Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
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• Indicate that everything possible was done to save the baby. Respond to the questions<br />
the family may wish to ask <strong>and</strong> let them express their feelings.<br />
• Show the baby to the parents <strong>and</strong> family members <strong>and</strong>, if culturally appropriate, provide<br />
them with an opportunity to hold the baby. Ensure that the family has privacy for holding<br />
the baby in these sad circumstances.<br />
• Explain that the mother will need rest, good nutrition, <strong>and</strong> emotional support at home.<br />
• With the baby’s death, the mother will face mammary engorgement 2-3 days after<br />
delivery. Advise the mother to:<br />
o support the breasts with a large cloth b<strong>and</strong> or a bra.<br />
o apply cold compresses on the breasts to decrease congestion <strong>and</strong> pain.<br />
o avoid breast massage or exposure to heat.<br />
o avoid stimulating the nipples.<br />
o prescribe oral paracetamol when necessary for pain.<br />
• Make arrangements to follow the mother for at least three days to make sure she is<br />
improving.<br />
• Discuss the options of family planning <strong>and</strong> explain that in this case there is a greater<br />
chance of the woman conceiving earlier <strong>and</strong> that for the health of the mother <strong>and</strong> future<br />
babies it is better to have an interval of three years before the birth of the next baby.<br />
• Prepare the death certificate <strong>and</strong> follow the protocol to register the death.<br />
Completing Medical Records<br />
All healthcare facilities must keep charts/documents that record each birth <strong>and</strong> information<br />
about the events surrounding the birth. The basic protocols must provide the necessary<br />
information, such as the condition of the infant at birth <strong>and</strong> if resuscitation or any other treatment<br />
was administered. This information must be copied into the health records of the baby where<br />
separate records exist for the baby.<br />
All problems detected at birth as well as procedures <strong>and</strong> treatment applied must be written<br />
legibly in the chart for future reference in case it is needed for healthcare or administrative<br />
reasons. The systematic collection of information is important to establish health statistics <strong>and</strong><br />
to serve as educational material to improve the quality of care. Good documentation is also<br />
extremely important in case of medico-legal issues that may surface later. The following details<br />
should be present:<br />
• date <strong>and</strong> time of birth<br />
• condition of the baby at birth<br />
• procedures used to initiate breathing where applicable<br />
• time delay between birth <strong>and</strong> the first breath<br />
• observations during <strong>and</strong> after resuscitation, if any<br />
• result of resuscitation procedures<br />
• in case of unsuccessful resuscitation, list the likely reason(s) for failure<br />
• name of the healthcare worker(s) present at resuscitation<br />
The key steps in resuscitation <strong>and</strong> for integrating with AMTSL are summarized in the algorithms<br />
given below (Figures 8.9 <strong>and</strong> 8.10).<br />
106<br />
<strong>Integrated</strong> maternal <strong>and</strong> newborn care<br />
<strong>Basic</strong> skills course
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