Integrated Maternal and Newborn Care Basic Skills Course ...

Integration of AMTSL and ENC
Keep required items for the mother and baby close by, load oxytocin in syringe.
Inform the woman what is being planned in a way she can understand.
Receive and dry the baby, discard wet linen.
Baby cries well
Cry not heard
Place the baby on the mother’s
abdomen; cover with a dry cloth.
Inform the mother about her baby
and AMTSL; administer uterotonic
after checking for a second baby.
Clamp cord when pulsations
stop/2-3 minutes after birth. Place
the baby on the mother’s chest
and keep the baby warm.
Place the baby on the mother’s abdomen; cover the
baby with a dry cloth.
Breathing well
Inform the mother about
her baby and AMTSL;
administer uterotonic
after checking for a
second baby.
Not breathing/
gasping
Cut the cord; resuscitate
the baby. If possible,
administer uterotonic
after checking for a
second baby.
Apply controlled cord traction +
countertraction; perform uterine
massage.
Clamp cord when
pulsations stop/2-3 mins.
after birth. Place the baby
on the mother’s chest and
keep warm.
Apply controlled cord
traction + countertraction;
perform uterine
massage.
Depending on the level of
resuscitation efforts
needed and whether an
assistant is present,
deliver placenta by
maternal effort or
controlled cord traction.
Monitor the woman and baby closely.
Implement ENC at birth: eye prophylaxis; cord care; warmth (skin-to-skin); breastfeeding.
Continue routine care for the woman and her baby.
Figure 8.10 Algorithm for integration of AMTSL, ENC and resuscitation for birth asphyxia
108
Integrated maternal and newborn care
Basic skills course