Integrated Maternal and Newborn Care Basic Skills Course ...

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