ESSENTIAL INTRAPARTUM AND NEWBORN CARE checklist (1).docx

ESSENTIAL INTRAPARTUM AND NEWBORN CARE

PRIOR TO PATIENT’S TRANSFER TO THE DR 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.

PATIENT ALREADY IN THE DR 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 traction on 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.