Warning If the heartbeat speeds up or slows down and does not go back to normal stop turning the baby If the

heartbeat stays fast or slow, turn the baby back to the position he started in . If the heartbeat still does not go back to normal, give the mother oxygen if you have it, and have her lie on her left side. If the baby's heartbeat still does not go back to normal, take her to a medical center immediately

1. Ask the mother to urinate and then lie down on her back with her knees bent . It is important for her to relax her body as much as she can . It may help for her to take slow, deep breaths

2. Listen to the baby's heartbeat (see page 139).

3. If the heartbeat is 4. Grasp the baby's head with one hand . Put normal, feel the baby's your other hand under the baby's bottom, position again to be and push up, towards the top of the sure he is breech womb, to move the baby out of the pelvis

5. Gently but firmly move the baby in the direction he is facing . If he does not move easily, try moving him in the other direction . Try to keep the baby's chin tucked into his chest

6. Each time the baby moves — even a little — stop and listen to his heartbeat. If the heartbeat is not normal, stop.

7. Keep turning the baby until his head is down .

7. Keep turning the baby until his head is down .

WARNING! Never force a baby to turn. If the baby feels stuck, or the mother is in pain, stop

Turning a sideways baby

Turning a sideways baby is the same as turning a breech baby. Turn the baby in the direction he is facing. If he cannot turn in that direction, you may need to turn him the other way so that he is in a breech position Breech is not as safe as head-down for birth, but he will be able to be born vaginally this way.

If a sideways baby does not turn easily, you must stop and the baby must be born in a medical center by cesarean surgery

Chapter 20 The pelvic exam:

how to examine a woman's vagina and womb

In this chapter:

When to do a pelvic exam 374

Making the pelvic exam safe 374

Before the exam 375

Help the woman relax 375 Ask the woman about her history ... 375

The visual exam 376

The speculum exam 377

Tests for infections and cancer 379 Pap test for infections and cancer ... 381

Vinegar test for HPV 380 Cancer of the cervix 383

The bimanual exam (2-hand exam) 385

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