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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Supportive care during labor<br />
• Encourage the woman to have personal support from a person of her choice throughout<br />
labor <strong>and</strong> birth:<br />
o Encourage support from the chosen birth companion.<br />
o Arrange seating for the companion next to the woman.<br />
o Encourage the companion to give adequate support to the woman during labor <strong>and</strong><br />
childbirth (rub her back, wipe her brow with wet cloth, assist her to move about).<br />
• Ensure good communication <strong>and</strong> support by staff:<br />
o Explain all procedures, seek permission, <strong>and</strong> discuss findings with the woman.<br />
o Provide a supportive, encouraging atmosphere for birth, respectful of the woman’s<br />
wishes.<br />
o Ensure privacy <strong>and</strong> confidentiality.<br />
• Ensure mobility:<br />
o Encourage the woman to move about freely.<br />
o Support the woman’s choice of position for birth.<br />
• Encourage the woman to empty her bladder regularly.<br />
Note: Do not routinely give an enema to women in labor.<br />
• Encourage the woman to eat <strong>and</strong> drink as she wishes. If the woman has visible severe<br />
wasting or tires during labor, make sure she is fed. Nutritious liquid drinks are important,<br />
even in late labor.<br />
• Teach breathing techniques for labor <strong>and</strong> delivery. Encourage the woman to breathe out<br />
more slowly than usual <strong>and</strong> relax with each expiration.<br />
• Help the woman in labor who is anxious, fearful, or in pain:<br />
o Give her praise, encouragement, <strong>and</strong> reassurance.<br />
o Give her information on the process <strong>and</strong> progress of her labor.<br />
o Listen to the woman <strong>and</strong> be sensitive to her feelings.<br />
If the woman is distressed by pain:<br />
• Suggest changes of position (Figure 5.1).<br />
• Encourage mobility.<br />
• Encourage her companion to massage her back or hold her h<strong>and</strong> <strong>and</strong> sponge her face<br />
between contractions.<br />
• Encourage breathing techniques.<br />
• Encourage a warm bath or shower.<br />
• If necessary, give pethidine 1 mg/kg body weight (but not more than 100 mg) IM or IV<br />
slowly or give morphine 0.1 mg/kg body weight IM. Do not give Pethidine (to avoid<br />
respiratory depression <strong>and</strong> birth asphyxia in the baby) if you envisage that the baby is<br />
likely to be delivered within 2 hours of administering the drug, especially not in peripheral<br />
centers since Naloxone (0.1mg/kg) that can be used to reverse the respiratory<br />
depressant effect of Pethidine may not be available.<br />
If the woman is infected with HIV, follow national protocols to prevent mother-to-child<br />
transmission of HIV/AIDS.<br />
50<br />
<strong>Integrated</strong> maternal <strong>and</strong> newborn care<br />
<strong>Basic</strong> skills course