Methods of delivery
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.
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