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NOTE: Content on definitions, newborn resuscitation, and minor and major infections was adapted from Le Manuel de Référence–Sante du Nouveau-né. Ministère de Sante et USAID/BASICS, 2005. All unidentified black and white illustrations were taken from: Engelbrecht, SM. Guide de la Matrone: Tome 2–La consultation postnatale. Editions Nanondiral: Dakar, Sénégal, 1998. vi Integrated maternal and newborn care Basic skills course
Reference Manual TABLE OF CONTENTS INTRODUCTION ....................................................................................................................... 1 Four Million Neonatal Deaths: Where do they occur?................................................................. 1 Four Million Neonatal Deaths: What do babies die of?............................................................... 2 Four Million Neonatal Deaths: When do they occur?.................................................................. 2 CHAPTER 1: PREVENTING INFECTION ................................................................................. 4 Principles of Infection Prevention ............................................................................................... 4 Equipment and Supplies Related to Resuscitation ....................................................................22 CHAPTER 2: CLINICAL DECISION-MAKING ........................................................................ 23 The Problem-Solving Method....................................................................................................23 Documentation of Care .............................................................................................................26 CHAPTER 3: MATERNAL CARE TO IMPROVE MATERNAL AND NEWBORN SURVIVAL..29 Every Pregnancy is “At Risk”.....................................................................................................29 Maternal Conditions Affecting Fetal and Newborn Survival .......................................................30 Antenatal Care..........................................................................................................................33 Delays Resulting in Maternal and Newborn Deaths ..................................................................40 Birth-Preparedness Plan ...........................................................................................................40 Complication-Readiness Plan ...................................................................................................42 CHAPTER 4: PREVENTING POSTPARTUM HEMORRHAGE............................................... 44 Causes of Postpartum Hemorrhage..........................................................................................44 PPH Prevention and Early Detection.........................................................................................45 CHAPTER 5: ROUTINE CARE DURING THE THIRD STAGE OF LABOR .......................... ..48 Preparation for the Birth............................................................................................................48 Essential Newborn Care ...........................................................................................................55 Care During the Third Stage of Labor .......................................................................................62 CHAPTER 6: MONITORING THE WOMAN AND NEWBORN DURING THE FIRST SIX HOURS POSTPARTUM ……………………………………………………………………………….77 Monitoring the Woman..............................................................................................................77 Monitoring the Newborn ............................................................................................................80 CHAPTER 7: ROUTINE POSTPARTUM CARE FOR THE WOMAN ...................................... 83 Male Involvement......................................................................................................................83 Postpartum Care.......................................................................................................................84 CHAPTER 8: RESUSCITATION FOR BIRTH ASPHYXIA ...................................................... 93 Causes of Birth Asphyxia ..........................................................................................................94 Preparation for Resuscitation....................................................................................................94 Steps in Newborn Resuscitation ...............................................................................................99 Post-Resuscitation Care .........................................................................................................104 Integrated maternal and newborn care Basic skills course vii
Page 1 and 2: HEALTH INTEGRATED PROGRAMMING MATER
Page 3 and 4: Reference Manual U.S. Agency for In
Page 5: Reference Manual ACKNOWLEDGEMENTS M
Page 9 and 10: Reference Manual List of Figures In
Page 11 and 12: Reference Manual About the Learning
Page 13 and 14: Reference Manual List of Abbreviati
Page 15 and 16: Reference Manual INTRODUCTION While
Page 17 and 18: Reference Manual 4 Million Newborn
Page 19 and 20: Reference Manual Materials required
Page 21 and 22: Reference Manual The Hand Rub When
Page 23 and 24: Reference Manual Use of Gloves Glov
Page 25 and 26: Reference Manual Gowns and waterpro
Page 27 and 28: Reference Manual Dispose of hypoder
Page 29 and 30: Reference Manual The materials need
Page 31 and 32: Reference Manual When preparing chl
Page 33 and 34: Reference Manual Table 1. Mixing A
Page 35 and 36: Reference Manual Recommended cleani
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Page 39 and 40: Reference Manual Step 3: Identify n
Page 41 and 42: Reference Manual When writing the p
Page 43 and 44: Reference Manual CHAPTER 3: Materna
Page 45 and 46: Reference Manual Malaria Susceptibi
Page 47 and 48: Reference Manual ANTENATAL CARE Ant
Page 49 and 50: Reference Manual Have the woman tak
Page 51 and 52: Reference Manual Informing the preg
Page 53 and 54: Reference Manual Provide post-test
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Reference Manual family values. If
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Reference Manual • prolonged labo
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Reference Manual • Assist the wom
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Reference Manual linen and blanket
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Reference Manual Figure 5.1. Positi
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Reference Manual Supportive care du
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Reference Manual Advance preparatio
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Reference Manual • Cutting the co
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Reference Manual Place an Identific
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Reference Manual If the mother’s
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Reference Manual • Controlled cor
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Reference Manual Scientific evidenc
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Reference Manual 2. Administer a ut
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Reference Manual 4. Place the clamp
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Reference Manual 11. As the placent
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Reference Manual 2. Hold the cord w
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Reference Manual Managing the Third
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Reference Manual CHAPTER 6: Monitor
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Reference Manual Danger Signs: Brea
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Reference Manual Table 8. Monitorin
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Reference Manual CHAPTER 7: Routine
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Reference Manual • perform the fo
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Reference Manual Prevent tetanus
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Reference Manual Counsel on the imp
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Reference Manual • Severe abdomin
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Reference Manual CHAPTER 8: Resusci
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Reference Manual “shocks.” Wher
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Reference Manual Equipment for Vent
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Reference Manual Identifying a Baby
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Reference Manual Clearing of the Ai
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Reference Manual • Reassess the b
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Reference Manual • Measure the ax
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Reference Manual Figure 8.9 Algorit
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Reference Manual CHAPTER 9: Basic S
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Reference Manual The following thre
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Reference Manual Check for jaundice
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Reference Manual Table 11. Key Step
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Reference Manual normal. Skilled he
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Reference Manual Steps of Postnatal
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Reference Manual • Identification
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Reference Manual Table 12. Suggeste
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Reference Manual Table 14. Summary
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Reference Manual Underarm position
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Reference Manual Management • Tre
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Reference Manual Inverted Nipples S
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Reference Manual How to Express Bre
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Reference Manual • An LBW baby st
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Reference Manual CHAPTER 12: Care o
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Reference Manual Table 15. Complica
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Reference Manual CARE OF LOW BIRTH
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Reference Manual • Explain the re
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Reference Manual Breastfeeding the
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Reference Manual Follow-up checks b
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Reference Manual CHAPTER 13: Treatm
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Reference Manual Major infections i
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Reference Manual difficulty in brea
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Reference Manual o As Chlamydia may
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Reference Manual Table 17: Summary
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Reference Manual Table A.1. Uteroto
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Reference Manual Oxytocin Table A.3
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Reference Manual APPENDIX B: Altern
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Reference Manual Eyes • Cephalhem
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Reference Manual • A white discha
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Reference Manual survival of babies
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Reference Manual REFERENCES The fol
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Reference Manual World Health Organ
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