The final assessment we will describe in this study session is to check the mother's external genitalia and the inner surface of her vagina for warning signs. Look carefully to see if there is:

• Any abnormal discharge (thick yellowish or white and foul smelling) from the vagina, or inflamed sores on the external genitalia, which may be due to a urinary tract infection or sexually transmitted infection.
• Vaginal scarring due to injury during a previous birth, or from female genital mutilation (circumcision). This increases the risk of a fistula occurring during labour (a torn opening between the vagina and other organs).
• Is there swelling in the vagina, and if there is, could it obstruct the passage of the baby?

If you see any of the signs above, you should refer the mother to a health facility, unless the labour is advanced and the baby is about to be born. In the next study session, we describe how to care for the woman in labour.