Good day sir im Brendan Narciso and for today video i'm going to demonstrate the Essential

Intrapartum and newborn care

So we will assess the client's knowledge regarding intrapartal and newborn care and we will
also assess the client's progress of labour. We will assess the infant's airway and breathing
and circulation . We will check the baby’s breathing and colour once the baby is out. We will
also assess the mothers vital signs and her uterine contractions. And lastly we will be able to
assess the infants feeding cues.

So by the end of our procedure we will assess that the baby is able to adjust and adapt to
the outside world after birth. And we will also assess the mother for any intrapartal
complications and ensure that she is free from these complications.

Introduction
So good morning Mrs cathleen my name is brendan and i'm your student nurse for today. So
today I will assist in your delivery before, after, and during. So Mrs Cathleen, is this position
okay for you or do you want me to adjust you. Okay so you're okay with that position do you
want to go to the bathroom or take a break and eat. Okay you do not want to. So right now
um your progress of labour you're currently in your seven centimetres so it's still not fully
dilated but we will wait and i will be here along the way before and after and during your
delivery. So do you feel any pain uncomfortableness is there anything you want me to assist
you with okay

Preparing for Delivery

So while in the delivery room we have to assess if there are any air drafts so we will use this
piece of paper. If this paper falls directly on the ground it means that there is no air draft.
but if it flows into other directions or not straight to the ground it means that there is air draft.
We have to ensure that all the windows and doors are closed if there are air drafts (stop).
Okay so the paper fell directly on the ground meaning there is no air draft.

So Mrs Cathleen, are you okay with that position? so this is the default position in the
delivery room. It is the semi upright position.

After that we need to provide privacy

So I will now remove all my jewellery including rings, watches, and earrings or any type of
necklace and bracelets. And then we need to perform a proper hand washing in order to kill
the bacteria or microorganism.

Preparing for the delivery

Prepare a clean and clear resuscitation area to make sure that equipment is working. we
have the gloves, the dry linen, the bonnet, the oxytocin, the plastic and the instrument
clamp, scissors, and two basins,

eye ointment, stethoscope, vitamin k, hepatitis b and bcg vaccines, cotton balls and
micropore tape.
So Mrs Cathleen i will be cleaning your perineal area first with an antiseptic solution. So um
can i reveal the area, put down your blanket? okay thank you mrs cathleen so we're just
gonna clean the perineal area. I'm gonna expose it okay and we're just gonna clean it. Okay
mrs Cathleen im done so i'll put back your blanket. And now we're going to discard the ppes
or the things that we use such as our gloves and what we use to clean the perineal area.

Again we need to perform a proper hand washing.

Preparing for delivery

Okay so now we will wear the sterile gloves we need to pair. So I'm gonna go ahead and put
the first one. Okay and now we're done.

Ongoing delivery
So mrs Cathleen um for us to deliver the baby I want you to push for me okay and we will do
breathing techniques as well so okay. One, two, three, push,3x. Okay so now we will place a
dry linen over the mothers abdomen. This is so um we prepare for the baby's arrival. And
now we will provide support for the perineum. So okay ma'am i want you to push,push, one,
two, three, push 2x. Baby boy out at 12: 30am and place the baby on the dry linen and we
want to wipe the baby, wipe the eyes, the face,, the trunk, the body, the arms and the legs.
Once the baby is dry we will place the baby on the mothers abdomen for skin to skin contact.
We will remove this soaked linen and carefully carry the baby onto the mothers abdomen.

And after placing the baby on the mothers chest we will now put a dry linen over the baby
and put on the babys bonet. So after doing so we will now um palpate the mothers abdomen
to exclude a second baby in preparation for giving oxytocin. So excuse me ma'am I'm just
going to palpate, okay .

Now we will use a wet cloth to wipe our soil gloves after palpating the mother and we will
give IM oxytocin within one minute after the baby’s birth. We are now going to dispose of
this. So we will now inject our patient with oxytocin were gonna give it intramuscularly. But
first we're gonna grab a cotton ball and clean the area that we're going to inject it with. Into
just going to inject you okay Mrs Cathleen. Okay and prepare our oxytocin. On a count of
three. One, two, three okay. And cover it with a cotton ball. Okay mrs cathleen thank you so
much.

After wiping we will now remove our first pair of gloves and we're gonna place this into a
chlorine solution for at least 10 minutes to decontaminate.

Now we're going to palpate if the umbilical cord is still pulsating. Okay so it’s not pulsating
anymore. We're going to grab our clamp and place it two centimetres above the base. clamp
here. We want to milk the cord and were going to clamp 5cm above the base. We're now
going to cut near the clamp, not midway near the clamp. Okay i'm going to wrap this on the
scissors and place it in our kidney basin.
So we're going to wait for strong uterine contraction and applied controlled core contraction
and counter traction on the uterus continuing until the placenta is delivered. So we'll assess
the uterus and the placenta . So we're going to massage the uterus until it is firm. Okay, and
we're going to assess the mother;s vagina. For any lacerations and tears so there seemed to
be none. Okay, and now we're going to inspect the mothers placenta after the delivery so the
placenta seems to be complete, no missing cotyledons, no abnormalities. Also the vagina
does not have any lacerations.

Okay so now Mrs Cathleen im going to do perineal flushing were just going to clean the
area, okay to avoid any infections and were also going to apply a perineal pad or napkin if
necessary, okay. Now we are also going to assess the colour of the baby and the baby’s
breathing. So the baby's colour is normal, and breathing seems to be normal.

So Mrs Cathleen, how are you doing, okay so that's good. Client is okay and we're going to
see if the uterus is already contracted, okay so the uterus is now fine.

And now we're going to discard or dispose of the mothers placenta in a leak proof bag so I
have mine here and we're just going to place the placenta in here, okay and close the bag
make sure to discard it properly.

So we will now remove our gloves and place this in a chlorine solution for at least 10 minutes
along with all the other equipment or ppes that we use before discarding.

So now we're going to advise our client to maintain her skin to skin contact with the baby and
the baby must be in a prone position which he is in with the head turned to one side.

So okay mrs Cathleen I want you to watch out for feeding cues which may indicate that the
baby might want to feed on you already so the cues are mouth opening, lip licking and
sucking, bringing hands to the mouth, moving head as if im looking for the mothers nipple or
your nipple. Um there is clenching of the fist and the finger over the tummy, there is bending
of arms and legs and there is fussiness.

So Mrs Cathleen um if you identify those cues you can hold your baby close to your nipple
nose level and then wait for the baby to open its mouth and latch on your nipple.

So after the baby latches on the nipple we will wait until the full breast feeding is completed.

After successfully breastfeeding the baby we will now apply eye ointment on the baby's eye.
So this eye ointment will actually prevent transmission of any infection such as gonorrhoea
which is an unknown manifestation on the mother to the baby. And now we are going to do a
thorough physical examination on the newborn noting any abnormalities which must be
reported right away.
And now we're going to inject vitamin k on the baby or the newborn. This is to prevent or
decrease bleeding as babies tend to have really low levels of vitamin k and vitamin k is
important for stopping bleeding. So we're going to administer on the right leg.

So now we're going to inject hepatitis b vaccine onto the baby on the left leg. This is to
prevent any transmission of the hepatitis b virus or infection, okay,

And now we’re going to inject the bcg vaccine on the baby's arm and this will help prevent
any serious form of tuberculosis such as meningitis tuberculosis or miliary tuberculosis. So
were going to inject this on the babys arm intradermally.

So Mrs Cathleen's bathing procedure should be delayed. This is advised at least six hours
after your baby's delivery as this will help prevent hypothermia. The baby may feel too cold
and the baby's temperature will drop beyond normal levels and it may lead to further
complications. Also delayed bathing period gives you more time to have skin to skin contact
with your baby, also if your baby wants to be breastfeed just give them your nipple and let
them breastfeed on you as they demand.

So within the first hour after the delivery we were going to assess the baby's breathing and
colour. So the baby;s breathing seems to be normal and the colour is of normal complexity
and tone so we're also going to assess the mothers vital signs just to identify if there has
been any problem or complication. So we're going to assess the respiratory rate, Heart rate,
blood pressure temperature and so on.

So on the second hour after the delivery we were going to check the diet care of the mother
and the baby every 30 mins to an hour. So the diet care includes the mother and the baby in
skin to skin contact. We must address the need of one in order to suffice the need and
interest of the other one.

So now we will just complete the record of the mother and the baby so we're going to put
that into their papers..

So we are now going to evaluate the baby was able to adjust and adapt to the outside world
after delivery and the mother is actually free from any intrapartal complications