Managing Complications in Pregnancy and Childbirth: - IAWG

NORMAL LABOUR AND CHILDBIRTH C-57NORMAL LABOUR• Make a rapid evaluation of the general condition of the womanincluding vital signs (pulse, blood pressure, respiration,temperature).• Assess fetal condition:- Listen to the fetal heart rate immediately after a contraction:- Count the fetal heart rate for a full minute at least onceevery 30 minutes during the active phase and every 5minutes during the second stage;- If there are fetal heart rate abnormalities (less than 100 ormore than 180 beats per minute), suspect fetal distress(page S-95).- If the membranes have ruptured, note the colour of thedraining amniotic fluid:- Presence of thick meconium indicates the need for closemonitoring and possible intervention for management offetal distress (page S-95);- Absence of fluid draining after rupture of the membranesis an indication of reduced volume of amniotic fluid, whichmay be associated with fetal distress.SUPPORTIVE CARE DURING LABOUR AND CHILDBIRTH• Encourage the woman to have personal support from a person ofher choice throughout labour and birth:- Encourage support from the chosen birth companion;- Arrange seating for the companion next to the woman;- Encourage the companion to give adequate support to thewoman during labour and childbirth (rub her back, wipe herbrow with wet cloth, assist her to move about).• Ensure good communication and support by staff:- Explain all procedures, seek permission and discuss findingswith the woman;