2. ◦In advance prepare a decontamination
solution by mixing 1 part % Chlorine
bleach to 9 parts water to make 0.5%
chlorine at the beginning of each day or
wherever solution is very contaminated or
cloudy.
4. Prior to woman’s transfer to delivery
room
◦Ensure that the mother is in her position of choice
while in labor.
◦Ask the mother if she wishes to eat/drink or void.
◦Communicate with the mother: inform with the
progress of labor, give reassurance and encouragement
5. Woman at the delivery room: Preparing
for delivery
◦Check temperature in delivery room area to be in 25-
28 C and eliminate air draft.
◦Ask woman if she is comfortable in the semi upright
position.
◦Ensure woman’s privacy.
6. ◦Remove all jewelry then wash hands thoroughly
observing the WHO 1-2-3-4-5 procedure.
◦Prepare a clean, clear newborn resuscitation area.
Check the area if clean, functional and with in easy to
reach.
◦Arrange materials in linear sequence:
Gloves, dry linen, oxytocin injection, cord clamp, cord
pr bandage scissor, 2 kidney basins.
7. ◦In a separate sequence, before after the 1st breastfed.
◦Eye ointment, stetoscope, Vitamin K 0.1 ml , Hepatitis
B 0.5 ml, BCG vaccine, thermometer, cotton swab or
cotton balls with ROH, dry cotton balls and waste
receptacle.
◦Clean the perineum with antiseptic solution
◦Wash hands and put on 2 pairs of sterile gloves
aseptically. (If same worker handles perineum and
cord.)
8. At the time of delivery
◦Encourage women to push as desired.
◦Drape mother’s abdomen with clean linen in
preparation for drying the newborn.
◦Applied perineal support and control delivery of the
head.
9. ◦Call out time of birth and delivery of baby.
Baby boy out 9:00 am
Baby girl out 9:00 am
oInformed the mother of the outcome.
10. First 30 seconds
◦Dry the baby for at least 30 seconds, starting from the
face and head, going down to the trunk and lower
extremities while performing a quick check for
breathing.
11. 1 – 3 minutes
◦Remove wet cloth.
◦Place the baby in skin-to-skin contact on the
mother’s abdomen or chest.
◦Cover the baby with dry cloth and baby’s head with
bonnet.
12. ◦Excluded a second baby by palpating the abdomen
in preparation for giving oxytocin.
◦Use wet cloth to wipe the soiled gloves. Administer
Oxytocin IM within 1 minute of baby’s birth. Dispose
wet cloth properly.
◦Remove 1st set of gloves and decontaminate them
properly in 0.5% Chlorine solution for at least 10
mins.
13. ◦Palpate umbilical cord for pulsations.
◦After pulsations stop, clamp the cord using the cord
clamp 2 cm from the base.
◦Place the instrument clamp or forcep 5 cm from the
base.
◦Cut near the cord clamp.
14. Perform the remaining steps of AMSTL
◦Wait for strong uterine contractions then apply control
cord traction and counter traction of the uterus,
continuing until the placenta is delivered.
◦Check VS every 15 mins for the 1st hour then q 30 mins
for the next hour and q hourly thereafter.
◦Examine the placenta for completeness and
abnormalities.
15. ◦Clen the mother, flush the perineum and apply diaper.
◦Check the baby’s color and breathing, check the
mother if comfortable and uterus is contracted.
◦Dispose the placenta in a leak proof container or
yellow bag.
16. ◦Decontaminate instruments in 0.5% Chlorine solution
before cleaning and 2nd pair of gloves before
disposing for at least 10 mins.
◦Advise mother to maintain skin to skin contact. Baby
should be prone on mother’s chest/in between breast
with head turned to one side.
17. 15-90 minutes
Advise mother to observe for feeding cues and cited
examples of feeding cues.
Support and instruct mother on positioning and
attachment.
Wait for full breastfeeding.
After a complete breastfeeding: administer eye
ointment, inject Vit. K 0.1ml and Hepa Vaccine 0.5ml
and perform antroprometric measurements.
18. ◦ Advise delayed/optional bathing of the baby.
◦ Advise breastfeeding per demand.
◦ In the 1st hour check baby’s breathing, color and check mother’s
VS and massaged uterus every 15mins.
◦ In the 2nd hour chek mother baby dyad every 30 mins -1 hour.
◦ Complete all RECORDS
