Decided to build/add an Obstetrics Kit to my Truck First Aid Kit system just in case. I plan on taking some birthing class this summer and would really appreciate some input/ideas for this kit (see kit w/inventory below). Thanks

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I like your packing list sheet. I need to do something similar to keep track of my stuff.

How often do you come across childbirth at work? EMS/LEO?

Never, although there always seems to be a pregnant woman at events I go to. Just never know, I figure its better to have it and not need it than need it and not have it. 

It's late, but message me if you want. My wife is a labor/delivery charge nurse and prior NICU charge. I can run it by her if you want.

@Rapidfire_85 

Yes please, I would really appreciate that! 

Thanks

Mask and gown with gloves.

Towels or dressings to dry baby. Hat. Bulb suction. Blankets to wrap baby after. Bulb suction. 2 clamps and scissors to cut cord.

Sterile water for cleaning. Sterile dressings for transporting the placenta/after birth.

Or just do what I do, put them on their left side or face down with their ass in the air and drive like hell to a hospital.

Talk to your local EMS, they have OB kits in their rigs. I've only had to use mine once. Once was enough.

Did I mention a bulb syringe?

Realistically, in a pinch, there is not much more you will need outside a properly stocked trauma kit than blankets and a bulb suction. If they present breech there is very little you or anyone can do except drive like hell. If it's a cord presentation wet dressing and pressure and drive like hell. If the head delivers with the cord around the neck clap and cut and drive like hell. YMMV.

"I'm no doctor, but I'll take a look"

so your plan to deliver babies??? after some classes???

good luck

and, apparently, care for yhe newborn simultaneously.

Gloves
Bulb suction
Couple towels
Trash bag
Stocking cap
Cord clamps and scissors
Cell phone


Everything else is.gravy

Good list.  A little labor and delivery cheat sheet might be a nice addition, including APGAR scoring guidleines

Cord clamps and bulb syringe for the minimalist (although OP's setup doesn't exactly look like a minimalist )

Babies deliver themselves pretty good most of the time. I delivered several in a previous life.  Just stand back and hold the catcher's mitt.

I know right, preparing/training for something that may never happen is silly and useless! I guess I shouldn't mention the CPR classes I took either considering I never actually performed CPR on anyone. 

What's the stocking cap for?

Any recommendations on the cheat sheet? I figured I'd get handouts/book with the class but a nice cheat sheet/reference guide would be a nice plus to the kit.

The cap is for the baby to wear. It's probably not absolutely necessary but every baby gets one at the hospital to keep their head warm and it won't take up much space.

face shield

Kk, thank you, will add to the kit.

Yes, the face masks I have in the kit have an eye shield attached.

I wouldn't go crazy on this, really. 12 years as a paramedic and I've delivered 1 kid, and that was only because the blizzard kept us from reaching the hospital in time.

38 years a cop.  I have been in on delivering two in the field.  One on an apartment couch, the other in a gas station parking lot.  
Getting a unitasker kit for that specific purpose seems overkill to me.  YMMV.   Seems to me basic kit would provide 90% of what you NEED.  
As far as APGAR score, ain't nobody got time for that.

I'm not sure what part of my kit is crazy, can you please elaborate. Thanks

I'm trying to mimic this kit, which appears to be close to what a fire Dept has. I like the idea of having a dedicated/separate kit, seems more organized, which meets my OCD needs. 

Like I said earlier, a basic trauma kit with added clamps and a bulb syringe is more than adequate. Getting a full OB kit would absolutely be wasting money, especially if you rotate items via expiration date. The chances of you actually field delivering a child are near zero, I get paid to take these calls and have had on average 1 OB pending delivery every 2 years. 5 transports and 1 field delivery in my career in a major metropolitan area. We have OB kits we trash on a regular basis because they hit their expiration date and can no longer be legally carried on our ambulances. It's all money wasted but we are required to keep them and trash them as they go unused over time.

It's your money to spend, do so as you wish. However, in my professional opinion, it would be money better spent on other first aid items that get used much more often.

As far as APGAR, are they acting appropriately for a new born? Yes/no. Is their color good? Yes/no. Is their pulse rate above 100? and their breathing adequate? Yes/no. If the answer to any of these questions is no, drive faster or call an ambulance.

You're not going to be delivering meds or oxygen so your ability to treat much of anything is limited. You need to recognize the scope of that limitation and do what you can before a paramedic arrives. You're not going to treat someone while driving to the hospital in your own vehicle so what you need to build your kits around is what you are going to need to stabilize someone long enough for an ambulance to arrive. Which for the majority of everyone in America with access to a 911 system is less than or equal to 8 minutes.

First time expected mothers commonly go more than 24 hours in labor, so they will make it to a hospital long before you need to worry about an OB kit. Multiple child mothers will deliver quickly, however most of them know the routine and will make it to a hospital before they deliver out of experience. The rest of the women who deliver outside of a hospital do so because of desire and typically have mid wives, so you will never see them.

My personal kit only has trauma items and survival gear inside as it only ever sees use during range trips or while camping/hiking. You will get more mileage out of SAM splints, kurlex, alcohol, and quick clot than you will any OB item. I only have bulb suction and extra clamps in my kit and I feel 100% comfortable in my ability to deliver a child should I ever be so unfortunate to do so again. YMMV.

This is all you realistically need outside of a basic trauma pack with burn sheets or a blanket. Talk you your local medics or hospital ER, we literally give these things away when they are near or past expiration date because of the legal necessity to dispose of them.

Bulb suction

Hemostats

The classes will be far more use than anything else, and most of that will revolve around simply knowing what to expect. When baby wants to come out, you're just along for the ride. There's very little you can do to fix any problems without extensive training, but understanding the process enough to be able to reassure and guide the mother will genuinely help. Knowing that the baby probably won't come out a healthy glowing pink (like they do in the movies) will be useful to avoid panic, while knowing how to encourage the baby to start breathing would be useful. Knowing how to respond to a perineal tear would also be useful I suppose, but that's more about controlling it until you get to hospital rather than fixing it.

Most important thing to remember - pregnancy and childbirth are not illnesses. They don't need medical intervention unless something goes wrong, and they generally don't need to be fixed with tourniquets and medicine and first aid kits. The body is designed to do it, so let it go at its own pace and nine times out of ten it will do absolutely fine. That one time out of ten, you're not going to have any way of fixing things outside of a fully equipped hospital.

Kit: Your list looks fine, though I really don't want to know what you're thinking of doing with that scalpel. Towels are probably the most useful thing (aren't they always!) along with something to deal with the cord. After that, you're looking at gloves and stuff to keep the gunk out of your eyes/face, and some covering to keep the gunk off your upholstery

Source: married to a midwife who does occasionally have to deliver out in the community, and who goes on about this topic on a regular basis

Agree with this guy...

Something to think about.  You deliver a kid, heart rate is below 100... you need to start CPR.  So.... who is.with mom now?

This isn't something that's easy to tackle alone, even when things go right.  I've delivered 15, and will be in OB on another rotation in June.

Major earthquake hits California (we're overdue), neighbor goes into labor however roads aren't accessible/blocked, hospitals and medical personnel are inundated and there is no one coming for awhile. I have a choice, I can ignore my neighbor and let them fend for themselves or I can provide some kind of help. I choose to help, I know it isn't going to be easy and I will be scared shitlist but I just can't leaving the innocent to suffer. Is this a possibility, sure, I hope not but I want to be prepared as much as possible in any case. That's why I seek advice and input.  As for who is with mom, I don't know. I'm guessing whomever is with me at the time, it could be the dad, another neighbor, some older kid. What more sure I know? Should I make sure I have other equipment to do some testing of the child? What equipment do the women who do home child births have that I haven't listed? The goal is to do as much as possible to keep mother and child healthy and safe until medical arrives or we get them to a hospital.

Thanks

I've said my piece. Good luck to you.

Knowledge and experience. I know that sounds really trite, but that is genuinely the key equipment that they are bringing to the table. Equipment is very much secondary. Even clamping and cutting the cord isn't strictly necessary unless it's getting in the way of providing medical attention. After putting this question to my wife, her response is: the most important tool (aside from a brain) is the hand. From palpation and VEs, to encouraging babies to turn, to fixing (hopefully) shoulder dystocia in emergencies... it's mostly hands on, or rather "hands in". There aren't many tools used to fix anything that it going to be within the skill set of the enthusiastic first-aider. Sterile gloves and towels are the most practical, with a small knitted cap for baby.

Again, stop thinking of it as a medical injury where you need "x" tool to fix "y" problem. Go learn about the process. Go watch birthing videos. Focus on homebirths, because what happens in a hospital is usually based around making life easier for the staff rather than the patient. That isn't meant as a jibe at hospitals, to be clear, but there are practical issues surrounding managing a ward full of laboring women that mean they will be handled differently to someone in their own home with no other competing patients.

Just as a bit of context: my wife's education and training took 7 1/2 years to reach the stage where she was considered qualified to handle home births, requiring 2 degrees and extensive supervised practice in the delivery rooms at the hospital first, with cycles through wards from antenatal up to ICU and NICU to be assessed for competencies, followed by further post-qual training and ongoing CPD. Despite the back of our car containing essentially a mobile clinic loaded with boxes of gadgets that go "beep" and appear to do magical things, she says that one of her most-useful pieces of midwifery-specific equipment is... a pinard horn:

[img width=636,height=465]http://c8.alamy.com/comp/ATB490/midwife-listening-to-fetal-heart-with-pinard-stethoscope-ATB490.jpg[/img]

Which still does you no good if you don't know what you're listening to, how to interpret it, or how to factor it into your decision making process!

Just to be clear, I am in no way wanting to discourage you, I just want you to understand that childbirth (according to someone who does this for a living) is NOT something you can "pack a kit" for, it's a process that you have to understand. The body is going to do exactly what it's programmed to do; without the cocktail of chemicals used to speed up/slow down/otherwise influence the process, you're just an observer for most of that particular roller-coaster ride. That's why you hear all the stories about "cab driver successfully delivers baby" - they're not natural-born medical professionals, the truth is that they don't do much except be there when the baby pops out. If there are no complications, there's nothing to actually do except be supportive during and then mop up afterwards.

Both of my daughters were born at home. The eldest (now 12) was delivered with the assistance of a midwife and her assistant. Our youngest (now 9) was delivered by my wife. For both, I was the designated "catcher". Here are a couple of things that learned:

1. When the water breaks, it can get a bit messy. Having something other than your jeans to soak up the fluid is helpful. Think about 2-3 cups of warm, semi-set Jello to mop up. 

2. According to the midwife at my eldest's birth, and born out by experience with two births (I know, that makes me an expert, right?), the baby ain't the only thing being delivered. Many women will clear out the last bit of their colon to help make space for the birth process. My wife wasn't even aware of it. Just grab a wipe and clean it up. So, make sure you have wipes available.  

3. Cord clamps are cheap, and effective. In a pinch you can use twine, shoe laces, or zip ties. Or, you can just not cut the cord. Don't rush to cut things. If the cord is still pulsing, it's doing good things for baby. Just leave it intact until the placenta is delivered. Then, clamp/tie/zip the cord about 1.5" - 2" from baby and cut on the placenta side of the clamp. If for some reason you think you have to cut the cord prior to delivery of the placenta, for the love of God use two clamps and cut between them. When my youngest was born, she didn't start breathing right away. In fact, it was probably close to a minute before she took her first breath. But the cord was pulsing the whole time. I knew she was getting oxygen. If I had cut the cord, we would likely have had serious problems. As the cord stopped pulsing, Meghan began breathing, opened her eyes, and gave her war cry. Don't rush things. Just be patient.

4. The baby has come from a nice, warm environment. It was about 98.6 degrees where it was hanging out for the past several months. Wrap the baby up and cover its head. Remember how much heat loss occurs through the head? That's why we wear watch caps, yes? Do baby a favor and keep it warm. It's a cold, hard world out there. Baby doesn't need to make that adjustment in the first 10 minutes of life outside.'

5. The commenter who said that most babies deliver themselves just fine are absolutely right. If that was not the case, we wouldn't be worried about overpopulation. Hell, we wouldn't be here. Don't restrict the mother's movements. Let her get comfortable. If she wants to squat, then she squats. Lay your ass down and be ready to help gently guide the baby. Adjust the tarp/blanket/towel to provide a clean landing spot. The mom on her back position is for the convenience of the doc. It ain't medically necessary, and it can slow things up/make delivery more difficult.

6. My "OB" kit consists of this: 2 cord clamps; sterile scissors to cut cord; bulb syringe to suction nose/mouth if necessary. That's it. Everything else is probably not needed.

The best thing you can do, as has been said, is to be supportive. Vocalize what you are thinking. It'll change from "Wow!! Poop! That's gross!" to "Wow! I can see the head! Oh, wow! This is so freaking cool!" It's all good.

I'm not an expert, just a dad who helped his wife bring two beautiful girls into the world (and by helped, I mean that I was there to guide the baby, answer my wife's questions, and tell her what I was seeing).

YMMV, however. I am sure most medical professionals would react in horror at how we did things. (Most have. Except for the kids' pediatrician who simply said, "In med school, we watched one, did one, and then taught one. Then we were experts.")

P.

Buddy, those years in EMS I mentioned?  LA and Orange Co.  Believe me, I get it.  But if it's bad enough that the roads are impassible, you're probably squashed under your house anyway.

I'm just giving you food for thought.  Can you do it?  Sure, millions have.  Of course, the infant mortality rate is pretty high in those cases, so can you handle watching a newborn or mom die as you do what you can?

Go take a first aid or EMT class.  Then go to galls.com and just buy an OB kit.  It's not.that expensive.

Thank you!

Out of everything to train and prep for, you chose childbirth?  Have any trauma training?

Don't knock it. It's a great excuse to watch videos of naked sweaty ladies

Kit seems more comprehensive than the ones I have used to do about a dozen or so field deliveries so I would say you are good on that front.

How are your infant CPR skills?