Delivery of the head is an important step in the main skill of prehospital childbirth. Newborns lack sufficient musculature to effectively hold their heads up and as such need to be supported throughout the entire process. A normal birth will generally see the neonate's head in a face down position which may rotate laterally as the birth progresses.

When delivering the head, first assess for the presence of a prolapsed cord or a nuchal cord, both of which should be managed. Prevent spontaneous expulsion by gentle, but firm pressure on the top of the baby's head and allow the birth to progress, making sure to provide stabilization as the baby's head exits the vagina. Once the head has fully cleared the vagina, you may be able to suction first the mouth, then the nose. Never pull on the head or attempt to flex or extend it to assist continuation of delivery; complicated deliveries are outside the normal scope of the EMT and can require procedures such as Mauriceau's Maneuver or suprapubic pressure. If there is presentation of the foot, buttocks, or hand transport immediately.

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