You should always have all midwifery kit and medications needed for normal delivery. These are listed below and indicated in the figure 4.5 and box below:
Birthing equipment
- Clean water, soap and hand towel.
- Apron, goggle, face mask and gown.
- Sterile gloves and clean gloves.
- Sterile or very clean new string to tie the cord.
- New razor blade or sterilised scissors.
- Two sterile clamp forceps, for clamping the umbilical cord before you cut it.
- Mucus trap or suction bulb to suck mucus from the baby‘s airways (if needed).
- Sterile gauze, cotton swab and sanitary pad for the mother.
- Two dry, clean baby towels and two drapes.
- Blood pressure cuff and stethoscope.
- Antiseptic solution for cleaning the mother‘s perineum and genital area.
- 10 IU (international units) of the injectable drug called oxytocin or 600 mg (microgram) tablets of misoprostol. These drugs are used for the prevention of post-partum haemorrhage.
- Tetracycline eye ointment (antibiotic eye ointment used for the prevention of eye infection in the newborn.
- Three buckets or small bowls each with 0.5% chlorine solution, or soap solution and clean water. (To prepare 0.5% chlorine solution you can use the locally available Berekina. Read the concentration from the bottle — if it is 5% you can make a solution of 0.5% strength by mixing one cup of Berekina with nine cups of clean water).
- Plastic bowl to receive the placenta.
- Safety box.
- Vitamin K.
- Pediatric Weight scale
Fig. 4.5. Equipment needed for attending a normal birth. Source RKI-WHO.
What are the things that you should do during the second stage of labour?
Important points during second stage labour
- Continuously provide information, support, and encouragement to the woman and her companion.
- Encourage active pushing once the urge to bear down is present, with encouragement to adopt any position for pushing preferred by the woman, except lying supine which risks aortocaval compression and reduced utero placental perfusion.
- Listen frequently (every 5 minutes) to the fetal heart in between contractions to detect bradycardia.
- Check the maternal pulse and blood pressure, especially where there is a pre- existing problem of hypertension, severe anaemia, or cardiac disease.
- Observe progressive descent and rotation of the presenting part. This includes observing progressive distension of the perineum and visibility of the presenting part, and vaginal examination especially where progress appears to be slow.
- Conduct the delivery with support for the perineum and add flexion on back (occiput) part of the fetus as well as delivering the shoulder one by one to avoid tears.