Republic of the Philippines

Laguna State Polytechnic University

Province of Laguna
COLLEGE OF NURSING & ALLIED HEALTH

Name: Garcia, Jairus Aztrid M. Date: Nov. 7, 2020

Group: 4
Instructor/Evaluator: Sir Jaymar E. Rogado Position: RN, MAN
Essential Intrapartum Newborn Checklist (EINC
Procedure Rationale

PRIOR TO WOMAN’S TRANSFER TO THE D.R.

Ensure that the mother is in her position
of choice while in labor.
Ask mother if she wishes to eat/drink or
void.
Communicate with the mother and inform This helps the mother to be informed of her
her progress of labor, and give
reassurance and encouragement
This helps to allow the mother to achieve
her greatest comfort during labor.
-It is not advisable for a mother in labor to
eat or drink prior to the delivery because she
will just eliminate those during the delivery.
-Voiding is okay as it helps the mother
achieve comfort prior to delivery.
status, and make her relax. Thus, ensuring
safe parturition.

WOMAN ALREADY IN THE D.R. AND PREPARING FOR DELIVERY

Check temperature in the DR area to be
25-28℃(ideal temperature in the D.R. for
newborn) and eliminate air draft.
 -The air conditioner is turned off at
the time of delivery.
 -To check for air draft, hold a piece of
tissue up and observe its movement.
If it falls straight to the ground, then
there is no air draft. But, if the tissue
sways upon falling to the ground then
there is an air draft. Immediately
check and close the windows or door.
 -Eliminating air draft is important as it

Ask woman if she is comfortable in the
semi-upright position (the default position
of the delivery table.)
Ensure the woman’s privacy.
Remove all jewelries, then wash hands
thoroughly by observing the WHO’s 1-2-
3-4-5 procedure.
Prepare a clear clean newborn
resuscitation area and check the
equipment if it’s clean, functional, and
within easy reach.
Arrange the material supplies in a linear
sequence:
Gloves, 2 dry linen, bonnet, oxytocin
injection, plastic clamp, Kelly clamp,
mayo scissors, 2 kidney basins.
In a separate sequence, for after the first
breastfeed:
Eye ointment(erythromycin), (stethoscope
to symbolize PE), vit. K, hepatitis B and
BCG vaccines (plus cotton balls, etc.)
Clean the perineum with antiseptic
solution.
Wash hands and don 2 pairs of sterile
gloves
prevents the newborn to lose heat by
convection when air currents carry
heat away from the baby’s body
surface.
This helps to allow the mother to achieve her
greatest comfort during delivery.
Close the door or curtains to provide privacy
This is done to prevent disruption upon the
delivery, as well as to reduce the
transmission of microorganisms.
This is done to place the set of equipment
needed for the delivery, to ensure safe
progress of delivery, and to provide the best
way of delivering a baby.
This is done to easily identify and use the
instruments and supplies upon the delivery.
This is done to reduce microorganisms.
-This is done to reduce the transmission of
microorganisms.
-Double gloving is done if you’re going to
handle both perineum and cord.

AT THE TIME OF DELIVERY

Encourage the woman to push as
desired.
Drape a clean, dry linen over the mother’s This serves as the area for the newborn to be
abdomen
Apply perineal support and control of
delivery of the head.
Call out time of birth and sex of baby.
This helps the mother to push down the best
she can.
placed, and prepare for the drying of the
newborn.
This is done to safely handle the newborn
once it comes out of the birth canal and
perineum.
This is done to inform the health care
provider who is assigned to document the
findings.
 Inform the mother of outcome.
FOR 30 SECONDS
Thoroughly dry the baby for at least 30
seconds starting from the face and head,
going down to the trunk and extremities
while performing a quick check for
breathing and applying APGAR scoring
FOR 1-3 MINUTES
Remove the wet cloth
Place the baby in a skin-to-skin contact
on the mother’s abdomen or chest in a
prone position.
Cover the baby’s back with a dry linen
and the baby’s head with the bonnet
Exclude a second baby by palpating the
abdomen in preparation for giving
oxytocin.
Use the wet cloth to wipe the soiled
gloves.
Then. give 10 IU oxytocin IV within 1
minute of baby’s birth.
This is done for the mother to be informed
about the sex and status of her baby.
 -This is done to stimulate the baby to
breathe and prevent hypothermia.
 -Do not wipe off the vernix caseosa as
it continues to provide a natural
protective cover for the baby, against
infection, as well as it helps to
insulate the baby, and thus
preventing hypothermia
 -Do not wash the baby within the first
6 hours because washing can lead to
hypothermia and infection.
 - To identify the baby’s appearance,
pulse, grimace, activity, and
respiration whether if extra medical
care or emergency care is needed.
As it is already wet and dirtied, and to
prevent the baby from getting cold.
This helps to achieve success in
breastfeeding, lymphoid tissue system
stimulation, exposure to maternal skin flora,
protection from hypoglycemia,
thermoregulation, and last but not the least,
promotion of the mother-child bonding.
To provide warmth and comfort
This is done to determine if there is a second
baby. If there is one, do not give the oxytocin
now, and reassess for the delivery of the
second baby.
-This is done to remove the debris from the
gloves
-Oxytocin is given IM or IV to prevent uterine
atony, a condition in which the uterus fails to
 contract after the delivery of the baby and it
can lead to a potentially life-threatening
condition known as postpartum hemorrhage

-as it is already wet and dirtied.

Dispose of wet cloth properly.
Remove the first pair of gloves and
decontaminate them in a 0.5% chlorine
solution for at least 10 minutes
Palpate the umbilical cord for 1 to 3
minutes
After the cord pulsations have stopped.
Clamp the umbilical cord with a sterile
plastic clamp at 2 cm from the base.
Then, use the Kelly clamp to clamp the
cord at 5 cm from the base
This is done to disinfect the used gloves as a
0.5% chlorine solution is an antiseptic one,
thus removing bacteria and other
microorganisms and preventing infection
This is done to check for cord pulsations.
Not cutting the cord immediately gives
benefits, such as it helps to prevent anemia
and protects preterm(s) from intraventricular
hemorrhage

Cut the cord by using a mayo scissor

near the plastic clamp
Perform controlled cord traction -This is done to deliver the placenta
by placing the Kelly clamp near the
woman’s perineum to make CCT easier.
Then, hold the cord near to the perineum
using the Kelly clamp.
Place the palm of the other hand on the
lower abdomen just above the woman’s
pubic symphysis to assess for uterine
contractions. (If a clamp is not available,
CCT can be applied by encircling the cord
around the hand)
When there is a contraction, apply
external pressure on the uterus in an
upward direction with the hand just above
the pubic symphysis. At the same time
with your other hand, pull with firm,
steady tension on the cord in a downward -Avoid jerky or forceful pulling. Do not
direction release support on the uterus until the
placenta is visible at the vulva. Deliver the
placenta slowly and support it with both
hands.

As the placenta is delivered, hold and

gently turn it with both hands until the
membranes are twisted. Slowly pull to
 complete the delivery. Gently move
membranes up and down until delivered.
Massage the uterus after the delivery of
the placenta until it is firm
Inspect the lower vagina and perineum
for lacerations/tears
Examine the placenta for completeness
and abnormalities
Clean the mother, by flushing the
perineum and apply perineal
pad/napkin/cloth.
Check the baby’s color and breathing;
Check if the mother is comfortable, and
palpate the uterus every 15 minutes for 2
hours
Dispose the placenta in a leak-proof
container or plastic bag.
Decontaminate instruments before
cleaning (soak in 0.5% chlorine solution,
Decontaminate 2nd pair of gloves before
disposal stating that decontamination
lasts for at least 10 minutes.
Advise mother to maintain skin-to-skin
contact. Baby should be prone on
mother’s chest/in between the breasts
with head turned to one side.
FOR 15-90 MINUTES
Advise mother to observe for feeding
cues and cite examples of feeding cues.
This is done to promote uterine contractions.
Thus, reducing PPH
This is done to determine if repairs are
needed, and thus preventing PPH
This is done to determine that no part of the
placenta have been retained as this may
result in a PPH
This is done to remove debris, such as blood,
wastes, or secretions.
This is to done to determine if the baby is
cyanotic or not, and if necessary,
interventions are needed, such as ventilation
and such.
-This is done to make it is firm.
This is done to prevent infection.
This is done to disinfect the used gloves as a
0.5% chlorine solution is an antiseptic one,
thus removing bacteria and other
microorganisms and preventing infection
This helps to achieve success in
breastfeeding, lymphoid tissue system
stimulation, exposure to maternal skin flora,
protection from hypoglycemia,
thermoregulation, and last but not the least,
promotion of the mother-child bonding.
It means that the baby is ready to breastfeed
 Instruct her and support on positioning
and attachment.
Wait for FULL BREASTFEED to be
complete
After a complete breastfeed, do Crede’s
prophylaxis, administer eye ointment,
Thoroughly examine the baby, get the weight,
anthropometrics measurement and check
patency of the anus through rectal
temperature and record.
then inject Vit K 1 mg IM at left vastus
lateralis,
Next, Hepatitis B .5 mg IM at right vastus
lateralis,
These are important interventions that are
correct and safe for both mother and baby.
Because after that, the administration of
vaccines is accomplished
-Eye ointment(erythromycin) is given for the
prevention of eye infections like Ophthalmia
neonatorum, conjunctivitis in newborns that
occurs within the first 30 days of life. It is
caught during birth by contact with the
mother's birth canal that is infected with an
STD.
 To determine if the baby is Small for
Gestational Age (less than 2.5 kg) or
Large for Gestational Age (more than
4 kg) or normal (2.5 to 3.5)
 The baby’s head circumference must
be 34-35 cm. if more than 33,
suggests occipitofrontal
circumference
 The baby’s chest circumference must
be 32-33 cm
 The baby’s length must be 46-50 cm
 The baby’s abdominal circumference
must be 29-33 cm
 Rectal temperature is done to
determine if there is an imperforated
anus.
 The baby’s temperature must be 37.2
-Vitamin K helps the blood to clot and
prevent serious bleeding. In newborns, they
have low levels of vitamin K that’s
why vitamin K injections are given to prevent
a bleeding disorder called 'hemorrhagic
disease of the newborn' (HDN).
-to prevent liver disease and cancer from
hepatitis b virus

and Bacillus Calmette Guerin injections .
05 ml at deltoid region
Advise OPTIONAL/DELAYED bathing of
baby
Cord Care, put nothing on the stump and
keep it loosely covered with clean and dry
clothes.
Dress the baby by folding diaper below
stump.
Attach and secure name tag on the lower leg
or upper foot
Swaddle the baby with a towel
Advise breastfeeding per demand of the
baby
In the first hour; check baby’s breathing
and color and checked mother’s vital
signs
and massaged uterus every 15 minutes.
In the second hour; check mother-baby
dyad every 30 minutes to 1 hour.
But after the first 90
minutes
Keep the newborn in the room with her
mother. Do not separate them and
support exclusive breastfeeding on
demand day and night
Complete all RECORDS.
-to prevent severe TB in infants, which can
affect the lungs and the brain.
Because washing is usually done after 6 hours
to prevent hypothermia
 Because there are no such studies
that binding a baby’s umbilicus can
improve the removal of the stump.
 To provide warmth and comfort
 To allow the baby to void and
defecate inside of it, and thus
preventing leakage and wetting of the
surface
 To easily identify the baby
 To provide warmth and comfort
Because breastfeeding allows the baby to be
satisfied with his hunger and get enough milk
for nutrition and immunity. It also benefits
the development of emotional and cognitive
aspects.
-This is to done to determine if the baby is
cyanotic or not, and if necessary,
interventions are needed, such as ventilation
and such. And to determine the mother’s
status
-This is done to make it is firm.
To ensure safety and effective care
 To promote maternal-child dyad
Because breastfeeding allows the baby to be
satisfied with his hunger and get enough milk
for nutrition and immunity. It also benefits
the development of emotional and cognitive
aspects.
For baseline data and future references