When an emergency childbirth occurs outside of a hospital, emergency medical technicians (EMTs) must rely on training, preparation, and composure to ensure both the mother and baby remain safe. The EMT emergency childbirth skill sheet is a structured guide that outlines the essential steps and assessments required during a prehospital delivery. It helps EMTs follow a consistent, evidence-based approach while managing one of the most unpredictable and delicate emergencies they can face in the field.
Understanding the EMT Emergency Childbirth Skill Sheet
The EMT emergency childbirth skill sheet is designed to evaluate an EMT’s ability to assist with an imminent birth safely and efficiently. It provides a systematic list of procedures that ensure both mother and newborn receive proper care during and immediately after delivery. This skill sheet is often used in EMT training, certification, and real-life practice to reinforce critical actions in a high-stress environment.
Emergency childbirth can happen anywhere at home, in an ambulance, or even in public places. Since these situations are time-sensitive and unpredictable, the EMT skill sheet helps guide responders step by step, minimizing mistakes and ensuring high-quality care. The skill sheet typically includes sections such as scene safety, initial assessment, delivery procedure, newborn care, and post-delivery care for the mother.
Scene Size-Up and Initial Assessment
Every emergency begins with ensuring safety and assessing the situation. The first part of the EMT emergency childbirth skill sheet focuses on evaluating the environment and identifying potential hazards. EMTs must always make sure the scene is safe before approaching the patient. They should also wear appropriate personal protective equipment, such as gloves, a mask, and protective eyewear, since childbirth involves exposure to body fluids.
Key Steps in Scene and Initial Assessment
- Confirm the scene is safe for both patient and responders.
- Use standard precautions to prevent contamination or infection.
- Determine the patient’s age, condition, and primary complaint.
- Assess if childbirth is imminent this includes checking for crowning or contractions less than two minutes apart.
- Request additional resources or prepare for rapid transport if complications are likely.
At this point, communication with the patient is essential. The EMT should ask questions such as how many pregnancies the mother has had, the timing of contractions, and whether she feels the urge to push. This initial information determines whether immediate delivery is required on-site or if there is time for safe transport to a hospital.
Preparing for Delivery
When it is clear that the birth will occur before reaching a hospital, EMTs must prepare a clean and controlled environment as best as possible. The childbirth kit should be opened, and sterile items should be laid out on a clean surface. The EMT skill sheet reminds responders to prepare for both normal and complicated deliveries by anticipating possible scenarios such as breech presentation, umbilical cord prolapse, or excessive bleeding.
Equipment Checklist
- Sterile gloves and towels
- Umbilical cord clamps or ties
- Bulb syringe for suctioning the infant’s airway
- Blankets for warmth
- Obstetric (OB) kit
- Sterile scissors for cutting the cord
- Bag-valve mask for neonatal resuscitation
The EMT should position the mother on her back with knees bent and legs spread comfortably. Supportive communication is key reassuring her and instructing her not to push until contractions are strong and the head begins to crown helps maintain control and reduces the risk of tearing or premature delivery actions.
Assisting the Delivery
This is the most critical section of the EMT emergency childbirth skill sheet. During delivery, precision, calmness, and clear observation are required. The EMT must provide physical and emotional support while monitoring both the mother’s and baby’s condition. The goal is to assist in a natural delivery while avoiding unnecessary intervention unless complications arise.
Steps During Delivery
- Observe the perineal area for crowning of the baby’s head.
- Place a sterile pad or towel under the mother’s buttocks.
- Apply gentle pressure to the baby’s head to prevent explosive delivery.
- Check for the presence of the umbilical cord around the neck. If present, gently slip it over the baby’s head or, if too tight, clamp and cut it immediately.
- Guide the baby’s head and shoulders out carefully, supporting the body as it emerges.
- Do not pull the baby allow natural contractions to complete the delivery.
Once the infant is delivered, the EMT should immediately clear the airway if needed. Using a bulb syringe, the mouth is suctioned first, followed by the nose, to remove any fluids or mucus that may obstruct breathing.
Newborn Care and Assessment
After the baby is delivered, immediate attention shifts to ensuring that the newborn is breathing and warm. The skill sheet guides EMTs through the APGAR assessment a quick evaluation done at one and five minutes after birth to assess the baby’s condition. It evaluates five key factors appearance (skin color), pulse (heart rate), grimace (reflexes), activity (muscle tone), and respiration (breathing effort).
Initial Newborn Care Steps
- Dry the infant thoroughly to prevent heat loss.
- Wrap the baby in a clean, dry blanket and maintain warmth.
- Position the baby slightly lower than the mother to allow fluids to drain from the airway.
- Clamp and cut the umbilical cord once it has stopped pulsating, typically after about one minute.
- Encourage spontaneous breathing or stimulate it gently if absent by rubbing the baby’s back or flicking the soles of the feet.
- If the baby is not breathing or has a low heart rate, begin neonatal resuscitation following EMT protocols.
The newborn should be reassessed continually, with special attention to breathing and skin color. If the baby remains blue or limp despite stimulation, advanced life support may be required. EMTs must be ready to use the bag-valve mask or call for paramedic backup if the baby shows signs of distress.
Post-Delivery Care for the Mother
Once the baby is stable, focus returns to the mother. The EMT emergency childbirth skill sheet includes essential postpartum care steps to prevent complications such as hemorrhage or shock. The placenta usually delivers within 10 to 20 minutes after birth, and EMTs should never pull on the umbilical cord to expedite this process.
Maternal Care Steps
- Observe for the delivery of the placenta, and place it in a plastic bag for hospital inspection.
- Gently massage the uterus through the abdomen to help it contract and reduce bleeding.
- Apply a sterile pad to the vaginal area to absorb blood and monitor the amount of bleeding.
- Record the time of birth, placenta delivery, and estimated blood loss.
- Monitor the mother’s vital signs and level of consciousness continuously.
If excessive bleeding occurs or the uterus does not firm up after massage, immediate transport to a medical facility is necessary. The EMT should also provide emotional reassurance and keep both mother and baby warm throughout transport.
Documentation and Handoff
Accurate documentation is the final section of the EMT emergency childbirth skill sheet. It includes recording vital information such as the time of delivery, complications encountered, condition of both patients, and any treatments provided. When transferring care to hospital staff, the EMT must provide a detailed handoff to ensure continuity of care.
The EMT emergency childbirth skill sheet serves as a vital guide for handling one of the most intense and rewarding medical emergencies. By following each step scene safety, assessment, delivery, newborn care, and postpartum management EMTs can ensure the safety of both mother and child, even in unpredictable environments. Mastery of this skill not only builds confidence but also reinforces the professionalism and preparedness that define high-quality prehospital care.