NAME: ________________________________________ SCORE: __________________________YEAR AND SECTION: _____________________________ DATE: ___________________________

ASSISTING AND HANDLING NORMAL DELIVERY

2 1 0A. PREPARE THE EQUIPMENT NEEDED:

Delivery bed that supports the woman in a semi-sitting or lying in a lateral position, with removable stirrups

Stethoscope Blood pressure apparatus Body thermometer Sterile Straight catheter Delivery instruments (Obstetric pack)

Scissors Needle holder Artery forceps and clamp Sutures Sponge forceps Sponges Sanitary pads/underpads

B. PREDELIVERY PREPARATION OF THE MOTHER1. Ensure the mother's privacy2. Obtain and open emergency obstetric pack. This will provide all the sterile

supplies needed for care of the mother and infant before and after delivery.

3. Do hand washing.4. Put on gloves, mask, gown, and goggles for infection control precaution.5. Position the mother and prepare work space for both delivery and care of

the newborn (Have another individual to do the task)o Position mother lying with knees drawn up and spread apart

(Lithotomic position). Elevate the hips with a folded blanket or pillow. (optional)

o Place the Kelly pad under the buttocks of the patiento Place the trash containero Clean the perineum with a warmed antiseptic (cold solution causes

cramping), and then rinse it with a designated solution before birtho Always clean from the vagina outward (so that microorganisms are

moved away from the vagina, not toward it), using a clean compress for each stroke

o Be sure and include a wide area (vulva, upper inner thighs, pubis, and anus)

o Flush feces expelled when the woman pushes to prevent contamination of birth canal

o Monitor the airway, render assistance if she should vomit, and provide emotional support

6. Create a sterile field around vaginal opening with sterile towels or paper barriersa. Place sterile towel under the buttocks.

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b. Place sterile leggings on the patient’s leg, do it one at a time.c. Place sterile towel over the abdomen

C. ASSIST IN DELIVERY OF THE BABY1. Encourage mother to breathe deeply through her mouth. She may feel

better if she pants.2. When the infant's head appears during crowning, place fingers on the bony

part of skull and exert slight pressure to prevent an explosive delivery. Use caution to avoid "soft spot" (fontanelle.)

3. If the amniotic sac does not break, or has not broken, use a clamp or your finger to puncture the sac and push it away from the infant's head and mouth as they appear.

* perform episiotomy at the peak of contraction and while the mother has urge to push

4. As the infant's head is being born, determine if the umbilical cord is around the infant's neck.a. If the umbilical cord is around the infant's neck, slip it over the

shoulder or clamp, cut, and unwrapb. Umbilical cord must be clamped and cut if it is wrapped too tightly

around the infant's neck.5. After the infant's head is born, support the head, suction the mouth first

then the nostrils two or three times with a bulb syringe if available6. Continue to support the baby's head between contractions while waiting

for the rest of the body to be delivered WARNING: DO NOT pull on the baby's head to assist with the delivery.7. As the feet are born, grasp the feet. Wipe blood and mucus from mouth

and nose again.8. Wrap the infant in a warm blanket and place on his side, with the head

slightly lower than the trunk WARNING: Keep infant warm to prevent hypothermia, which can occur

quickly.9. Keep infant level with vagina until the cord is cut.10. Have a partner monitor and complete initial care of the newborn.11. The infant must be breathing on its own before clamping and cutting the

cord.a. Palpate the cord with the fingers to make sure it is no longer pulsating.b. Use clamps or umbilical tape found in the obstetric kit.c. Apply the first clamp about 8 to 10 cm from the babyd. Place the second clamp 2 to 3 cm below the first, approximately 4

fingers width from infante. Cut the cord between the clamps or knots using sterile surgical scissors

CAUTION: NEVER unclamp a cord once it has been cut, or attempt to adjust a clamp once it is in place.

12. Observe for delivery of the placenta13. When the placenta is delivered, note the time, unclamped and put it in the

receptacle or container. Pack the perineum with gauze. Suture the lacerated perineum

14. Place sterile pad over vaginal opening, lower mother's legs, help her hold them together.

15. Record the birtha. Document exact time of birth on the run sheet

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b. Make a double-backed tape bracelet with the time of birth and the mother's full name. Apply to baby's wrist or ankle.

Comments and Suggestions:

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Clinical Instructor

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