The Neonatal Resuscitation Program® (NRP®) course conveys an evidence-based approach to care of the newborn at birth and facilitates effective team-based care for healthcare professionals who care for newborns at the time of delivery. NRP utilizes a blended learning approach, which includes online testing and hands-on case-based simulation/debriefing that focus on critical leadership, communication, and team-work skills.
In all my 51 years of practice, I have never resuscitated a baby using an Ambu bag though.
When I first began practicing as a midwife, it was not easy for me to get the birth supplies I have access to today, so I learned my own methods for resuscitation of babies who needed help to breathe after a difficult birth.
The one thing I still do today is the “cold rag” trick, which works fast to stimulate a distressed baby to take that first important breath!
Texts advise caregivers to keep the baby warm after birth, especially if the infant is in distress, but I have found that when a baby isn’t breathing, the best thing to do, at least what I do, is wring a washcloth out in cold water and vigorously rub the baby down with it, starting with the face and scalp and then onto the tummy. Most babies respond right away by gasping and then taking that needed breath.
As I do that, I talk to the baby and welcome him or her to earth. That is important. I ask the parents what the baby’s name is and call him/her by that name. If necessary, I also give blow-by oxygen or blow on the baby’s face myself. I continue with the cold rag massage until the baby is yelling lustily and stays pink. Then I hand the baby to its mother and cover him/her. Skin to skin works very well to warm the baby up fast.
The following is a true story to illustrate the importance of understanding that babies have feelings and fears just like we all do and addressing them is as important for the baby’s survival and well-being as any physical resuscitation method is.
When my oldest daughter was pregnant with her first and only child, Cameron, I was her midwife up until the 8th month of her pregnancy when I discovered during a routine pre-natal check-up that his heartbeat indicated something was wrong with him.
I advised my daughter to make an appointment with a doctor and to get an ultrasound, which she did. We were all shocked to find out that Cameron had problems with his brain- hydrocephalus and Dandy-Walker Syndrome. The two halves of Cameron’s brain had failed to fuse together resulting in him also having total cleft lip and palate.
The doctor gave my daughter the option of having a cesarean at term or an induction a month early. I was with my daughter during her visits with the Obstetrician, so I asked him, “But if you induce my daughter now, the baby can’t be born vaginally. His head is too big!”
He replied, “If his head won’t pass through the birth canal, we will crush his skull!” He was giving my daughter an option to abort her baby boy. That option was not acceptable to my daughter or me or any of our family. Kim chose to deliver him by cesarean at term.
I was in the delivery room when the day came for his birth. His father couldn’t handle what was happening, so he chose not to be in there when Cameron was born.
I watched as they lifted my Grandson out of my daughter’s womb and laid him on the recovery table so they could resuscitate him. There were four experienced doctors working on him to get him to breathe.
I waited in anticipation for him to take his first breath, but it seemed like forever that he still hadn’t started breathing. I looked at the clock on the wall in the delivery room and after ten minutes decided to step in and do what I felt needed to be done.
I had been standing respectfully behind the doctors to let them do their job without being in the way, but in desperation I finally just walked around them over to where my Grandson lay and took his chubby, precious little hand in mine and leaned down by his face and whispered in his ear, “Cameron, we want you to be here. We love you!”
That was when he took that precious first breath and started crying.
My belief is that babies know exactly what is happening and they have emotions like we have. Souls are eternal and they choose their parents and the lessons they are here to learn. I felt Cameron was afraid of the body he was to inhabit here in this lifetime and that is why he hesitated to take that first life-saving breath until I reassured him that he would be loved.
He had many surgeries during his fourteen years here, but it was certain my daughter and all of our family loved him very much.
Love is as necessary as anything the doctors did for him.