How should an EMT react if an expecting mother is in labor?

An expecting mother in Houston often busily prepares for her big day, whether it's packing a bag for the hospital, selecting a maternity suite or determining who will be invited into the delivery room. Some women may have the understandable fear that they will go into labor unexpectedly; in most cases, this fear is unfounded and the family arrives at the hospital in time. In some cases, though, paramedics or EMTs will need to be called if a woman is in labor and can't get to a hospital or is experiencing sudden complications at home. In such cases, emergency personnel must follow certain steps in order to avoid contributing to pregnancy-related injuries.

First, it's important for emergency personnel to proceed with treating a pregnant woman with two guiding principles in mind. The first is that the care needed by the woman may simply not be possible to provide outside of a hospital - or "in the field." Secondly, the most suitable care for the mother determines the appropriate care for the fetus.

With this in mind, when EMTs or paramedics are called to a woman in labor, they generally must first determine if there is indeed time to transport the woman to a hospital. Paramedics must check for all signs of impending delivery, as perineal bulging, visible crowning or pushing that the mother can't control. Missing or misinterpreting these and other signs could cause problems for either mother or fetus.

It is important that EMTs do not assume that delivery can be delayed in every situation. Even something as simple as allowing a mother with signs of imminent delivery to use the restroom can produce complications. If delivery is indeed imminent, paramedics should determine if the baby is in a breech position or not. If so, it is often proper protocol for the mother to be in a different position, with her head down, than if the baby is not breech.

A breech birth outside of a hospital can be particularly dangerous, as sometimes the baby must be stimulated to breathe prior to the actual emergency of its head. An emergency provider must frequently insert his or her gloved fingers into the vagina and manually push away the birth canal from baby's nose and mouth.

In any emergency situation, there are any number of things which can go wrong and proper protocol on the part of emergency providers is absolutely critical. In some instances, pregnancy trauma or other pregnancy-related injury may result from negligence on the part of a provider or that person's employer.