Integrated Maternal and Newborn Care Basic Skills Course ...

Reference Manual
linen and blanket for the baby can be kept for pre-warming before the delivery, and
where resuscitation can be carried out.
• Make sure that all surfaces the woman and baby will come in contact with are clean,
warm, and dry.
• Make sure the room is well-lit.
• Review and complete the woman’s medical records (if available):
o the antenatal care card (take special care to check the woman’s HIV status, and if
she is infected with HIV, ask about her antiretroviral (ARV) regimen and if she has
brought ARV drugs for her baby)
o partograph
o any other records she may have with her
• Maintain cleanliness of the woman and her environment:
o Encourage the woman to wash herself or bathe or shower at the onset of labor.
o Put a clean, waterproof sheet under the woman’s bottom.
o Clean the vulval and perineal areas before each examination.
o Wash hands with soap before and after each examination.
o Ensure cleanliness of laboring and birthing area(s).
o Clean up all spills immediately.
• Follow infection prevention practices to reduce exposure to blood and other body fluids
during labor and delivery, and thereby help protect the woman and providers from
infection:
o Wash hands with soap and water and dry with a clean, dry cloth before examining
each client; after examining each client; before putting on gloves for clinical
procedures (such as a vaginal exam or examination of the placenta); after touching
any instrument or object that might be contaminated with blood or other body fluids,
or after touching mucous membranes; after handling blood, urine, or other
specimens; after removing any kind of gloves; after using the toilet or latrine.
o Wear protective clothing: sterile/HLD gloves, masks, gowns, and waterproof aprons,
caps, eye covers/face shields.
• During the first stage of labor, preferably in between contractions and before
contractions are very intense:
o Explain and offer AMTSL to the woman and obtain her permission to apply it.
o Explain skin-to-skin contact and that the newborn will be placed first on her abdomen
and then on her chest, and obtain her permission to do this.
o Explain that essential newborn care will be provided while the baby is in skin-to-skin
contact with her and obtain her permission; care includes placing an identification
bracelet on the baby, eye and cord care, vitamin K1 injection, and early initiation of
breastfeeding .
Routine Care for the Woman in Labor
Regardless of how the third stage of labor is managed, basic care for the woman and baby
during labor and postpartum remains the same. The following actions represent the elements of
essential care for the woman during labor.
Integrated maternal and newborn care
Basic skills course
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