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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• facilitate breastfeeding.<br />
• encourage the woman to empty her bladder <strong>and</strong> ensure that she has passed<br />
urine.<br />
• ensure the room is warm (25 °C).<br />
• ask the woman’s companion to watch her <strong>and</strong> call for help if bleeding or pain<br />
increases, if the woman feels dizzy or has severe headaches, visual<br />
disturbance, or epigastric distress.<br />
• keep the mother <strong>and</strong> baby together.<br />
• never leave the woman <strong>and</strong> newborn alone.<br />
• document all findings <strong>and</strong> care provided.<br />
Just prior to transfer out of the delivery room or at least one hour after childbirth, ideally the<br />
provider should perform a comprehensive exam of the woman.<br />
Monitoring the Woman 1-6 Hours after Delivery of the Placenta<br />
During the next five hours the woman <strong>and</strong> newborn should be placed in an area where<br />
providers can easily continue to monitor their condition. During hours 1 to 5 after delivery of the<br />
placenta, the provider will monitor the woman as follows:<br />
• Uterine contraction, vaginal bleeding,<br />
blood pressure, <strong>and</strong> pulse:<br />
o every 15 minutes for 1 hour<br />
o then every 30 minutes for the third<br />
hour<br />
o then every hour for three hours<br />
Danger Signs: BP, pulse, vaginal bleeding,<br />
<strong>and</strong> uterus<br />
• Diastolic BP ≥90 mmHg<br />
• Systolic BP 110 beats/minute<br />
• Pad soaked in less than 5 minutes<br />
• Constant trickle of blood<br />
• Estimated blood loss of 250 mL or more or a woman<br />
who gave birth at home <strong>and</strong> presents with persistent<br />
vaginal bleeding<br />
• Uterus is neither hard nor round<br />
• Genital laceration extending to the anus or rectum<br />
Danger Signs: Temperature <strong>and</strong> Respiration<br />
• Temperature >38 °C<br />
• Rapid breathing<br />
• Palmar or conjunctival pallor associated with 30 respirations<br />
per minute or more (the woman is quickly fatigued or has<br />
rapid breathing at rest)<br />
• Temperature <strong>and</strong> respiration<br />
every 4 hours<br />
• Urinary bladder (assist the woman to<br />
empty her bladder, if distended/full, every<br />
hour)<br />
Danger Signs: Bladder<br />
• The woman cannot void on her own <strong>and</strong> her<br />
bladder is distended <strong>and</strong> the woman is<br />
uncomfortable.<br />
• Urinary incontinence<br />
78<br />
<strong>Integrated</strong> maternal <strong>and</strong> newborn care<br />
<strong>Basic</strong> skills course
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