UNCONTROLLED WHEN PRINTED
Indications
  • To assist in the safe delivery of a baby.
Contraindications
Contraindications
Patient Factors & Considerations
Procedure
  • All relevant infection control methods to be utilised.
  • Consider vehicle for back-up.
  • Prepare equipment required:
    • Adult and infant BVM
    • Baby mucus extractor & bacterial filter
    • Oxygen
    • Plastic bag
    • Small combine
    • Space blanket
    • Sterile gauze pad
    • Sterile scissors
    • Towel
    • Umbilical clamps
    • Incontinence sheets
  • Reassure mother, remove constrictive clothing and place an incontinence sheet below pelvis.
  • Place in position of comfort.
  • Administer high flow oxygen.
  • Insert IV cannula if clinically indicated
  • Consider appropriate analgesia.

Delivery of the child

  • Identify if delivery is imminent by evidence of crowning[1], contractions 2-3 minutes apart or an urge to push.
  • Coach mother to breathe deeply to relax between contractions and push with contractions.
  • As the baby’s head delivers provide support with one hand to prevent rapid delivery, spreading fingers to evenly distribute pressure on fontanels.
  • Use the other hand to support the perineum with a dressing pad.
  • Once the head is delivered gently slide finger along back of head and neck to ensure cord is not wrapped around neck. If cord is present around neck and loose slide the cord over the baby’s head prior to the next contraction. If it is too tight place two clamps on the cord approximately 3cms apart and cut between the clamps.
  • Guide the baby’s head downwards to deliver the upper shoulder and then gently guide the head upwards to deliver the lower shoulder while supporting the baby[2].
  • Allow the baby to deliver itself without pulling.
  • Suction the mouth and nose of the newborn using a mucus extractor to ensure cleared airway if required.
  • Stimulate baby to induce crying, e.g. rubbing with towel on back.
  • Clamp the umbilical cord with two clamps. Place the first clamp 4 fingers from the baby’s body and then another clamp 2 fingers distal from the first clamp. 
  • Wait for cord to stop pulsating and cut the cord in between the two clamps, ensure no bleeding post cut. If there is bleeding attach another cord clamp.
  • Wrap baby warmly and hand to mother and allow baby to suckle, this will assist in the release of oxytocin and delivery of the placenta.
  • Record delivery time, second officer to perform APGAR (3) and care for newborn.

  1. OBS 1

  2. OBS 3

 Sign0 Points1 Point2 Points
A Appearance (Skin Colour) Blue-gray, pale all overNormal, except for extremitiesNormal over entire body
P Pulse AbsentBelow 100 bpmAbove 100 bpm
G Grimace (Reflex Irritability) No ResponseGrimaceSneeze, cough, pulls away
A Activity (Muscle Tone) AbsentArms and Legs FlexedActive Movement
R Respiration AbsentSlow, irregularGood, crying

Placenta Delivery

  • The suckling of the newborn will induce the delivery of the placenta. The mother will experience the same contractions as with delivery of the baby.
  • Prepare a Bio-hazard bag to place the placenta into when delivered.
  • Do not pull on cord.
  • The placenta may take up to 20 minutes after the delivery of the baby to be expelled.
  • Ensure the placenta is taken with the mother to hospital.

Care of the Mother

  • Apply pad to vagina post delivery, and ensure no excessive blood loss has occurred.
  • Instruct mother to keep pad in place by keeping legs closed.
  • Remove the soiled linen from under buttocks and wipe off any fluids from mother’s legs.
  • Cover mother and keep warm.
  • Monitor mother and baby en route to hospital.
Success
  • Record APGAR at 1, 5 and 10 minutes.
Discontinue
Discontinue
Additional Information

Potential complications:

  • Bleeding prior to delivery
  • Cord prolapse
  • Malpresentation
  • Placenta previa
  • Postpartum haemorrhage
  • Premature birth
  • Shoulder dystocia

References

Colour assist:

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Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

Published Date

Review Date

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