OB case: textbook with the wrong treatment?

[spenac]

Spenac that is why you make a conscious choice: Can i make it to the hospital, if not, deliver at home, and let them clean up the mess. It is way to messy for the back of an ambulance, and god forbid if you are in a van.

Crotch I have had a woman start crowning we stopped ambulance and baby disappeared we waited a few minutes then drove the final 20 miles to hospital and I delivered in the OB hallway. There is no dependable way to know. I think it was my first delivery patient was 20 minutes apart on scene. We delivered 30 minutes into transport. I have had others under 2 minutes make a two hour transport. Again just can't tell. Do to distance we load and drive till crowning. Yes I have delivered in homes and in hotel rooms as well as at the hospital. Even checking for dilation does not tell how long till they deliver. Some go from 1 or 2 to 10 in just minutes. Others will linger at 7 or 8 for hours. Oh and water break is not any indication of imminent delivery as many have had water break before calling for ambulance and we take them to hospital. $ hours later when back with the next patient they still have not delivered.

So my advice is drive till baby shows. If cord is wrapped try and remove if not able to clamp and cut.