NCMA ❑ No routine episiotomy

Essential Intrapartum and Newborn Care (EINC) ❑ Companion of choice during labor
December 7, 2009 - DOH launched UNANG YAKAP campaign ❑ Mobility during labor (within reason)
Non time-bound procedures ❑ Non-pharmacologic pain relief before offering anesthesia
Done after the 1st full breastfeeding

❑Immunization Unnecessary procedures

❑Eye care (Crede’s prophylaxis) ❑Suctioning
❑Vitamin k administration ❑Separation for observation
❑Weighing ❑Administration of pre-lacteals
❑washing/bathing (postponed up to 6 hrs) ❑Water formula
❑Hinders crawling reflex ❑Foot printing

❑Application of substances to the cord

New Trends

❑Position: position of comfort* PROCEDURE

❑No NPO Prior to woman’s transfer to DR
❑Light meals are allowed ❑Ensure that the mother is in her POSITION OF CHOICE
❑ No IV unless CS ❑ASK the mother if she wishes to eat/drink or void
❑ No Shaving ❑Communicate with the mother. Inform her
❑ No fundal push/pressure the progress of labor, give reassurance and
encouragement 10. Drape the clean, dry linen over the mother’s abdomen or arms in
preparation for drying the baby.

11. Apply perineal support and control delivery of the head.

Woman already in the DR – preparing
12. Call out time of birth and gender of the baby. Inform the outcome to
for delivery
the mother.

1. Check the temperature in the DR area. It should be 25-28 degrees

First 30 seconds – after delivery
Celsius.
13. Thoroughly dry the baby for at least 30 seconds, starting from the
2. Ask the woman if she is comfortable in semi-upright position.
face and head, going down to the
3. Ensure the woman’s privacy
trunk and extremities while performing a quick check for breathing.
4. Remove all jewelries, wash hands.

5. Prepare a clear, clean newborn resuscitation area. Check if equipment

1-3 minutes – after delivery
is clean, functional, and within easy reach.
14. Remove wet cloth
6. Arrange materials/supplies in linear sequence (gloves, dry linen,
bonnet, oxytocin injection, plastic 15. Place baby in skin-to-skin contact on the mother’s abdomen or chest.

clamp, instrument clamp, scissors, 2 kidney basins, eye ointment, 16. Cover baby with a dry cloth and baby’s head with a bonnet.
stethoscope, vitamin K, Hepatitis B and BCG vaccine, and cotton balls)
 Temperature Check
7. Clean the perineum with antiseptic solution.
Room: 25-28 °C
8. Wash hands and put on 2 pairs of sterile gloves aseptically (if same
Baby: 36.5 – 37.5°C
worker handles perineum and cord)
17. Use wet cloth to wipe the soiled gloves, then dispose wet cloth
properly.
At the time of delivery
18. Remove first set of gloves and decontaminate them properly (0.5%
9. Encourage woman to push as desired. chlorine solution for at least 10 minutes)
19. Palpate umbilical cord to check for pulsations. After pulsations
stopped, clamp the cord using plastic clamp or cord tie 2cm from the
base.

20. Place the instrument clamp 5 cm from the base and then clamp.

21. Cut near plastic clamp (not midway)

22. Perform the remaining steps of AMTSL (Wait for strong uterine
contraction then apply controlled

cord traction and counter traction on the uterus (Brandt-Andrews

Maneuver and Crede’s Maneuver),

continue until placenta was delivered. Massage the uterus until it is firm.

23. Inspect the lower vagina and perineum for laceration.

24. Examine the placenta for

completeness and abnormalities.

(Schultz or Duncan Presentation)

 15-90 minutes – after delivery

30. Advise mother to observe for feeding cues. Support mother and
instruct her on positioning

and attachment.

31. After a complete breastfeeding, administer eye ointment, thorough

physical exam, and then do injection of vitamin K, Hepatitis B and BCG
vaccine injections.

32. Advise optional/delayed bathing of baby.

33. Complete all records.

Administration of Crede’s prophylaxis

1. Verify the type of prophylaxis to be used. (ERYTHROMYCIN EYE

25. Clean the mother.
OINTMENT)
26. Check baby’s color and breathing. Check if mother is comfortable and
2. Do hand washing.
uterus is contracted.
3. Gather supplies (check for expiration date).
27. Dispose the placenta in a leak-proof container or plastic bag.
4. Ensure that the medication is clearly labeled.
28. Decontaminate (0.5% chlorine solution) instruments before cleaning
and decontaminate second pair of gloves before disposal. 5. Place the infant in supine position.

6. With one hand, open eyelids.

Within 90 minutes of age 7. Apply ointment from inner to outer canthus.

29. Advise mother to maintain skin-to-skin contact. Baby should be prone 8. Make sure that the tip of the ointment tube will
on mother’s chest in between
not touch the eyelids of the infant.
the breasts with head turned to one side.
9. Avoid the infant’s hands to get contact with his 13. Clean the injection site using cotton ball with alcohol. Do it in a
circular motion, from inner to outer.
eyes.
14. Hold the thigh of the infant firmly.
10. Do hand washing.
15. Inject the needle in a 90 degree angle then aspirate.
11. Document the procedure
16. If no blood, introduce the medication slowly.

17. Remove the needle and apply pressure on site.

Administration of Vit. K
18. Discard the syringe after use.
1. Do hand washing.
19. Wash hands.
2. Prepare the needed materials.
20. Document the procedure done.
3. Get vitamin k (Aquamephyton/Phytomenadione)

4. Check the expiration date and if it is clearly labeled.

5. Tap liquid in top chamber of the ampule into the bottom part.

6. Wipe the neck of the ampule with cotton ball.

7. Snap top off away from your body.

8. Using a tuberculin syringe, withdraw medication by inverting the

ampule or by holding it and insert the needle then pull the plunger.

9. Remove the syringe from the ampule and remove bubbles from the
syringe.

10. Check the dosage of the medication in the syringe.

11. Place the infant in a supine position.

12. Locate for vastus lateralis.