PRIOR TO TRANSFER TO DR 1-3 MINS
1, Position of choice (freedom of movement) 1. Remove wet cloth.
-w/ companion of choice or medicine ball (non-pharmacological) 2. Place at abd of mother for SSC.
2. Ask mother if wishes to EAT/DRINK/VOID. 3. Cover baby w/ dry cloth & bonnet
3. Communicate with mother 4. Exclude 2nd baby by palpating the uterus, preparing oxytocin.
-inform progress of labor, give encouragement and reassurance 5. Use wet cloth to wipe soiled gloves
- Give 1 cc Oxytocin IM after 1 min. of birth
WOMEN IN DR PREPARING FOR DELIVERY - Dispose wet cloth properly
1. Check temp of delivery area. 25-28 C, eliminate air draft, turn off ac 6. Remove 1st set of gloves & decontaminate (soak at 0.5% chlorine solution for 10 mins)
2. Ask if comfortable in semi-upright position 7. Palpate cord pulsations.
3. Ensure privacy 8. If it stops, clamp the cord 2cm from base.
4. Remove jewelries, HAND WASH 9. Instrumental clamp at 5 cm from base.
5. Prepare a clear, clean newborn resuscitation area in a flat surface. 10. Cut the cord near 1st clamp (not midway)
- check if equipment are clean, functional, and easy to reach. 11. Perform remaining steps for AMTSL
6. Arrange materials in linear sequence: - wait for strong contractions, CCT and counter traction, until placenta is delivered.
Gloves (3) 12. Massage uterus until firm.
Dry linen/towel (2) - Inspect lower vagina & perineum for laceration
Baby bonnet - Repair laceration/tears PRN
Oxytocin syringe (1) 13. Examine placenta for completeness & abnormalities
Cord clamp, Forcep, Scissors 14. Clean mother, perineum flushing , applies peri pad/cloth
Kidney basin , (cotton balls for perineal cleaning, leak-proof container) 15. Assess baby’s breathing and color, (assess baby & mother VS q 15 mins)
Eye ointment, Steth for PE (weight, measurement), Vit K. Hepa B, BCG - Assess if mother is comf., uterus is contracted.
7. Clean perineum with antiseptic solution. 16. Dispose placenta at leak-proof container/plastic bag
8. WASH HANDS, sterile double gloving. 17. Decontaminate instruments before cleaning. Decontaminate 2 nd set of gloves before disposal (soak
at 0.5% chlorine solution for 10 mins)
AT TIME OF DELIVERY 18. Advice mother to remain SSC for early initiation atleast 1 hr to 90 mins.
1. Encourage the women to push as necessary. - baby prone to mother’s chest b/w breasts w/ head turned to side.
2. Drape the clean dry linen in mother’s abd /arms for preparing drying of baby
3. Support perineum and do CCT to deliver head. 15-60 MINS
4. Call out time of birth and gender of baby. (inform mother) 1. Advice mother to observe for feeding cues (tonguing, crawling, hand to mouth, movement of arms
- Place at abd of mother. and legs, etc.)
2. Support mother with positioning and attachment
1ST 30 SECS 3. Wait for FULL BREASTFEED to complete.
1. Dry thoroughly for 30 secs. Face, head, trunk, extremities. 4. Administer eye ointment, PE, Vit. K, Hepa B, BCG (explain purpose)
2. Assess breathing. (resuscitate if not breathing after 30 secs of drying) - Eye ointment to protect babies from getting bacterial eye infections that can occur during birth.
- Vit K. promotes blood clotting prevents bleeding.
- Hepa B for immunization and protection from infection or virus.
- BCG as protection from Tuberculosis
5. Advice optimal/delayed bathing of baby (after 6 hours) explain why.
- prevents hypothermia, don’t wash vernix (strep, e.coli)
6. Advice breastfeeding per demand.
7. 1st hour, check baby’s breathing and color and mother’s VS and sterile massages, (q 15 mins)
8. 2nd hour, check mother-baby dyad (bond/SSC) q 30 min - 1 hr
9. Completes all records.
