How to deliver a baby in a taxicab

Note: This was a writeup following a reprint of (obviously copyrighted) material from the The Worst-Case Scenario Survival Handbook. My writeup therefore does not stand out so well by itself ... hmm ... maybe one day ...

If the baby's head has not already completely come out but is just visible at the cervix (this is "crowning"), it is worthwhile putting a hand in and feeling around the baby's head to see if the umbilical cord is wrapped around its neck. If it is, take a moment to try and untwist it over the baby's head so that the bady does not get strangulated by its own umbilical cord as it is delivered.

After the baby is out, it is of paramount importance, after the baby has started breathing, that you keep the baby warm. Babies have a much higher surface area to volume ratio than adults so they lose heat quickly. In a pinch, this can be done by having the mother cuddle the dried baby.

God help you if you have a placenta praevia baby in the back of a taxi ... or any of the other obstetric emergencies. If in doubt, get the mother to a hospital immediately.

If (God forbid) an extremely unfortunate situation arises, attempt to save the mother's life first. If the mother is already dead, attempt to save the baby - perform an unsterile caesarean section if necessary.

First, acquire a baby. The old-fashioned way is cheapest, but labor and time-intensive (may take up to 9 months). Depending on where you live, you may be able to adopt one with a minimum of fuss. If you live in a large city, check garbage cans near hospitals.

Now that you have a baby, hail a taxi. Again, the exact procedure varies from place to place, but generally includes at least one of: waving; yelling "Taxi!"; throwing yourself in front of the cab (WARNING! Do not try this in New York City); throwing money in front of the cab; small arms fire.

Get in the taxi with the baby and tell the cabbie what address you would like to deliver the baby to. Get out once you're there, being sure to tip extra to compensate for the fact that he will have to remove baby vomit from the back seat. Ring the doorbell and/or knock on the door, and when the recipient answers, say "Here's the baby!"

Better yet, just forget the whole thing.

As a woman who has had two beautiful, planned and very satisfying homebirths I offer a few other words of advice:

If you were not planning to have the baby away from the hospital you may be very nervous. Contractions are very intense and can be frightening, especially if you are not where you expected to be for the birth and you are having your first baby. You will need to relax and not focus on the next contraction, just think of the powerful work your body is doing to give birth.

Moaning in very low tones often helps, as it creates a low hum that makes a great focal point. If you are helping a lady and her voice gets shrill try to moan in a low tone and see if she will join you. The low tones open the cervix and the higher, shriller tones tend to sound pinched, which in turn pinches the cervix and makes everything slower and more painful.

Telling a woman she is beautiful while she gives birth is always helpful (and she will be, look at her, she is amazing!) It is also helpful to say, “You are about to meet your baby!” And “You are strong, you can do this!” Remind the woman to touch her baby while the baby is crowning, as this can really make things real for her.

Also, feel around the neck for the cord once the head is out. It is often around the neck, which sounds more alarming than it really is. Slip your fingers between the cord and the neck to prevent it from tightening.

Do not make the woman lie flat on her back. Squatting or sitting up will allow gravity to aid in her efforts.

Also it is not necessary to make those comical panting noises that you often see depicted in movies. A woman knows how to breathe and will adopt whatever style is best at the moment. If she looks panicked you can try deep breathing with her while making eye contact and making positive statements like I mentioned above.

If you are not really as rushed as a taxicab there is something else worthy of mention. Watch for white areas on the perineum (the area between the anus and vagina). White spots indicate a lack of blood flow to the area, signaling that this would be a likely place for a tear to occur. If you massage the area until it returns to its normal color you can help to prevent tearing. (My personal testimony for perennial massage is this: I had an eight pound girl and a ten pound son without tearing or laceration of any sort, thanks to the efforts of my midwife.) Of course, if things are happening really fast there will be no time for this, and luckily natural tears heal faster and better than the surgical cut, or episiotomy the doctor might give you if you were in the hospital.

alex.tan mentions keeping the baby warm, which is crucial. Skin to skin contact with the mother will keep the child warm. The mother should cradle the child against her chest, under her shirt or blanket. The baby may show interest in breastfeeding immediately and should be encouraged.