What is happening?

What to do

1. If the baby is coming now or there is a strong urge to push, call an ambulance now. Use speakerphone.
2. Ask permission to help. Report pregnancy weeks, bleeding and whether the baby is visible/already born, if known.
3. Use a comfortable, safe position. Lying on your left side is an option. Avoid lying flat on your back.
4. Have another person bring clean towels and wash hands. Use available gloves. Mother alone: stay somewhere safe with the phone. No toilet or driving.
5. If the baby emerges, gently support head and body to prevent a fall. No pulling or pushing back. Keep close to the mother without stretching the cord.
6. Feet/bottom first, head out but body stuck, or cord visible before baby: tell dispatcher now. No pulling or abdominal pressure. Request specific instructions.
7. Cord before baby: no touching or pushing back. If able, knees and elbows on floor, lean forward until help. Otherwise lie on your side and tell dispatcher.
8. Very premature or under 32 weeks: report now, request thermal instructions. Do not rub to dry. Protect from cold with face clear, without delaying breathing. Unknown gestation: say so, do not guess.
9. If born at term and breathing: gently dry and replace wet towels with dry ones. For a very premature baby, request specific care guidance.
10. If both stable, mother awake and willing: skin-to-skin under dry cloth. Keep the face visible and airway clear. Watch both.
11. If the baby is not breathing normally or is very floppy, report immediately. Place on the back with the head neutral and follow dispatcher neonatal resuscitation guidance.
12. No breathing or only gasping: request neonatal help now. Keep cloth off mouth/nose. Head neutral. Briefly rub back/soles gently. Do not delay breathing support.
13. No equipment and not breathing: wipe visible fluid from the face. Seal your mouth over mouth/nose. Give small puffs 40–60/min, just enough for slight chest rise/fall. Follow dispatcher guidance.
14. Chest not rising: correct neutral head position/seal and report now. No forceful blowing or mouth suction. Still unresponsive: tell dispatcher and follow neonatal CPR instructions.
15. Very heavy bleeding, dizziness or fainting after birth: alert emergency services immediately.
16. Mother unresponsive: call/check breathing. Abnormal: adult CPR/AED. Another person supports baby safely without cord traction. Do not delay CPR for supplies.
17. Very heavy bleeding after birth: emergency now. Mother lying, warm, accompanied. Clean towel externally to collect blood. Nothing inserted, no placenta/cord pulling.
18. If placenta comes out itself, leave on clean towel for the team. No pulling. Note birth time, breathing and bleeding. Mother and baby need assessment even if apparently well.