Neonatal Resuscitation: Crucial Skill for Your Midwife

A video of a homebirth neonatal resuscitation (NR) was brought to my attention, being asked what I thought of it. Sharing it here is irrelevant, but the ensuing discussion after my viewing is not. Just know the whole unfolding was horrible to watch as the baby received tactile stimulation instead of Positive Pressure Ventilation (PPV), had wet blankets (and sometimes no blankets) on him and the PPV was done incorrectly.

As the discussion unraveled, commenters noted the assistant didn’t look very skilled in NR, that maybe she was nervous or just forgot some things she should have been doing… namely getting the bag & mask into the midwife’s hand so she didn’t have to do mouth-to-mouth on the baby.

My response to the entire video was one of, not only distress, by intense frustration (and anger?) that such a crucial, life-saving skill wasn’t second nature to the midwifery team.

Your homebirth midwife and her assistant should have NR embedded in their entire being, it being a body memory, able to be tapped into almost in their sleep. I don’t care how nervous anyone is. I don’t care how green the assistant. No professional should be at a birth without exquisite skill at NR.

If you’re reading this and go to births, I hope you’ll schedule a NR practice this week. Encourage your Peer Review to do a NR practice session at every meeting. If you have prenatals during the week, practice there.

Your skill can… and will… save lives.

Resuscitation Board

This is the board (photos below) I carry with me to births. Its main purpose is to be a hard surface in case we need to do the chest compressions part of CPR. A previous client's husband made this for me and, happily, made a place to hand carry it if I need to.

When I'm at a birth, the board, encased in a flannel pillowcase, comes into the house. I use the board as a place for the "warm" blankets and such... layering as such:

- open (flat) a non-disposable, water resistant, thick underpad

- a heating pad

- a few blankets and a couple of washcloths

- the stethoscope

- a few more blankets and the rest of the washcloths

- another heating pad

- close/wrap the underpad around the whole shebang

I used to keep the hat/s in there, too, but now that the hats are passe, they don't make an appearance anymore.

I also have an extension cord that allows both heating pads to be plugged in, but using one outlet.

As mom labors, the board hangs out in an out of the way place, but as she gets closer to the birth, the board starts following mom around... discreetly, of course. It tucks under things nicely, but is close enough to grab if we need it.

One of the best parts of having a board is that if the baby needs help, someone can hold the board under the baby, allowing the cord to remain attached, but also doing chest compressions correctly.

I make sure the stethoscope is in the middle of the pile so it isn't burning hot if we have to use it; this is really important!

This is the naked board with my (old!) cell phone as a size gauge.   

This one shows the pillowcase on, opening at the top so I can grab the "handle" to carry it.    

This is the full board, still showing the handle. 

 The full board again with the cell phone size gauge.