MIDWIFERY CARE IN LABOR

Lecturers: Dr. KrisdianaWijayanti, M.Mid

Compiled by:

1. Anis Fitrotun Nada P1337424619024

2. RafikaAuliaKhijrotul I. P1337424619025
3. Mala IntaninDhuha P1337424619026
4. DintyaOktaviaPutri P1337424619027
5. Novita Sri Irawati P1337424619029
6. AyuRachmawati P1337424619030

SEMARANG POLTEKKES MINISTRY OF HEALTH

PRODI'SMIDWIFERY BLORA DIII

ACADEMIC YEAR 2020/2021

 Prologue

Praise Allah SWT for completing this paper, about "Midwifery Care In Labor" which is
presented systematically and clearly. Prayers and greetings, hopefully always poured out to our
great lord, Prophet Muhammas SAW, who has shown the straight path in the form of Islamic
teachings so that it becomes a gift and blessing for the universe.

Thepurpose of this paper is to fulfill one of the tasks of English in Midwifery with Dr.
KrisdianaWijayanti, M.Mid. We are aware of the deficiencies in the preparation of this paper.
We hope that this paper can be useful for all of us. To our readers, we apologize if in the
presentation of this paper there are still many deficiencies or errors. We really hope for
constructive criticism and suggestions for further improvement.

           

                                                                                                Blora, 26 January 2021

Author

 
 NORMAL PERSONAL MIDWIFERY CARE AT MRS. E 33 YEARS OLD

G2P1A0 AT PRACTICE INDEPENDENT MIDWIFE’S LANGGENG SRI ASIH S.ST

Date : May 12, 2018

Hours : 08.25 a.m

STAGE 1

A. SUBJECTIVE DATA
Wife Husband
Name : Mrs.E Mr. T
Age : 33 years old 38 years old
Religion : Islam Islam
Tribe : Javanese Javanese
Education : Senior High School Senior High School
Occupation : Housewife Enterpreneur
Address : Melati street number 10 Melati street number 10

1. Reason for entering the delivery room Mother said she was 37 weeks pregnant, mother
said she felt tight and mucus since 12 May 2018 at 02.00 a.m
2. Signs of labor
Regular speeding since May 12 2018 at 02.00 a.m
Vaginal discharge
Blood mucus : There is
Amniotic fluid : Has not broken
Blood : There is a little brownish blood
3. Menstrual history
Menche : 12 years old smell : Typical blood
Old : 5- 7 day cycle : 28 days
Blood characteristics : Liquid complaints : None
 4. History of pregnancy
The first day of the last menstuation : 27 August 2017
Approximate day of birth : 3 June 2018
ANC visits :
TM I : 1 time

TM II : 1 time

TM III : 2 times

- Habits that interfere with health

Mother said they doesn’t have habits that interfere with health such as smoking and
drinking
- Immunization
Mothers say they have immunized complete
fetal movement24-hour : more or less 13 times

5. Obstetric history : G2P1A0

6. Past history of pregnancy, childbirth and the puerperium

a. Past pregnancy, childbirth and postpartum history

Preg- Labor Lactation

nant
Born Gestat Type of Helper Complication Gender Weig- Compli-
ional Labor ht cation
Age
1 2010 38 Normal Midwi No Male 3200 No
-fe complication complicati
on

b. History of contraception

The mother said that she had used injectable contraceptives for 3 months
 7. Medical history

Mother’s said that she had no history of infectious diseases (HIV / AIDS, tuberculosis,
hepatitis), chronic diseases (heart disease, hypertension), decreased diseases (Diabetes
mellitus, asthma) and no history offspring of twins.

8. The pattern of fulfilling daily needs

a. Nutritional pattern

Eat : 3 times / day, 1 full portion of rice, side dishes

Drink : 5-7 times / day, water, tea

b. Elimination

Defecation : 1 times / day, dense, brownish and no complaints

Take a pee : 4-6 times / day, a lot, yellowish color, no complaints

C. Rest

Naps : 2 hours / day

Night sleep : 7–8hours / day

d. Patterns of activity : taking care of the house, children and husband

e. Personal hygiene : Mother takes a shower twice / day, brushes her teeth 2 times /
day, changes clothes 2 times / day

9. Psychosocial spiritual data

Mother’s says that her family and husband support her pregnancy, the mother says she
performs prayers 5 times a day , the mother said that she was already in labor

B. OBJECTIVE DATA

1. General description

General condition : Good

Awareness : Composmetical
 Vital sign Blood pressure : 120/70 mmHg pulse : 82 x / minute

Respiration : 21 x / minute temperature : 36.7 ° C

Weight : 66 kg

Height : 154 cm

Arm circumference : 33 cm

2. Physical examination

a. Head : No odem , no dandruff, clean hair, black color

b. Face : Symmetrical, no cloasmagravidarum

c. Eyes : Symmetrical, not anemic, not icteric

d. Nose : Symmetrical, no swelling of the polyp gland

e. Mouth : Symmetrical, moist, no dental caries, clean, no stomatitis

f. Neck : No swelling of the thyroid, lymph glands, and enlarged jugular veins

g. Ear : Symmetrical, no secretions

h. Chest : Symmetrical, no retraction

i. Breast : Symmetrical, protruding nipples, colostrum is out, hyperpigmentation in

aerola

j. Abdomen: There are no surgical scars, there are striegravidarum and lineanigra

Palpation Leopold

Leopold 1 : Uterine Fundal Height 2 fingers under the umbilical cord, the fundus is
rounded, soft and not bouncy (buttocks)

Leopold 2 : On the right, the long part is felt and there is hard resistance (back), on
the left a small part of the fetus is felt (ekstermitas)

Leopold 3 : On the lower abdomen you can feel a round, hard and bouncy part (head)
has entered the upper pelvis (divergent)
 Leopold 4 : Decrease 3/5 (hodge 2)

Fetal Heart Rate : 135 times / minutes

Contraction :3 times in 10 minutes 30 second long

k. Genetalia : No odema, no varices

l. Deep Examination

The vaginal wall is slippery, there is no lump, thin portion, 2 cm opening, intact
amniotic fluid, head presentation, forehead indication, 2 decrease in hodge.

m. Anus : There are no hemorrhoids

n. Limbs

Hands : no edema, clean nails, not pale

Feet : no edema, no varicose veins, right (+) left (+) patellar reflex.

3. Supporting data

There is no checking of supporting data

C. ASSESMENT

Mrs. E age 33 years old G2PIA0, Gestasional Age 37 weeks inpartum 1 latent phase, single
intra-uterine fetus, back of the head presentation

D. PLANNING

Date: May 12 2018 hours: 08.25 a.m

1. Explain to mother that her condition is currently in good condition

Evaluation: Mother know about her current condition that her condition is in good
condition
2. Provide information consen that the mother is willing to give birth at Practical
Independent Midwife’sLanggeng Sri Asih
Evaluation: Mother has agreed
 3. Explain to the mother that back pain that runs down the lower part is normal because of
the opening and guiding the mother to remain relaxed.

Evaluation: The mother already understands that the pain inside is normal

4. Give the mother soft or liquid food to increase her energy and so that the mother doesn’t
feel weak when pressing
Evaluation: The mother has been given 2 cups of soft food in the form of energy
5. Prepare parturition set, heacting set and medicines
Evaluation: Parturition set, heacting set and medicines have been prepared
6. Provide a comfortable position for the mother
Evaluation: Mother wants to sleep on her left side
7. Observation of the 1st stage of monitoring
Monitoring the 1 stage

Hours Dilatation Contraction Amniotic fluid Fetal Heart

Rate
08.25 2 cm 3 times in 10 minutes 30 Intact 135 times /
seconds long minutes
08.45 10 cm 5 times in 10 minutes 45 Spontaneous 135 times /
seconds long rupture minutes

Stage II
Date :May 12, 2018 houre : 8.45 Am

A. SUBJECTIVE DATA
Mother said more and more and i can affroad again holding back his urge to accept
B. OBJECTIVE DATA
1. Inspection
Push to push, presure on the anus, protruding penineum, vulva open, seen spontaneous
rupture of membranes
2. Palpation
 Indication : there is
Vagina : slippery, no lumbs
Cervix : not palpable
Opening : 10 cm
The amniotic membrane : Ruptured
Lowest fetus : head
Fetal head drops : front crown
Fetal heart rate : 135×/minute
Contraction : 5 time in 10 minutes 45 seconds long

C. ASSESMENT
Mrs. E 33 years old G2P1A0 37 weeks pregnant of second stage labor

D. PLANNING
Date : May 12, 2018 hours : 8.45 a.m
1. Tell the Mother that the opening is complete And mom it's time to give brith
Evaluation : the mother al ready knows the result of the examination and know that the
mother has intered labor
2. Present a husband or family to accompany the mother in giving brith
Evaluation : mother is accompanied by her child
3. Arrange the position of the mother half sitting or according to the mother wishes
Evaluation : mother is comfortable with sleeping position
4. Do it normal delivery assistance
- Asking Husband or family to accompany the mother
- preparing for maternal birth assistance
- put a towel over the mother's stomach
- put on the gloves
- guide the mother to accept
- attach fabric 1/3 of the buttocks
 - After ponding the baby's head then protect the perineum with one one covered with a
clean, dry cloth. the other hand holds the back of the head to maintain a deflection
position
- Check if there is a twist of the umbilical cord
- Wait for the baby to do the outer rotation
- Biparental hand to deliver baby’s shoulder
- Support the baby’s shoulders, trace the baby’s body to the legs
- Put a cursory value on the mother’s stomach
- Dry the baby with a towel
- Check the uterus again to make sure only one baby was born
- Explain an tell the mother to be injected with oxyticin IM in the thigh so that the uterine
contractions of the mother are good
- Cut the umbilical cord with one hand at about 5 cm from the baby's navel, then massage
it towards the baby 3 cm then clamp, then massage back 2 cm toward the mother then
clamp, cut the umbilical cord and protect the baby's stomach with your left hand, tie the
umbilical cord
- Do it Early Initiation of Breastfeeding to provide warmth to the baby, and tie the bond
between mother and baby
E. EVALUATION
Babies born at 08.58 a.m, female, strong crying, good muscle tone, red skin color, and the
baby is still in a Early Initiation of Breastfeeding state.

STAGE III

Date : May12, 2018

Hour : 09.05

A. SUBJECTIVE DATA

The mother said she was happy because the baby was born, she was tired from stressing, her
stomach was still churning
B. OBJECTIVE DATA

Uterus contractions : good

High fundus : as high as the center

Bleeding : 100cc

C. ASSESMENT

Mrs.E, 33 years old P2A0 in stage III labor

D.PLANNING

Date : May12, 2018

Hour : 09.05

1. Tell the mother that the mother is in good condition and mother already knew that the
baby was doing well .

Evaluation : Mother already knows

2. Perform third stage labor

a. Palpate the abdomen to confirm a single pregnancy

b. Wearing gloves

c. Notify the mother that she will be given a 10 IU injection of oxytocin

d. Controller cord stretching

e. Move the cord clamps 5-10 cm from the direction of the vulva

f. Perform controlled cord stretching

g. The left hand perform a dorsocranial to the placenta detaches and right hand doing
controlled cord stretching
 h. When the placenta appears intraotus vagina deliver the vagina, deliver the placenta
with both hands holding and rotating the placenta so that the membranes are
twisted, than deliver and place the placenta in the container

i. Perform uterine massage until the uterus contracts properly

j. Evaluation of vaginal birth canal and perenium was seen second degree rupture

k. Make sure the uterus is properly contracted

E. EVALUATION

The placenta was bron spontaneously at 9.10 am, the membranes were intact umbilical
cord length 51 cm + 1.5 cm in diameter.

STAGE IV

Date : May 12, 2018

Hours : 09.20

A. SUBJECTIVE DATA

Mother said she was tired, she said she still felt heartburn

B. OBJECTIVE DATA

Blood Pressure : 120/70 mmHg

Respiration : 22 x / minute

Pulse : 82 x / minute

Temperature : 36.7℃

Contractions : Hard

High Fundus : 2 fingers below pusnt

Maternal condition : Good

Awareness : composmetical

Bladder : Empty

Bleeding : 100 cc

Genetelia : Second degree rupture

C. ASSESSMENT

Mrs. E, 33 years old P2A0 in stage IV labor

D. PLANNING

Date : May 12, 2018

Hours : 09.20

1. Explain to the mother that her condition is currently in good condition

Evaluation: BP: 120/70 mmHg, R: 22x / minute, Pulse: 82x / minute, Temperature
36.7℃, Contractions: Good, Bleeding: 100 cc

2. Explain to the mother that the mother has a second degree rupture and will be heacted.
Evaluation: The mother knows about it and ready to be heacted

3. Heacted the second degree rupture with 1% lidocaine anesthesia.

Evaluation: Baste and subtucular heacting has been carried out using 1% lidocaine
anesthesia

4. Monitoring uterine contractions in the first 15 minutes of the first hour, at the second
hour every 30 minutes

Evaluation: Maternal uterine contractions are good

5. Give the mother food and drink to the mother

Evaluation: The mother has eaten half a slice of bread and drank half a bottle

6. Explain the danger signs stage IV, namely bad contractions characterized by the uterus
that is not contracting or the mother's uterus is flaccid and bleeding suddenly in large
amounts

Evaluation: The mother knows the danger signs stage IV

7. Weighing and anthopometric measurements on infants

Evaluation: Weight: 3000 grams, Body length: 48 cm, Head circumference: 31 cm

8. Give tetracycline 1% eye ointment to babies to prevent infectio

Evaluation: The baby has been given eye ointment

9. Gives 1 mg of vitamin K to the baby's left thigh

Evaluation: Vitamin K injection has been given

10. Gives HB0 a dose of 0.05 mg on the right thigh After 1 hour of giving Vit K.

Evaluation: Hb injection, given

11. Cleaning the mother with antiseptic water using a washcloth, wearing sanitary napkins
andcloth

Evaluation: the mother looks comfortable

12. Moving the baby and mother to the nursing room

Evaluation: Mother and baby have been moved