1.

Prepares room, instruments and equipment needed:

“In preparing room, I will turn on the spot light and make sure that
curtains are close for privacy. For the instruments and equipment, I
have arrange it in the table (show the table)”
2.Transport client safely while providing privacy
Assuming that I have transported mother safely while providing
privacy via stretcher with siderails up and covered with blanket.
3.I will now place the mother in lithotomy position.
“Ma’am please straighten your back while lying and flex your both
legs 90 degrees at your hips”
4.Performs perineal care using sterile technique correctly.
Wear gloves first & dispose after 4. Right majora
1. Pubis
5. Left majora
2. Right thigh
6. Vulva or vaginal opening
3. Left thigh
7. Anus

Drape patient (Leggings, abdomen and buttocks)

5.Performs proper hand scrub. There is no available faucet
therefore I will just use alcohol for hand scrubbing.
1. Palm to palm
2. Right palm over left dorsum (Left palm over right dorsum)
3. Fingers interfaced
4. Fingers interlocked
5. Rotational rubbing of right thumb clasped in left and vice versa
6. Rotational rubbing, backwards and forwards with clasped fingers of right
hand in left palm and vice versa

6.Wears gown and gloves according to hospital policy.

 Jacket, towel and gloves
7.Performs Ritgen’s maneuver safely.
Now, I’m going to perform this maneuver since the head of the fetus
distends the vulva and its perineum is enough to open the vaginal
introitus to a diameter of 5 cm or more. This maneuver is performed
to deliver the head of the baby.”
 What is the purpose of Ritgen’s Maneuver?
Ritgen's maneuver denotes extracting the fetal head, using one hand
to pull the fetal chin from between the maternal anus and the coccyx,
and the other on the fetal occiput to control speed of delivery.
8.Coaches mother on breathing and pushing techniques.
“Ma’am push!!”
Count 1-10 before delivering the baby completely.
“Okay ma’am the baby is out”.
When to push and hold: Slow deep breath as your contraction starts
and then slowly breathe out. Slowly inhale through your nose and
then pause. Then exhale slowly through your mouth.
9.Delivers baby
Skin to skin (Lower the drape first)
10. Checks and manages cord recoil correctly
11. Demonstrate clamping and cutting of cord.
12. Enumerate the signs of placental separation (GURLA)
The signs that the placenta has separated includes:
 Gush of blood
 Uterine involution
 Rising of the fundus
 Lengthening of umbilical cord
 Appearance of the placenta
13. Delivers placenta then put it in a bowl or any container.
14. Check the completeness of placenta.
The placenta is complete and there is no sign of abnormalities.
15. Assesses amount of blood loss
The amount of blood lost during delivery is about 450 cc which is
considered as normal.”
16. Employs interventions to achieve and maintain a well
contracted uterus to prevent/control hemorrhage.
  Uterine massage
The purpose of uterine or fundal massage to encourage the uterus to
contract properly after delivery of the placenta.
 Administer Oxytocin thru IM at deltoid muscle
 Cold compress
Applying cold compress to perineal area can help ease pain and reduce swelling
17. Crede’s maneuver
Place palms flat on the patient’s abdomen just below the navel. Then apply
gentle firm pressure and move downwards towards the symphysis pubis.

18. Assesses presence and degree of laceration.

There is a presence of laceration and it is in second degree.
Vagina, perineal skin, fascia, levatorani muscle, and perineal body.
19. Assists in episiorrhaphy
“This is the proper way on how to load a needle with a suture by the
use of the needle holder”
Now, I will pass the needle holder with the suture to the Doctor.
20. Checks size, consistency and location of uterus.
“Immediately after delivery, the upper portion of the uterus is midline
and palpable halfway between the symphysis pubis and the umbilicus.
By approximately one hour post delivery, the fundus is firm and at the
level of the umbilicus.”
21. Performs perineal care and applies pad correctly.
Flushing, Betadine paint on lacerated area, apply perineal pad
22. Evaluates patient’s condition and records pertinent data
accordingly.
Get DR notebook, record
There is no bleeding observe in the mother. The baby boy is delivered
at ____ in the morning and the placenta is out.
23. Provide dry and clean gown
I will now assist the mother in transferring from DR table to stretcher.
Keep the side rails up and ready for transfer to recovery room/ward.
24. Performs after care of the materials and equipment used.
  Wash and dry all instruments used.
25. Ensures proper disposal of hospital waste including blood
and other fluids
- Proper disposal of waste materials with color coding
- Orange for infectious clinical waste
- Yellow non infectious
- Green for wet and biodegrable waste
- Blue for non biodegradable
- Separate Container for sharps, syringes, vials and ampules