Preparedness for Parents with Infants
For families with infants, the Memsahib offered this advice: The most important thing is to breast-feed your baby. Your biggest practical concern will be diapers. Depending on circumstances (availability of spring or well water and grid, generator, or photovoltaic power to run a washing machine), you will have to decide between cloth and disposable diapers. When I nursed my newborns, I often changed diapers more than ten times per day, to prevent diaper rash. Untreated, diaper rash can lead to serious infections. Proper hygiene is crucial. Choose your diapering method and then stock up.
The most useful items are:
For Childbirth:
• Sterilized cord clamp
• Betadine solution
• A bulb syringe
• Bed liners (like those made for the disabled, available at medical-supply houses)
For your newborn:
• Plan on breast-feeding, but as a backup consider stocking up on canned infant formula.
• Lanolin nursing cream
• Petroleum jelly and zinc ointment as diaper-rash preventives
• Diapers and diaper covers
• Multiple “onesies,” sleepers, or sacque gowns would be a real blessing.
Babies spit up a lot and diapers leak. In a post-TEOTWAWKI world, when washing and drying baby clothes won’t be so easy, having multiple changes in every size would make daily life easier.
I also would never be without a front-pack infant carrier or armed with a good sling or baby wrap like those you can fashion yourself (wearyourbaby.com).
I highly recommend the childbirth books Heart and Hands and Spiritual Midwifery, which present childbirth as a natural process—not just as a medical condition.
Survival Labor and Delivery
Having a baby is a blessing, but home delivery is best done under the supervision of a medical professional. In a TEOTWAWKI situation, you may have to fend for yourself. John O., M.D., shares the following on childbirth:
Home delivery is a fact that most of the survivalist community needs to face. A “normal” delivery with minor complications is the area in which preparation can make a big difference. Before we start, I believe that as a community, we need to accept the fact that the rates of death for both mother and infant are going to rise significantly if TSHTF. No amount of preparation is going to allow someone to do a C-section on their kitchen table, and even breach presentations may be more than a layman can expect to handle.
The services of a good midwife would be invaluable, and the addition of a text such as Heart and Hands by Elizabeth Davis may be a wise supplement to your stores as a second-best choice. My goal is to help you to keep a good delivery from going bad and to prevent complications. It should go without saying that this information is for educational/ survival purposes only, and I am not suggesting a specific course of care. Fortunately, nature really does run its course in most cases.
Labor can be divided into two phases: the first phase, when the cervix is thinning out and slowly dilating to form a canal roughly the diameter of pencil up to about ten centimeters; and the second phase, when the pushing begins and the mother actually pushes the baby out. The first phase is often divided into an early period, in which the cervix is dilated less than four centimeters and contractions are relatively mild and spaced further apart (seven to eight minutes), as well as a late phase, when the contractions are much harder and closer together. The early phase varies in length—from maybe two hours in multiparous women (having had previous pregnancies) to as much as twenty-four hours in prima gravis (first pregnancy). Late first phase tends to be more regular, with the average woman dilating about one centimeter per hour. Women will usually want to get up out of bed, especially in the late phase. Encourage it, as lying in a bed during labor is a bad habit that is really only necessary in hospitals due to the use of epidurals and intravenous (IV) narcotics. I have found that squatting really does help speed the progression as well as minimize labor pains. In a hospital birth a woman’s cervix is checked frequently; I would urge strongly against this practice at home. In the hospital setting, a woman who is not progressing may get a dosage of the labor hormone Pitocin or may even go for a cesarean section, neither of which you will be doing at home. In addition, hospitals have a limitless supply of sterile gloves, so the risk of introducing infection into the birth canal is relatively low. In home deliveries, in which labor without Pitocin (the synthetic version of the hormone oxytocin) tends to take longer, infection prevention is crucial. You will have a pretty good idea how things are progressing just by monitoring the frequency of contractions and the look on her face.
Speaking of infection, now would be a good time to discuss an infection called Group B Strep. Group B Strep (GBS) is a bacteria that roughly 30 percent of women carry in the birth canal. While passing through the canal about 60 percent of children will be colonized if the mom has GBS. Even in modern medicine, about one in two hundred newborns will develop severe complications such as pneumonia, meningitis, or sepsis (blood poisoning). All women are currently screened for GBS at about thirty-seven weeks and treated with IV antibiotics prior to beginning labor. This has been shown pretty conclusively to reduce the amount of GBS in the canal, lowering the rates of colonization of babies. In addition, penicillin-based antibiotics readily cross the placenta and afford the baby some protection even if he or she is colonized.
Since I don’t imagine people will be getting screened for GBS WTSHTF, I would recommend every woman start taking an antibiotic about ten to fourteen days prior to their due date. While IV antibiotics are currently recommended, oral were used pretty regularly until about ten years ago. Ampicillin is probably best; any -cillin or cephalosporin (medications with ceph or cef in the name, such as cephalexin [Keflex], Ceftin, Cefazolin, Rocephin, etc.) is good. You could probably use -mycin-based antibiotics in a pinch or for seriously penicillin-allergic patients. Do not use -cyclines or anything with floxin in the generic name, as these are both toxic to young children.
After getting through the first phase, the woman will begin to feel the need to push or the sensation of needing to have a bowel movement, from the baby’s head pushing on the pelvis and bowel. I generally recommend getting back into bed at this point, though some midwives keep them up. Now is the time to clean the entire pelvic area with Betadine, iodine, or high-proof alcohol, including one-half to one inch inside the vagina itself. Begin working on stretching the back wall of the vagina using KY lubricant or oil. Looking at the vagina, take the areas at about seven o’clock and five o’clock between your thumbs and forefingers and stretch sideways and outward. Start gently but work up in force. Trust me, no amount of force you apply is going to equal the stretching from the head.
As the child begins to crown, assuming that you have clean or sterile gloves, work your fingers up around the neck to make sure the cord isn’t wrapped around it. If it is, you can usually pull on the stretchy cord while pushing the head slightly back in to pull the cord up over the face and head to untangle it. If you don’t have very clean hands, wait a little longer, until the face is partly out, though this tends to increase the tension on the cord, making it harder to get off.
Unreduced nuchal cords (umbilical cords wrapped around the neck) are a major cause of death or brain damage in “normal” deliveries due to strangulation as they tighten. Don’t forget to check for the cord around the neck! Finally the face will be out, and the child will normally stick at the shoulders, as this is the widest point on the child. Take this time to suction the baby ’s nose and mouth thoroughly. I would highly recommend getting several blue bulb syringes over-the-counter now for just such a situation. If you note a greenish slime (meconium) on the baby or in his mouth, this means he has had a bowel movement due to the stress of labor, or because of the above mentioned nuchal cord. It is very important to get this out of the throat and nose now, because once he comes out the rest of the way and takes his first breath, he will suck this junk d
own into his lungs. A small amount of previously boiled water may help to make the meconium runnier and easier to suction. The meconium itself is sterile, and is no cause for alarm, other than the risk of aspirating it.
Passing the shoulder is a little more difficult. Most of the time you can reach up and grasp the shoulders, pushing the trunk down to deliver the forward-most shoulder, then up to deliver the trailing one. Sometimes an assistant can put pressure over the mother’s bladder while flexing her leg up into the air to help push the baby’s shoulder down to get it to pass under the pelvic bone. You can do a Google search for “McRoberts maneuver” for a more detailed and complex explanation. Do not tug down on the head itself, as it can tear the nerves going into the arm from the neck. Also, do not push down on the top of the uterus, as this can cause some serious problems as well. In a truly desperate situation, the baby’s collarbone can be broken to cause the shoulder to collapse some. While it sounds horrible, the bone heals fairly readily, and it’s something I’ve had to do even in the hospital setting once or twice. You put one palm over the breastbone of the baby and the other behind the shoulder of the collarbone to break, then press with both thumbs in the center of the clavicle with a force slightly greater than that used to break a turkey wishbone. You will definitely feel the “pop.” It is important to note that after the first shoulder delivers, the baby pretty much wants to pop right out. Try to get the mom to breathe through her nose and stop pushing while you apply pressure back in, so that the baby slides out in a controlled fashion. Letting it slide out uncontrolled will greatly increase the risk of a tear to the mom.
After the baby passes, lower him below the level of the birth canal to help his blood flow out of the placenta and back into his body. After about thirty seconds, clamp the cord with whatever you have, such as boiled clothespins. Clamp above and below where you intend to cut, which is usually about one-and-a-half inches from the baby’s belly. Cut with a sterilized blade, as this is a major source of infection in the Third World. Keep the clamp on the baby for a day or two, until the vessels scarify.
Clean the baby with a dry cloth to remove all the slime, and immediately wrap him in a warm blanket, as babies have a hard time controlling their body temperatures initially. You can stimulate the baby if he isn’t crying by rubbing his breastbone with your knuckle using moderate force, or by a light pinch. Try to get the baby to breast-feed right away, as it will help the mom’s uterus collapse down and minimize bleeding.
Massage the mother’s belly, pressing down on her uterus with moderate force (enough to be somewhat uncomfortable). After the uterus has contracted, the placenta will separate from it. After separation, apply gentle traction to the end of the placenta to get it to pass, taking care not to use too much force, which can cause the placenta to tear and leave behind a piece that can be a source for later infection. Be sure to apply traction only after the placenta has separated—doing so too early, when the placenta is still attached, can cause an internal hemorrhage and the mother to bleed to death.
Ibuprofen works well to help with postpartum soreness and residual contraction pain. Eight hundred milligrams will usually do the trick. As an aside, try to avoid aspirin products, because they thin the blood and will increase bleeding, especially if taken before the actual delivery.
I have not addressed breach births, as whole chapters can be written on the topic. One relatively simple procedure that can be tried before labor starts, if the head is felt to be up instead of down, is called external cephalic version. There are some risks, such as an early water breakage, but it is probably better to try to fix the problem early, rather than waiting until the baby has entered the birth canal. Once again, this is for informational/educational purposes, and is not a substitute for proper medical care.
Group Planning for a Flu Pandemic
There is no way to be certain to avoid exposure if an influenza outbreak is in close proximity. (See Appendix C for details.) The odds are that the first outbreaks will be in distant regions. That will be the time to act.
9
COMMUNICATIONS AND MONITORING
There’s a Whole Spectrum Out There
Plunging into the world of two-way radio communications and monitoring can seem daunting for newbie preppers. It is a technical field that has more than its share of jargon and acronyms. I suggest that you team up with someone who is a licensed amateur ham operator, and have that person walk you through the basics of the frequency bands, radio-wave propagation, the various equipment, and the legalities. Yes, there are plenty of legalities. Stay legal!
A ham who mentors new hams is called an “Elmer.” You can find an Elmer through your local ham-radio club affiliated with the American Radio Relay League (ARRL). Elmers are almost always willing to help, and quite generous with their time.
The radio-band designations can be confusing to folks who are newcomers to the shortwave-listening and amateur-radio worlds. One major source of confusion for newbies is hearing hams mention things like “on the forty-meter band” or “I was talking on two meters.” For a useful chart from the ARRL that puts the band designations into an easy-to-grasp graphic format go to snipurl.com/hsu6d.
Getting Started
I highly recommend that all preppers at the very minimum buy a shortwave radio and a multiband police scanner, and become familiar with their use. WTSHTF, hardwired telephones, cellular phones, AM and FM commercial radio, the Internet, and television may be essentially unavailable or unusable. Most radio and TV stations have enough fuel to run their backup generators for only few days. Ditto for the telephone company central offices (COs). After that, there will be an acute information vacuum. You may find yourself listening to overseas shortwave broadcasters for your daily news, and to your police scanner for updates on the local situation—to keep track of the whereabouts of looter gangs. Be sure to buy a CB radio and few walkie-talkies so that you can coordinate security with your neighbors. (The CB, FRS, and MURS bands do not require any license in the U.S.)
What to Buy for Disaster Communications and Monitoring
Shortwave Receiver
Your first receiver should probably be a compact, portable general-coverage AM/FM/weather band/CB/shortwave receiver. There are several brands on the market, most notably Grundig, Sangean, and Sony. I consider the recently-discontinued Sony ICF-SW7600GR receiver among the most durable portable general-coverage receivers for the money. It is about the size of a paperback book. The secrets to making a receiver last are to buy a couple of spare hand-reel antennas (the most fragile part), show care in putting stress on the headphone jack and power-cable connections, and always carry the radio and accessories in a sturdy, well-padded, preferably waterproof case. (I find that a small Pelican brand case with “pluck-and-chuck” gray foam inserts proves ideal for my needs.) One low-cost alternative is to cut closed-cell foam inserts to fit inside a .30 caliber United States Government Issue (USGI) ammo can. GI ammo cans are a very sturdy, inexpensive (often less than ten dollars each at gun shows) alternative, and they provide very good protection from nuclear EMP effects.
At auto wrecking yards, you can sometimes find a Becker or Blaupunkt brand Europa, Mexico, or similar model AM/FM/ shortwave radio pulled from a European car such as a Mercedes-Benz, for less than fifty dollars. These are not only very reliable radios but will also give you the opportunity to get time signals from the WWV and WWVH radio stations operated by the NIST, and some international broadcasts.
Transceivers
Your first transceivers should probably be a pair of MURS band walkie-talkies.
CB Radio
Next, an SSB-capable CB radio, such as the time-proven Cobra 148GTL.
Field Telephones
You’ll also want a pair of military-surplus field telephones, for coordinating retreat security. To someone who was first trained on the older-generation TA-1 and TA-312 simplex-only mode field phones, like I was, the current TA-1042 DNVT-generation phones seem very Buck Rogers. It is a great design. Ha
ving reliable field telephones is essential to coordinate retreat security in a post-TEOTWAWKI world. For semipermanent installation, it is best to buy cable that is rated for underground burial (UB), to conceal and protect all of your lines. For TA-1042s you will need four conductor cables (or two parallel runs of two conductor cables). Burying your lines will prevent both intentional and unintentional line cuts and breaks. Don’t overlook getting a few extra field phones, so that you can run commo wire to your neighbors and coordinate with them as well. Watch eBay for a circuit switch (AN/TTC-39D). The TA-1042 DNVT field telephones themselves are currently available from Ready Made Resources. They sell these field phones in pairs, with a free civilian photovoltaic panel included.
Table Radio
Then, you may want to get a relatively EMP-proof vacuum-tube-technology table radio, preferably one with shortwave bands. Something like a Zenith TransOceanic H500 would be a good choice. Tabletop vacuum-tube radios can often be found on eBay. It is wise to purchase redundant commo gear. There is certain logic in buying three, four, or even five older, used Radio Shack receivers for around nine hundred dollars rather than spending the same amount on just one shiny new Drake R8B.
How to Survive the End of the World as We Know It Page 17