Name: ______________________________________Date: _________Section/Group: _________

ESSENTIAL INTRAPARTUM AND

NEWBORN CARE
CHECKLIST

Legend:
3-Very Satisfactory 1- Needs Improvement
2- Satisfactory 0- Did not perform the procedure
PROCEDURES: PRIOR TO PATIENT’S TRANSFER TO THE DR 3 2 1 0

Ensured that mother is on her position of choice when in labor.

Asked mother if she wishes to eat/drink.

Communicated with the mother- informed her of progress of labor,

gave reassurance and encouragement.

PROCEDURES: PATIENT ALREADY IN THE DR 3 2 1 0

Preparing for Delivery

Checked temperature in DR area, checked for air draft.

Asked patient if patient is comfortable in the semi-upright position

which is the default position.

Removed all jewelry.

Washed hands thoroughly observing the proper procedure.

Arranged things in a linear fashion:

Gloves, dry linen, bonnet, oxytocin injection, plastic clamp,
instrument clamp, scissors, 2 kidney basins

Cleaned the perineum with antiseptic solution.

Washed hands.

Put on 2 pairs of sterile gloves aseptically (if same worker

handles perineum and cord).

At the time Delivery

Encouraged woman to push as desired.

Applied perineal support and did controlled delivery of the head.

Called out time of birth and sex of baby.

Informed the mother of outcome.

First 30 seconds

Placed the baby on a clean, dry cloth/towel on the mother’s abdomen.

Thoroughly dried baby for at least 30 seconds, starting from the face
and head, going down to the trunk and extremities.

1-3 minutes

Removed wet cloth.

Placed baby on skin-to-skin contact on the mother’s abdomen.

Covered the baby with a clean, dry cloth/towel.

Covered baby’s head with a bonnet.

Excluded a 2nd baby by palpating abdomen. Used the wet cloth to

wipe the soiled gloves. Gave IM oxytocin within one minute of
baby’s birth. Disposed of the wet cloth properly.

Removed the 1st set of gloves.

Decontaminated these properly (by soaking in 0.5% chlorine solution

for at least 10 minutes)

Palpated umbilical cord to check for pulsations.

After pulsations stopped, clamped cord using the plastic cord clamp at
2 cm from base.

Placed the instrument clamp 5 cm from the base.

Cut near plastic clamp (not midway).

Perfomed the remaining steps of the Active Management of Third

Stage of Labor:
Waited for strong uterine contractions then applied controlled cord
traction and counter tractionon the uterus, continuing until placenta
was delivered.
Massaged the uterus until it is firm.

Inspected the lower vagina and perineum for lacerations/tears

and repaired lacerations/tears if necessary.

Examined the placenta for completeness and abnormalities.

Cleaned the mother: flushed perineum and applied

perineal pad/napkin/cloth

Checked baby’s color and breathing; checked that mother

was comfortable, uterus contracted.

Disposed of the placenta in a leak-proof container or plastic bag.

Decontaminated (soaked in 0.5% chlorine solution) instruments

before cleaning; decontaminated 2nd pair of gloves before disposal.

Advised mother to maintain skin-to-skin contact. Baby should be

prone on mother’s chest/in between the breasts with head turned to
one side.

15-90 minutes

Advised mother to observe for feeding cues (cited examples)

Supported mother, instructed her on positioning and attachment.

Waited for FULL BREASTFEED to be completed.

After a complete breastfeed, administered eye ointment (first),

did thorough physical examination, gave Vit. K, hepatitis B and
BCG (simultaneously explained purpose of each intervention).

Advised OPTIONAL/DELAYED bathing of baby (and was able to

explain the rationale).

Advised breastfeeding per demand and about Danger Signs for

 early referral

In the first hour: checked baby’s breathing and color; and

checked mother’s vital signs and massaged uterus every 15
minutes.

In the second hour: checked mother-baby dyad every 30 minutes

to 1 hour.

Completed all RECORDS: administered eye ointment, vitamin

K, hepatitis B and BCG.

For the next items, evaluate the students in general according to the criteria. (5 as the highest
score)
5 4 3 2 1

Mastery

Orderliness

Proper attitude in assessing the client followed.

Ability to answer questions

Proper reporting observed.

Student’s Name and Signature:

___________________________________________________ Evaluator’s Name and

Signature: _________________________________________________

Comments:______________________________________________________________________
________________________________________________________________________________
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