1. Place the woman in left lateral position until the baby starts delivering. Then she can be allowed to roll on to her back and draw her legs up for bearing down.
2. Keep her covered with blankets until the baby starts delivering.
3. Put a clean cloth under her buttock.
4. Place a clean pad over the anus.
5. Moister her lips with water if she feels thirsty.
6. Ask her to push as when passing stools, whenever she gets pains.
7. Tell the mother to stop pushing and pant between pains. When the anus bulges and the baby’s head becomes visible, support it from the front as it emerges.
8. When the widest part of the head is through, make pressure with the pad on the anus in the forward direction to deliver the head. Check that there is no membrane covering the baby’s face. If present, remove them.
9. Check that the umbilical cord is not around the baby’s neck. If it is, slip it off over the baby’s head.
10. Deliver the rest of the baby by holding its head.
11. Suck out fluid in the baby’s mouth and nose with a rubber bulb.
12. Dry the baby’s head and trunk. It is does not cry immediately, stimulate its feet by tapping on them gently.
13. Wrap the baby in a dry towel.
14. Clamp the umbilical cord at two places when its pulsations stop.
15. Cut it between the two clamps with a new razor blade or scissors that have been kept in boiling water for at least 10 minutes.
1 6. Do not pull on or cut the umbilical cord. When the placenta separates, the cord appears to lengthen and there is some bleeding vaginally. Then pull on the cord and deliver the placenta attached to the other end of the cord.
1 7. Examine the placenta and membranes to see if any portion of them is left behind. If it is, it needs to be removed or severe hemorrhage may take place.
18. Clean the external genitals of the mother with a hot sponge or a clean cloth. Put one or two cotton pads there.
19. Give her hot tea, coffee or milk.
BLEEDING CONTROL
There is always a little loss of blood when the placenta comes out. If it is more, it must be stopped. Put your hand on her abdomen and massage the uterus that lies below the level of the umbilicus. Shift her to a hospital immediately.
□ CARE OF THE NEW-BORN
1. Hold the baby’s head down so that mucus comes out of his mouth.
2. Keep the baby between the mother’s legs, below the level of the uterus until the cord is tied.
3. If the baby does not begin to breathe right away, rub his back or tickle its soles.
4. Perform suction of the baby’s mouth and then of its nose using mucus catheter or rubber bulb with a narrow pointed end.
5. Dry the baby’s head first and then the rest of its body.
6. Wrap the baby in a clean towel. Then warp it in a blanket to keep it warm.
7. Put the baby to the mother’s breast as soon as the mother’s condition allows.
8. Put one drop of soframycin or gentamicin eye drops in each eye.
9. Tie the cord with two pieces of strong, clean thread. A cord clip may be applied instead, if available. Apply spirit to the cut end of the cord.