Birth in extreme conditions

This is a brief article written for a Russian-/Ukrainian-speaking audience during the War in 2022.

In the classic movie, “Gone with the Wind,” the beautiful heroine, Scarlett O’Hara, has gone in search of Dr. Meade. Scarlett’s friend is in labor, and Scarlett wants him to come attend the labor, as he usually would. She finds him working in an enormous field of wounded soldiers.

He refuses to come help with the birth, saying that he is more needed to help with the hundreds of dying soldiers, and he says a line I love: “Don’t worry, child. There’s nothing to bringing a baby.”

“Don’t worry, child. There’s nothing to bringing a baby.”

I don’t want to make light of having a baby, but what the doctor (and perhaps culture in general) understood is that childbirth is a self-starting and self-completing process that usually needs very little intervention.

If you find yourself a pregnant refugee, or possibly pregnant and hiding, I want to remind you of important practices that will keep your pregnancy and birth as normal as possible.

Before childbirth:

  1. If you can evacuate to a safer place, do so immediately. Do not “wait and see.”
  2. Ask God for His personal protection over your pregnancy and birth, over your body and your baby. Ask Him for miracles on your behalf. He deeply loves and cares for you and your baby.
  3. Create playlists of music that honors God and encourages you. Find verses in the Bible that comfort you and record your voice reading them in one long recording that you can turn on and listen to during pregnancy and labor.
  4. Healthy eating is the number one way you can physically influence your pregnancy and birth to remain uncomplicated. You need to be eating, daily, approximately 2200-2500 healthy calories. You need a mix of carbohydrates (grains, potatoes, macaroni, etc.) with protein (meat, eggs, tvorog). At least 80grams/day of protein is a basic estimate. Eat small portions throughout the day.
  5. Find help, if at all possible. Contact a midwife or doula or someone who can answer your questions, even “attend” the birth with you by phone, hopefully by video.
  6.  Gather birth supplies—if you only have minimal supplies, you need some newspapers or clean rags for the water and blood that accompanies birth. Also have towels and blankets for the newborn—one to initially wipe away the wetness, then clean and dry ones to cover the baby.
  7. Spend time relaxing your belling while on your hands and knees. This can help facilitate good positioning for the baby.

During childbirth:

  1. Light eating and drinking during labor helps your muscles maintain energy. Remember to use the toilet because you don’t want a full bladder when pushing the baby out.
  2. Move during labor and change positions. Your baby has reflexes that he uses to navigate his way through the birth canal. Changing positions, rocking, standing, hands and knees—these movements of your body allow the baby freedom to get himself out.
  3. When you start feeling like you want to poop, that means the baby’s head is close, and your body will start pushing. Don’t lay on your back to push! Stand, be on hands and knees, or lay on your left side if you must lie down.
  4. Don’t force pushing. During labor, the uterus muscles have been drawing upward, gathering at the top, exactly to push the baby out. Just follow the sensations that your body gives you. Pushing with force can cause tearing. (Vertical positions allow the baby to exit naturally without forceful pushing.)
  5. Whoever is with you will need to be able to catch the baby. Once the head is out, that person might want to check if there is the cord around the neck. This is perfectly normal, and if it is, it can be slipped off over the head. The body will slide out pretty fast and be very wet, so be ready 😊
  6. Put the baby on your stomach/breast. Rest. Talk to your baby. Feel all the relief and love God designed you to feel at this moment.
  7. Caregiver can check the baby’s breathing. He might sneeze out mucus. If you have a bulb syringe you can carefully suction the mouth then nose if needed. Rub his back to help stimulate breathing if needed. At this time the baby has to push all the fluid out of his lung sacs (alveoli) to start breathing, so some crying can help with that, but it’s not essential. The baby should be pink in color.

Placenta:

  1. There is no reason to cut the cord. You can wait almost indefinitely, and the blood in the placenta is the baby’s blood and will flow to him, helping him survive and adapt.
  2. The placenta should come out any time from 7 to 30 minutes after the birth (this is a general rule, not an aggressive standard). Don’t pull on the cord or aggressively try to remove the placenta! This is very dangerous because it can cause excessive bleeding. After birth, the uterus continues contracting and will expel the placenta itself. This phase might be confusing to some parents, so please have someone to call who can help.
  3. It’s important that the caregiver monitor how mom is doing. About too much blood loss: hemorrhage might happen suddenly, but usually it is too much bleeding over a period of hours in the immediate postpartum. When the body loses too much blood, it goes into shock to preserve itself, and intervention is needed. The signs of shock: pulse of over 90 bpm (the heart is pumping faster to compensate for less blood in the veins), pale skin and cold sweat; lowered body temperature; low blood pressure: systolic (upper number) is less than 100). This most likely will not be an issue. but it’s better have someone you can call on the phone for help if needed or even if you just need reassurance.

“You created my inmost being; you knit me together in my mother’s womb.” We often think of this verse when we think about the child we are carrying. But let’s pause and meditate on how this verse describes you, mother; it describes your body, created with the ability to carry, birth, and breastfeed this child. God is with you.

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