· Oxytocin injection for the mother after delivery if a health worker is present — reduces post-delivery bleeding
· Sterile cord clamps or ties
· Clean sterile scissors
🏥 Get Professional Help
Get to a hospital or maternity clinic as soon as possible after delivery — both mother and baby need to be assessed. Do not wait until tomorrow.