Integrated Maternal and Newborn Care Basic Skills Course ...

CHAPTER 5: Routine Care during the
Third Stage of Labor
PREPARATION FOR THE BIRTH
Developing a birth-preparedness plan during pregnancy will help ensure that the woman in labor
arrives at the health care facility in a timely manner and can be assisted by a skilled birth
attendant. Ideally there should be at least two qualified providers at each birth to ensure that
both the woman and her newborn receive the quality care they need. Having two qualified
providers is especially important if either the woman or her newborn require additional care.
Preparing the Delivery Room
The following guidelines will be helpful in preparing the delivery room.
• Ensure that the client care area is adequately prepared by:
o placing waste products and contaminated objects (from the previous birth) into the
appropriate containers.
o wiping down surfaces with 0.5% chlorine solution.
o tidying the area.
o checking that the injection safety box is accessible and does not require changing.
o making sure that buckets with 0.5% chlorine are available for decontamination and
that the solution does not need to be changed.
• Make sure that the woman’s bodily privacy is protected (curtains, doors that close, etc.);
if permitted, ask the woman if she would like a companion with her during childbirth and
facilitate that person’s presence in the delivery room.
• Check that all needed equipment and instruments for delivery care, essential maternal
and newborn care, newborn resuscitation, and adult resuscitation are available, clean,
sterile/HLD, and in good working order and readily accessible.
• Make sure that the room is warm (at least 25-28 °C/77.0-82.4 °F) and free from drafts
from open windows and doors or from fans. This is especially true for the area in the
room where newborns receive special care, such as resuscitation. Make sure that all of
the windows are closed.
• If the temperature of the room is less than optimal, a heater should be available to warm
the room. In some circumstances, it might be easier to warm a small area of a room
rather than the whole room. In hot weather, air conditioning or fans should be turned off
or adjusted in the delivery room.
• Make sure that supplies needed to keep the newborn baby warm are prepared. The
supplies should include as a minimum: two absorbent pieces of cloth/towels large
enough to cover a newborn baby's whole body and head, a cap, a sheet or blanket for
covering mother and baby, and suitable baby clothes if feasible/acceptable. In cool
weather, a source of heat should be available to pre-warm the clothes and towels.
• Even though the care of a normal baby can be carried out while he/she is in skin-to-skin
contact with the mother’s chest, it is important to have a “corner or area for the newborn”
in the delivery room where all the equipment and supplies can be collected and kept
together. Ideally there should be a heater/source of warmth under or near which the
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Integrated maternal and newborn care
Basic skills course