Friday, April 11, 2014

Preparedness, Supplies and the Childbearing Family

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                                                                                           by Jane-Alexandra Krehbiel BS ES RN

            First of all, for preparedness purposes, the definition of a potential "childbearing family" is any couple of childbearing age.  Whether married or not, whether intending to marry or not, emergency and stressful situations do tend to result in perhaps less well considered sexual contact. The strategy of "conserving the condoms" isn't always a good one.   Pregnancies that would normally be detected early, may not be, in a variety of longer term emergencies.Surprise pregnancies do not just happen with teenagers.  Women, married and single, in their twenties, thirties and forties may all discover a pregnancy much later than is ideal.  In addition, many women in their fifties are now in the best shape of their lives and are nutritionally quite well, and this too has resulted in some peri-menopausal and menopausal pregnancies that frankly have shocked the socks off their spouses and their families.

              I do recall one young woman who came through our emergency room with severe back pain. Later that day she later delivered a healthy boy, never having had the slightest clue that she had been pregnant !  Of course, for the vast majority of us who remember pregnancy to be fraught with a number of pretty significant changes and discomforts, think that such a case can only be the result of some type of  denial of a  psychiatric level, but this is simply not always the case.  Sometimes, a healthy woman carries a baby she just doesn't know about.  This is simply a part of the saying, "In reproduction, anything is possible".

               Since you are reading this, I am going to assume that you are either a member of a childbearing family, or a principle family member planning preparedness for yourself and perhaps your extended family, which also includes daughters or sons who could be members of a childbearing family.   I am also for purposes of this post going to assume that in an emergency such as civil unrest, financial collapse, earthquake, hurricane or ice storm with protracted electricity outage, that your extended family has been instructed to come to you.

                Of course as a person with even a passing interest in preparation, you have general references which indicate how you should supply water and food.  My first book would be one such source, and there is a lot of valuable information there, which you should read.  However, today, I am focusing on the potential that you will provide safe harbor for a child bearing family who is related to you.

                The first supplies you need to have:

 1. Buy a bulk container of non deodorant sanitary napkins.   (These have uses other than for menstruation,        and post childbirth discharge. These can also be used over top of sterile dressings at times.)  Shop around.  I bought 120 of these plain and clean without deodorant ( which can cause allergies and limit uses), for about twelve dollars.

2.  Buy a large container of condoms with an expiration date as far in the future as possible.  Again, big box stores and Wal-Mart could be the least expensive suppliers.  Big Lots is a great store, but I don't recommend the initial purchase of expired condoms, although they probably can be used for a short time past expiration, if you already own them.

3. Buy a tube of Ortho-Gynol brand of nonoxyl 9.  When used as a lubricant after a condom is already applied,( in amount of about one tsp) the effectiveness of the condom in terms of pregnancy prevention can become 99 point something percent in one study.   Make sure your family members know you have these.  I know this can be an uncomfortable conversation, but this is an emergency.  Yes, this is the same gel used with diaphragms.
     Ortho-Gynol Extra Strength Contraceptive Gel

There is an expiration date, but it reasonably can be used for eight weeks or so past its stated date of expiration if kept in a cool dry place.

4. Buy a set of perianal cleansing bottles.
   These can be used for menstruating women.  These can be used for those with bladder infections who need to run a stream of warm water over their urethra to permit the starting of a urinary stream.  They can be used to supplement daily perianal cleansing in anyone.  They can be very useful if you have a bedridden patient and need to do some perianal cleansing on a bedpan.   However, they are probably most useful in the important cleansing with must take place following childbirth, each time a woman urinates or defecates, for potentially weeks.

Remember that these supplies are in addition to your Family Evacuation Medical Kit and your Home Medical Kit which I speak about in my book at length and you can learn about at the following blog links:

Continuing with todays subject of disaster management of the childbearing family:

   The least expensive and some of the best Perineal Cleansing bottles

5.  The last thing you really do need to add to your supplies is something we used to call a precipitous delivery pack.   Now it's easier to find as simply a "birth kit".   Although on all my other first aid and medical evacuation kits, I urge you to assemble your own, this is the exception.  It is more frugal to simply purchase the kit readily assembled and sterile until opened.  Do not open such kits until you are about to use one.

Custom Birth Kit from Precious Packages                                  $79.00

This one contains:     It is a deluxe home birth kit often used by midwives

20 Basic Underpads, 23x36"
10 Alcohol Prep Pads
1 Plastic Back Sheet
1 Sterile OB Pads, 12/pkg
5 Synthetic Pair Gloves, medium
5 Synthetic Single Glove, medium
2 Mesh Panty, choose size
1 Peri Bottle
2 Cold Peri Pack, Standard
1 Economy Bulb Syringe, 3 oz
1 Digital thermometer with case
10 Gauze, 4x4, 2 per pkg. Sterile
2 Straws, Individually Wrapped, Flexible
2 Newborn Paper Tape Measure, 36”
1 Newborn 100% Cotton Hat
1 Povidone Iodine Solution, 4 oz.
5 Lubricating Jelly, 5 g
1 Mattress Cover, choice of King or Queen
2 Umbilical Cord Clamps, sterile
1 Fracture Bedpan
1 Kleenprint Footprinter
1 HomeBirth Certificate
1 Infant Heel Warmer
1 DeLee Mucous Trap, 8 Fr
2 Gallon Size Ziploc Bags
1 Sterile Field
1 Bottle of Hydrogen Peroxide, 16oz

The ones that I keep in house are:

 Birth Kit                                                                             $24.20

This one contains:

Underpad 23 X 36 15
Pad, Non-Sterile, Contoured, PEACH 10
Peri Bottle, 8 oz 1
Bulb Syringe, 2 oz. 1
Scrub Brush, Hibiclens 1
Gauze sponge, 4 X 4 12-ply (2/pkg) 6
Stretch Briefs - unisize 1
Tape Measure, infant, 2 ft/60 cm 1
Infant hat 1
Glove  Sterile Medium Single, VINYL 3
Glove, Medium, Pair, VINYL, sterile 3
Plastic Cord Clamp - Sterile 1
Lube Jelly, 3 grams, sterile 6
Flexible Drinking Straws 2
Plastic Backed Sheet, 40 X 72 2
Sani-Cloth towlette, germicide cloth, 11" X 11" 1

If you have everything listed in my listings at the links above, and you have everything listed in this post, you may wish to consider purchasing a #14 sized foley catheter and urine drainage bag.   A non-medically trained individual should not insert one of these, but in an emergency situation, if a physician on the phone or over a HAM radio instructed you to have a neighboring nurse insert one, it would be awfully good to have one.   If you do purchase one of these, DO NOT disrupt its sterile packaging by opening it.  It needs to be stored in a clean place and opened only immediately before use.   Buy also several packages of sterile gloves in both medium and large sizes.

One source of foley catheters

Lubricating jelly for foley catheter insertion

One source of Urinary drainage bag

The next post in this series will discuss attending emergency childbirth, and where to get the best written references for doing so

Copyright 2014     All Rights Reserved


Linda said...

Interesting information. Thanks. What is an infant heel warmer?

JaneofVirginia said...

Thanks for posting, Linda. An infant heel warmer is a device which warms the heels of newborns safely. This is particularly helpful sometimes because many newborns need blood drawn from their heels. Warm heels allows the nurse or medical family member to very easily obtain enough blood to test blood sugar or other things. For example, in a Type I, Type II or gestational diabetic woman, her babies blood sugars will need to be checked every so many hours following an emergency home birth. In normal times, such a delivery would occur in a hospital, but in emergencies, one of these women could conceivably give birth at home. Watching the baby's blood sugar while alternating the heel used would be extremely important.

BBC said...

People should stop making so damn many kids and over populating the planet.

JaneofVirginia said...

Overpopulation is indeed undesirable. However, we do need good, well raised children who become people who can help others and who can begin to solve many of the world's problems. People will continue to have children. Sometimes birth control methods will fail. In addition, in America, unlike China, we still have reproductive freedom.