Evidence-based Practices for Safe & Quality Care of Birthing Mothers & Their Newborn

Essential Intrapartum Care

Unnecessary InterventionsRecommended Intrapartum Care Enema Continuous Support During Childbirth ShavingMobility During Labor Restricted Intake of Food & Fluids Pain Relief in Labor Routine Intravenous Infusion Partograph Use to Monitor Progress of Labor Fundal Pressure Spontaneous Pushing in Semi- upright Position Early Amniotomy and Oxytocin Augmentation Hand Hygiene Routine EpisiotomyAMTSL Antenatal Steroids in Preterm Labor

Essential Newborn Care

Unnecessary Interventions Recommended Practices Routine Suctioning Immediate and Thorough Drying FootprintingEarly Skin-To-Skin Contact Early Bathing and Washing Properly Timed Cord Clamping Routine Separation Non-Separation of the Mother and Baby for Initiation of Breastfeeding Giving Glucose Water or Artificial Milk Substitutes

ESSENTIAL INTRAPARTUM AND NEWBORN CARE Prior to woman’s transfer to the DR: Ensure that mother is in her position of choice while in labor. Ask mother if she wishes to eat/drink or void. Communicate with the mother

ESSENTIAL INTRAPARTUM AND NEWBORN CARE In the Delivery Room: Check temperature in DR Position comfortably in semi-upright position Ensure privacy Remove jewelry/wash hands thoroughly Prepare a clear, clean newborn resuscitation area Arranged materials/ supplies in linear fashion

ESSENTIAL INTRAPARTUM AND NEWBORN CARE In the Delivery Room: Clean the perineum with antiseptic solution Wash hands and put on 2 pairs of sterile gloves

ESSENTIAL INTRAPARTUM AND NEWBORN CARE At the time of delivery: Encourage woman to push as desired Drape the clean, dry linen over the mothers abdomen Apply perineal support, controlled delivery of the head Call out time and sex of baby Inform mother of outcome

ESSENTIAL INTRAPARTUM AND NEWBORN CARE First 30 seconds: Thoroughly dry baby for at least 30seconds while performing a quick check of breathing 1-3 minutes: Remove wet cloth Place baby in skin-to-skin contact on the mother’s abdomen or chest

ESSENTIAL INTRAPARTUM AND NEWBORN CARE 1-3 minutes: Cover bay with dry cloth and bonnet in the head Exclude a second baby Use wet cloth to wipe the soiled gloves Give oxytocin to mother Remove 1 st gloves Palpate umbilical cord, check for pulsations

ESSENTIAL INTRAPARTUM AND NEWBORN CARE 1-3 minutes: After pulsations stopped, clamp cord (2cm/5cm) Cut cord near plastic clamp Perform AMTSL Controlled cord traction/ Countertraction Uterine Massage Inspect perineum and lower vagina

ESSENTIAL INTRAPARTUM AND NEWBORN CARE 1-3 minutes: Examine placenta Clean the mother Check baby’s color and breathing; mother if comfortable/uterus contracted Dispose placenta Decontaminate instruments

ESSENTIAL INTRAPARTUM AND NEWBORN CARE minutes: Observe feeding cues Support/instruct mother on positioning and attachment Wait for FULL breastfeed to be completed Administer eye ointment, PE, Vit. K, Hep B, BCG Advise delayed bathing