From the Research
After an en caul birth, the immediate step is to gently break the amniotic membrane to allow the baby to breathe, as this is crucial for ensuring the baby's first breath and preventing complications, as noted in the most recent study on the topic 1. The process of breaking the amniotic membrane can be done by carefully puncturing or tearing the sac with clean hands or sterile instruments. Once the sac is opened, it is essential to:
- Clear the baby's airway by suctioning any fluid from the mouth and nose if necessary
- Dry the baby thoroughly to prevent heat loss
- Place the infant skin-to-skin on the mother's chest to maintain temperature and promote bonding
- Clamp and cut the umbilical cord after it has stopped pulsating (typically 1-3 minutes after birth)
- Assess the baby's vital signs using the Apgar score at one and five minutes after birth, checking heart rate, respiratory effort, muscle tone, reflex irritability, and color Continue routine newborn care including:
- Vitamin K injection (1 mg intramuscularly) to prevent bleeding disorders
- Eye prophylaxis with erythromycin ophthalmic ointment to prevent infection It is also important to note that en caul births are rare and considered lucky in many cultures, but medically they require the same immediate care as any birth once the sac is opened, with particular attention to ensuring the baby's first breath, as discussed in 2 and 1. Key considerations in the care of en caul births include:
- Ensuring gentle handling of the baby to prevent injury
- Providing appropriate respiratory support, as discussed in 3 and 4
- Monitoring the baby's vital signs closely to promptly identify any potential complications
- Maintaining a warm and stable environment to promote the baby's comfort and well-being By following these steps and considering the unique aspects of en caul births, healthcare providers can help ensure the best possible outcomes for these rare and special deliveries, as supported by the most recent and highest quality evidence 1.