Unexpected birth in A&E departments

This paper discusses the current advice on and management of a woman who gives birth unexpectedly. It is written from the perspective of a midwife teacher who, whilst having fifteen years of midwifery experience, has not practised within an A&E department. However, lectures on the subject of unexpected birth to students undertaking trauma modules have led me to the conclusion that this event provokes anxiety in even the most experienced staff. Reflection upon their practice and discussion also leads them to appreciate that there are many invaluable skills, which are already part of every trauma nurse's repertoire and which are transferable to the situation of unexpected birth. An outline of the occasions when women may present unexpectedly in labour will be offered, followed by an outline of the physiology of normal labour and suggested management. This paper is not intended to replate departmental protocols; rather it offers some useful and basic information for guidance and will hopefully allay some anxieties regarding the skills required to effectively assist a woman to give birth.