ACTUAL DELIVERY CIRCULATING TO THE MOTHER

1. Washes Hands 1. Washes hands

2. Prepare the equipments needed 2. Prepare the materials needed
 Kelly pad  Footstool
 Receptacle  Unsterile drape to cover the mother
 Sterile ob pack  Bp apparatus with stethoscope
 Nametag of NB
 OB lab gown
 Perineal care tray : pick up forcep in container, soap sud solution,
 Towel for the mother (lengthwise: right pitcher with luke warm water
side out)  Oxytocin or methergine ampule
 Leggings  Syringe 5 cc
 Gyne sheet  Lidocaine 2%
 Towel for the baby (crosswise: wrong side 3. Note the time, method of DR entry of the patient
out) 4. Assist the patient in lithotomy or mc robert’s position
 Sterile surgical gloves 5. Drape the mother
 Primipara set (arrange in sequence accdg. to use) 6. Obtains initial BP
 Sterile pad 7. Does perineal care
 Suction bulb 8. Properly coach the mother on correct breathing technique
9. Properly coach the mother on correct bearing down technique
 2 forceps
10. Note the time of birth, gender
 1 surgical scissor 11. Support the feet of the baby in side lying position without touching the attending
 Placental bowl nurse
 Needle holder
 Thumb forcep 12.
 Tissue forcep
 Hypodermic needles : aspirating needle
(G 19 -21), injecting needle (G 21 – 23)
 Round needle, cutting needle
 10 or 5 cc syringe
3. Prepare the set up aseptically
4. Position the tray on the dominant hand
5. Open the ob pack, open the sterile gloves
6. Scrub hands
7. Wipe hands on the gown.
8. Wear the gown (asking for assistance from the circulating nurse)
9. Don gloves using correct technique *skin to skin, gloves to gloves* (tucking
in the sleeves of the gown on the gloves)
10. Aspirate from vial of lidocaine (asking assistance from the circulating nurse)
11. Charge needle to the needle holder
12. Drape the patient aseptically
 Towel for mother
 Leggings
 Gyne sheet
 Towel for baby
13. Support perineum with sterile pad ( maneuver)
14. Observe for the crowning, movements of the baby
 Engagement
 Descent
 Internal rotation
 Flexion
 External rotation
 Extension
 Expulsion
15. If the head of the baby comes out, support the head, other hand feeling for
cord loop.
16. Suction the baby (mouth nose, nose)
17. Support the baby, while delivering anterior and posterior shoulder
18. Slide hand immediately to support the body of the baby
19. Shouts “baby out!”
20. Position the baby in sidelying position on mother’s abdomen
21. Clamp the cord first on maternal side (8 inches from the baby)
22. Milks the cord towards the baby
23. Clamp the cord on the baby’s side ( 1 inch from the clamp on maternal side)
24. Make sure that the forceps would not hang
25. Cut the cord
26. Roll the cord towards the baby making sure that the pointed area of the
clamp would not touch the baby’s body
27. Roll the cord towards the maternal side
28. Wait for placental separation
29. Observe for the signs of placental separation
 Fundus rises and becomes globular
 Cord lengthens
 Sudden gush of blood
30. Does brandt andrew’s maneuver
31. Prepares the placental bowl
32. Shout’s “placenta out!”
33. Observe for the mechanism of placental delivery, number of cotelidons
34. Give the placental bowl to the circulating nurse aseptically
35. Clean the perineum (asking for assistance of the circulating nurse)
36. Inject methergine or lidocaine as ordered
37. Give the equipments needed for Episiorraphy
38. Does after care of the instruments