Obstetric & Neonatal Emergencies
OB calls are rare but high-stakes. The NREMT tests them heavily because a bad OB decision hurts two patients at once. Learn the normal delivery sequence first, then the three or four complications that change the plan.
EMT · AEMT · Paramedic
Normal delivery in seven steps
Confirm crowning, position the mother, support the head as it delivers, check for cord around the neck, deliver the anterior then posterior shoulder, dry and warm the neonate, clamp and cut the cord after pulsations stop.
The complications you must recognize
Four scenarios change your plan on the spot — memorize the maneuver for each:
- Prolapsed cord — knee-chest position, gloved hand to relieve pressure, rapid transport
- Breech — support the body, do NOT pull; if head trapped, form a 'V' around the mouth
- Shoulder dystocia — McRoberts maneuver (knees to chest) + suprapubic pressure
- Postpartum hemorrhage — fundal massage, IV fluids, transport
Preeclampsia and eclampsia
BP ≥ 140/90 after 20 weeks of pregnancy with edema and headache is preeclampsia. Add a seizure and it's eclampsia. Dim the lights, minimize stimulation, magnesium sulfate per protocol.
Neonatal resuscitation basics
Dry, warm, stimulate, position. If HR < 100 after 30 seconds, begin PPV at 40–60/min. If HR < 60 after adequate ventilation, start compressions at 3:1 ratio.
Frequently asked
- When do I NOT transport before delivery?
- When crowning is present and delivery is imminent. Prepare on scene, deliver, then transport mother and neonate.
- What Apgar score triggers concern?
- Under 7 at 5 minutes — provide active resuscitation and continue reassessment every 5 minutes.
Test yourself
Practice on this topic.
Free 10-question sample or build a custom quiz on obstetric & neonatal emergencies.