In addition to their delivery bags, midwives “carry” many other invaluable tools ... family planning, delivery preparation, postnatal counseling and breastfeeding. ... With this equipment, we can recover 80% of newborns. ... “Midwifery feels good when both the mother and baby come out of the labor ward alive.

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PREPARATION FOR DELIVERY OF
MOTHER, BABY AND MIDWIFE AND
EQUIPMENTS
MUKESH SAH, MD

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 Before second stage of labor reached, the delivery room should be
prepared for the birth of the baby.
 Room and floor should be cleaned with soap water and antiseptic
solutions.
 Maintain proper and adequate lightening and adequate ventilation.
 Maintain room temperature, up to 25degree centigrade.
 Prepare perineal light.
 Maintain safe environment i.e. dry and clean floor, clean beds
and furniture which are in order form, beds with step.
 Maintain comfortable by adjusting bed with pillows and blankets,
mackintosh to protect the bed and floor, floor bucket to collect
soiled things, clean sheet to cover the mattress.
PREPARATION OF DELIVERY ROOM (1/2)

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• Keep ready episiotomy set.
• Keep ready IV stand including IV set, Iv drip RL or NS, IV cannula,
sprit swab, tape etc.
• Prepare oxygen cylinder, nasal tube, emergency medicines and
suctioning machine.
• Keep ready neonatal resuscitation set, warm baby clothes,
weighing scale, room heater etc.
• Prepare for patient trolley for emergency transfer.
• Prepare screen, bed pan and vital sign set.
• Keep ready sterile pads, gauze pieces, cotton balls, drugs,
antiseptic solutions and local anesthetic drug for perineal
infiltration.
PREPARATION OF DELIVERY ROOM (2/2)

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The birthing table is prepared and instruments are arranged on the
instrument table.
The equipment needed for delivery should be sterilized and should
be kept ready and in working condition and accessible.
Keep ready all materials for baby and mother including
resuscitation set, oxygen, suction and warm dry clothes as well
as needed medicines.
DELIVERY SET:
• Sponge holder or forceps for cleaning of vulva-1
• Plain artery forceps for cord clamp-2
• Cord cutting scissors for cord cutting-1
• Galipot for anesthetic solution-1
PREPARATION OF EQUIPMENTS FOR DELIVERY

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• Bowl for placenta or collection of blood-1
• Gauze piece and cotton ball for swabbing.
• Perineal pads 3-4 piece
• Sterile clothes-
Perineal sheet-1
Baby wrapper-2
• Sterile gloves and gown for midwife/skill birth attendants.
• Antiseptic solution or boiled water.

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Sponge holder forceps Plain artery forceps

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Cord cutting scissors

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• Episiotomy scissors-1
• Small artery forceps-2
• Tooth dissecting forceps-1
• Non-tooth dissecting forceps-1
• Suture cutting scissors-1
• Small galipot-1
• Chromic catgut No 2.0 -1
• Gauze piece and cotton balls and perineal pads as needed.
• Xylocaine injection.
• 10ml syringe.
• Distilled water for dilution of local anesthesia.
EPISIOTOMY SET

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Episiotomy scissors Tooth dissecting forceps

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Suture cutting scissors Chromic catgut

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• Different size of syringe; 2cc, 3cc, 5cc and 10cc with needles 20
gauze, 21 gauze and 18 gauze.
• Container with spirit swabs.
• Container with dry clean gauze or cotton ball.
• IV cannula in different size that is 16, 18, gauze for mother and 26
gauze for neonate.
• Adult IV set.
• Pediatric IV set.
• IV fluid-5% dextrose, RL NS and haemaccele
• Tape or adhesive tape and tourniquet.
EQUIPMENTS WITH MEDICINE MUST BE
AVAILABLE IN THE LABOR ROOM

12. 4THCOFFEE • Injection ergometrine.
• Inj. Oxytocin.
• Inj. Magnesium sulfate.
• Inj. Dexomethasone
• inj. Hydralyzine
• Inj. Lignocaine
• Inj. Pethidine/ diazepam/morphine.
• Inj. Metoclopramide, promethazine or Phenergan.
• Inj. Vitamin k
• Vitamin A capsule
• Inj. Glucose 25% and 50% ampules.
• Inj calcium gluconate
• Inj. Atropine, adrenaline

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• Suction machine.
• Oxygen.
• Pre-warmed baby wrapper (soft, dry cloth) and blanket.
• Identification band.
• Eye ointment or drop, whatever available.
• Cotton ball soaked in sterile normal saline.
• Cord clamp.
• Tape measuring and weighing machine.
EQUIPMENT AND MATERIALS NEEDED FOR BABY

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• Resuscitaire with overhead radiant heater (switched on) and light,
piped oxygen, manometer and suction.
• Infant laryngoscope, spare batteries and bulb.
• Neonatal endotracheal tube in different size-2.5, 3.0 and 3.5 mm
size and connector and with plastic stylet.
• Mucus extractor.
• Suction catheter size, 6,8,10.
• Newborn size mask.
• Syringes 2cc, 3cc and 5cc.
NEONATAL RESUSCITATION SET

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• Drugs-inj. Naloxane hydrochloride 1ml/ampule (400microgram/mp)
-sodium bicarbonate 8.5%, 7.5% and 4.2%,
- Dextrose 5% and 25%.
- Vitamin k
- Normal saline.
• Pediatrics IV set, 26gauze, butterfly needle, spare needles etc.
• Sprit swab
• Warmed dry towels
• Adhesive tape.

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Neonatal Endotracheal Tube and stylet

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Resuscitaire Laryngoscope

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Mucus Extractor Suction Catheter

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Newborn size mask

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Perineal light

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Women should be kept in the bed.
Positioning of women during labor may be lateral or partial
sitting. Dorsal position with 15 degree left lateral tilt is commonly
favorable to avoid aortocaval compression and facilitates
pushing.
Toileting of the external genitalia should be done by using
antiseptic solutions.
One sterile sheet should be placed beneath the buttocks and
above the abdomen of the mother.
Never leave the women alone.
Ensure the bladder is empty.
Sponge the face with soaked towel.
PREPARATION OF MOTHER (1/3)

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• Provide water and juice.
• Keep constant monitoring of fetal, mother and labor conditions.
FETAL CONDITION:
Check fetal heart sound in every 5-15minutes till delivery or apply
continuous monitoring if possible.
• Record its rate and rhythm per minute.
• Observe for membrane rupture and its color and detect accidental
cord prolapse.
• Record and report any abnormalities.
PREPARATION OF MOTHER (2/3)

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MATERNAL CONDITION:
• Check pulse every 15minutes and BP every hourly and record it.
• Watch for maternal distress and inform any abnormalities.
LABOR CONDITIONS:
• Observe and record the progress of labor by abdominal and
vaginal examination.
• Monitor the labor condition, e.g. uterine contraction, its strength
and interval of contraction on abdominal examination and descent
of presenting part and rotation of fetal head by vaginal
examination.
PREPARATION OF MOTHER (3/3)

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 Collect all necessary information from women and chart, which
are necessary for delivery.
 Timing of self preparation depends on the rate of labor
advancement and parity of the mother.
- In multiparous women, who is progressing rapidly, scrub towards
the end of first stage of labor.
- In primigravida, when full dilatation of cervix occurs or crowning of
the head occurs during contraction.
 Early scrub tends to become contaminated and risk of infection.
 Prepare the oxytocin injection 10 unit for 3rd stage management.
 Put on clean and dry plastic apron.
PREPARATION OF MIDWIFE/NURSE (1/2)

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 Nails should be shortened; hair should be tidy and removed all
ornaments.
 Wash the hands with soap and running water.
 After washing or scrubbing the hands, dry on air or dry with sterile
towel by keeping the palm upwards in Namaste position.
 Prepare delivery set and open the delivery set.
 Put on sterile gloves.
 Keep the all necessary equipment's and article near by her.
 Ask the circulating nurse/circulating health worker to monitor fetal
heart sound, contraction and maternal vital regularly.
PREPARATION OF MIDWIFE/NURSE (2/2)

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• Durga Subedi, Saraswoti Gautam, part-II, Midwifery Nursing. Page
no:-78-82.
REFERENCES