What you need to know about births on airplanes.

What you need to know about births on airplanes.

There are different kinds of giving birth that depends on the culture, social environment and the most important, parents beliefs. Some parents prefer natural birth, others prefer caesarean section and a low parents population choose other new techniques like Leboyer birth, water birth or even hypnosis before the birth. There exist a lot of new or ancient techniques that are barely mentioned because of their complication or because they are known in some indigenous communities but giving birth on board more an accident than a chose. Although the number of cases is insignificant, airlines have to deal with several problems when these cases are on board.

Despite of the fact flight attendants have accomplish courses on first-aids intervention and also, airplanes have first-aid kits, these kits are designed to manage with small injuries like cuts, dizziness or motion sicknesses. Appendix A to Part 121 of Title 14 of the Code of Federal Regulations (14 CFR 121) includes the specific requirements for US carriers:

For 0-50 seats, one kit is required, 51-150 two kits are required, 151-250 requires three, and more than 250 requires 4 kits. 
That kit must include, at a minimum:
16 Adhesive bandage compresses, 1-inch
20 Antiseptic swabs
10 Ammonia inhalants
8 Bandage compresses, 4-inch
5 Triangular bandage compresses, 40-inch
1 Arm splint, no inflatable
1 Leg splint, no inflatable
4 Roller bandage, 4-inch
2 Adhesive tape, 1-inch standard roll
1 Bandage scissors.

An Emergency Medical Kit is also mandatory for over than 100 passengers flights and only a doctor or a qualified person authorized by the captain can use it. Also, at least one approved medical kit must be on board that includes, at a minimum:

1 Sphygmomanometer
1 Stethoscope
3 Airways, oropharyngeal (3 sizes): 1 pediatric, 1 small adult, 1 large adult or equivalent.
Self-inflating manual resuscitation device with 3 masks (1 pediatric, 1 small adult, 1 large adult or equivalent).
CPR mask (3 sizes), 1 pediatric, 1 small adult, 1 large adult, or equivalent.
1 IV Admin Set: Tubing w/ 2 Y connectors
2 Alcohol sponges
1 Adhesive tape, 1-inch standard roll adhesive.
1 pair Tape scissors
1 Tourniquet
1 Saline solution, 500 cc
1 pair Protective no permeable gloves or equivalent
6 Needles (2-18 ga., 2-20 ga., 2-22 ga., or sizes necessary to administer required medications).
4 Syringes (1-5 cc, 2-10 cc, or sizes necessary to administer required medications).
4 Analgesic, non-narcotic, tablets, 325 mg
4 Antihistamine tablets, 25 mg
2 Antihistamine injectable, 50 mg, (single dose ampule or equivalent).
2 Atropine, 0.5 mg, 5 cc (single dose ampule or equivalent).
4 Aspirin tablets, 325 mg
1 Bronchodilator, inhaled (metered dose inhaler or equivalent).
1 Dextrose, 50%/50 cc injectable, (single dose ampule or equivalent).
2 Epinephrine 1:1000, 1 cc, injectable, (single dose ampule or equivalent).
2 Epinephrine 1:10,000, 2 cc, injectable, (single dose ampule or equivalent).
2 Lidocaine, 5 cc, 20 mg/ml, injectable (single dose ampule or equivalent).
10 Nitroglycerin tablets, 0.4 mg
1 Basic instructions for use of the drugs in the kit.

Airplane wing_aviation_law_births on airplanes_shahram shirkhani
Image courtesy of Daniel Ruyter at Flickr.com

Are these kits enough for a birth attendance?

No, these kits are not enough for attend a birth but in cases where the baby has not special need and is in the right position, births can be successfully attended. In some cases, babies are lucky because at least one doctor was on board while their birth. Nevertheless, in order to avoid this situation that for sure is completely risky for the baby and the mom, it is recommendable to fly before 37 weeks or before 32 weeks in case of twins although airlines have their own rules on for pregnant woman.

Despite the risks babies, mothers and also passengers (some of them could suffer from weak nerves) have to face, it is the baby’s citizenship what concerns people the most because there are certain myths about this topic. Before making any decision, it is mom’s nationality the baby’s future nationality, it is called “jus sanguinis” citizenship. After this, baby can have one more nationality, where the land or the sea territory belongs to, “jus soli” rights all people are allowed to have.  When the baby was born, will be the nationality of the baby but in the case the birth took place in international waters, outside of territorial jurisdiction of any country, according to the 1944 Convention on International Civil Aviation the applicable laws follow those of the country the aircraft was registered. Furthermore, there are some cases as in Germany where citizens can only have one citizenship and with some exceptions, one more. It means, no matter is the aircraft was registered in Germany as Lufthansa for example, and a baby was born there, he or she will be German only if her mother or father are German. Definitely, births on flights are not common but it is important to take some considerations just in case.

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