This document provides a checklist for steps to be completed during labor, delivery, and immediate postpartum care. It outlines preparing supplies and the environment, monitoring the woman in labor, assisting with the delivery, immediate newborn care including drying, skin-to-skin contact and breastfeeding, administering oxytocin and vitamin K, and postpartum checks of mother and baby. The checklist aims to ensure all necessary steps are addressed to support a safe birth experience.
This document provides a checklist for steps to be completed during labor, delivery, and immediate postpartum care. It outlines preparing supplies and the environment, monitoring the woman in labor, assisting with the delivery, immediate newborn care including drying, skin-to-skin contact and breastfeeding, administering oxytocin and vitamin K, and postpartum checks of mother and baby. The checklist aims to ensure all necessary steps are addressed to support a safe birth experience.
This document provides a checklist for steps to be completed during labor, delivery, and immediate postpartum care. It outlines preparing supplies and the environment, monitoring the woman in labor, assisting with the delivery, immediate newborn care including drying, skin-to-skin contact and breastfeeding, administering oxytocin and vitamin K, and postpartum checks of mother and baby. The checklist aims to ensure all necessary steps are addressed to support a safe birth experience.
• In advance, prepare decontamination solution by mixing 1 part 5% Chlorine bleach to 9 parts water to make 0.5% Chlorine Solution. Change Chlorine Solution at the beginning of each day or whenever solution is very contaminated or cloudy. • PRIOR TO WOMAN'S TRANSFER TO THE DR • Ensured that mother is in her position of choice while in labor. • Asked mother if she wishes to eat/drink or void. • Communicated with the mother-informed her of progress of labor, give reassurance and encouragement. • WOMAN ALREADY IN THE DR • PREPARING FOR THE DELIVERY • Checked temperature in DR area to be 25- 28°Celcius, eliminated air draft. • Asked woman if she is comfortable in the semi- upright position.(The default position of delivery table) • Ensured the woman's privacy • Removed all jewelry, then washed hands thoroughly observing the WHO 1-2-3-4-5 procedure. • Prepared a clear, clean newborn resuscitation area. Check the equipment if clean, functional within easy reach. • Arranged materials/supplies in a linear sequence. • Gloves, dry linen, bonnet, oxytocin injection, plastic clamp, instrument clamp, scissors, 2 kidney basins. • In a separate sequence, for after the first breastfeed. • Eye ointment, stethoscope (to symbolize PE), Vitamin K, Hepatitis B and BCG vaccines plus cottonballs, etc.
• Cleaned the perineum with antiseptic solution
• Washed hands and put on 2 pairs of sterile gloves aseptically (if same worker handles perineum and cord) • AT THE TIME OF THE DELIVERY • Encouraged woman to push as desired • Draped the clean, dry linen over the mother's abdmomen or arms in preparation for drying the baby • Applied perineal support and did controlled delivery of the head • Called out the time of birth and sex of the baby • Informed the mother of outcome • FIRST 30 SECONDS • Thoroughly dried baby for at least 30 seconds, starting from the face and head, going down to the trunk • and extremities while performing a quick check for breathing. • 1-3 MINUTES • Removed the wet cloth • Placed baby in skin-to-skin contact on the mothers abdomen or chest • Covered the baby with the dry cloth and the baby's head with a bonnet. • Excluded a second baby by palpating the abdomen in preparation for giving oxytocin • Used with cloth to wipe the soiled gloves. Gave IM oxytocin within one minute of baby's birth. • Disposed of wet cloth properly • Removed first set of gloves and decontaminated them properly (In chlorine Sol for at least 10 mins) • Palpated umbilical cord to check for pulsations. • After pulsations stopped, clamped cord using the plastic clamp or cord tie 2 cm from the base • Placed the instrument clamp 5 cm from the base (3 cm from the plastic clamp) • Cut near the plastic clamp (not midway) • Performed the remaining steps of AMTSL: • Waited for strong uterine contractions then applied controlled traction (unilateral) on • the uterus, continuing until placenta was delivered. (twist and rotate) • Massaged the uterus until it is firm • Checked baby's color and breathing, checked that mother was comfortable, uterus contracted • Disposed of the placenta in a leak-proof container or plastic • Decontaminated (soaked in 0.5 Chlorine Sol) instruments before cleaning, decontaminate second pair of gloves before disposal, stating that contamination lasts for at least 10 mins • (handwashing again) • Advised mother to observe for feeding cues, and cited examples of feeding cues. • Supported mother, instructed her on positioning and attachment • Waited for FULL BREASTFEED to be completed • After a complete breastfeed, administered eye ointment, did thorough physical examination then did Vit K, hepa B and BCG injections (simultaneously explained purpose of each intervention) • Advised OPTIONAL/DELAYED bathing of baby (and was able to explained the rationale • advised breastfeeding per demand. • 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, check mother-baby dyad every 30 minutes to 1 hour • Completed all records.