HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 14-9
Emergency: Childbirth __RN
PURPOSE:
To provide care before, during, or after an unexpected
birth.
EQUIPMENT:
Bulb syringe (if available)
Soap and water
Clean towels
Tape
Blanket
Gauze pads or sanitary pads
Gloves – if available
Protective eyewear and disposable gown (if available)
PROCEDURE:
1. Adhere to Universal Precautions.
2. Ascertain immediate needs of the mother/infant.
Have the mother assume a lithotomy position.
3. Call for emergency assistance.
4. Prior to and during delivery:
a. Wash the mother's perineum.
b. Exert gentle pressure against the head of the
infant with a clean or sterile towel to control
progress. This also prevents undue stretching
of perineum and sudden expulsion of the infant
through the vulva with subsequent
complications.
c. Encourage mother to pant at this time to
prevent bearing down. If membranes have not
ruptured by the time the head is delivered, they
must be removed immediately by tearing them
at the nape of the infant's neck.
d. Holding infant's head in both hands gently exert
downward pressure towards the floor, therefore
slipping the anterior shoulder under the
symphysis pubis.
e. If the cord is looped around the infant's neck,
gently slip it over the infant's head.
f. Support the infant's body and head as it is born.
g. Pick infant up gently by feet with head down, to
help drain mucous and prevent aspiration.
Gently rubbing the infant's back may stimulate
breathing. It is important to immediately clear
the nasal passages and mouth thoroughly. You
can do this by using your finger, a gauze pad or
a bulb syringe.
h. If infant is not breathing, use gentle mouth-tomouth
breathing.
i. After infant cries, dry and wrap baby with clean
towel and place on mother's abdomen where
she can see him/her. This is to reassure the
mother and apply weight over the uterus to help
the uterus to contract.
j. Watch for signs of placental separation.
5. When placenta is delivered, do the following:
a. When cord stops pulsating gauze in two places
between the mother and newborn leave
placenta attached to newborn and place
placenta in plastic bag or wrap in a towel for
transport to hospital.
b. Do not cut cord. The physician will cut it later.
c. If placenta does not separate, continue
massaging uterus.
6. After the birth:
a. Depending on the immediate needs of the
mother and infant, observe the mother for
bleeding, and initiate appropriate emergency
procedures, e.g., treatment for shock if
necessary.
b. Check fundus for firmness and massage if
indicated. Breast feeding will stimulate
contractions to reduce risk of excessive
bleeding.
c. Assist in preparing mother and infant for
transportation to medical facility. Remain with
mother until assistance arrives.
d. Discard soiled supplies in appropriate
containers.
AFTER CARE:
1. Record and send pertinent information with mother:
a. Time of birth.
b. Condition of infant, i.e., color, cry, activity, vital
signs.
c. Any pertinent observations of mother and infant.
2.Contact physician and document discussion.
3.Inform nursing supervisor.
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