Methods of delivery - Management of patient in labour

 Dorsal Position: 

The advantages of this position are the woman can push more effectively.

 

·              Can rest and relax between contractions. Observation of the abdomen is are easily carried out and close observation on her face and general condition, early signs of distress detected.

 

·              No changing of position for the third stage. Clearer view on the perinium. The woman lies on her back with her knees Flexed and wide apart.

 

As soon as the head is delivered, the eyes are swabbed with sterile water from within out using one swab at a time. The nose and the month are cleared of mucus. Feel for the cord round the baby’s neck (Nuchal cord). If the cord is present and loose it should be clipped over the shoulder and the baby delivered through it, if tight, double clamp the cord and cut. Wait for the external rotation of the head which tells that the shoulders are in Anterio-posterior diameter of the outlet and ready to be delivered. With the hands on either sides of the baby’s head or gentle downward traction is applied on the head during the next contraction to free the anterior shoulder from under the symphysis pubis. When the anterior shoulder is delivered, the posterior one and the rest of the body are delivered by lifting the head up. To allow the posterior shoulder to escape over the perineum the more will grasp around the chest to aids delivery of the trunk towards the mothers abdomen by movement of lateral flexion. The midwife checks the time immediately. The baby is then held upside down or at on angle of 450 to drain fluid from the respiratory passage and later laid between the mothers legs. The nose and mouth are sucked clear of remaining mucus with soft rubber catheter and a low grade sucker or by mucus extractor. Double clamp the cord with the artery forceps. Separate the baby from the placenta by cutting the cord between the forceps, ligates the cord. Do the apgar score at 1minute then at 5 minutes later. Show to the mother for identification of the sex, put identification band wipe body, wrap in warm towel and keep in a clean warm cot.