Birth and Newborn Care

• What is term gestation?

  37 weeks - 40 weeks estimated due date
• When should you call the midwife


  Only if homebirth is planned and no immediate concers.
• History taking in labour

  How many week gestation? How many previous pregnancies? How many babies expected? Known complications? Pre-exisiting medical conditions? Have the water broke, colour, smell, meconium, blood? When did contractions start? How often are contractions? Urge to push?
• Stay on scene


  Contractions every 2 mins or less, urge to push, presenting part visible, tell you they need a poo.
• Try and convey 


  No signs of birth imminent, meconium or blood present, No progression after 10 mins, Pre term, Known complications
• What to do if staying

  Close windowns and heating full blast, Make sure mother is comfertable, Entonox, NLS area, Warm towels.
• Tears in vagina 


  First degree - involves skin. Second degree tear - Perineal muscles. Third degree tear - partial anal sphincter. Fourth degree tear - COmplete anal ssphincter and bowel lining
• What to do when baby is born

  Dry and stimulate baby for 60 seconds
• Assessing a newborn


  Colour - well perfuused? Tone - Good tone? Floppy? Breathing - Strong cry? Rate of breathing? Regular/irregular? Aponeic? Heart rate - 100bpm.
• How do we keep newborns warm?

  Dry thoroughly, wrape in warm towel, put a hat on, blizzard blanket, Wrape blizzard blanket with towel. Transwarmer mattresses, Heating on
• Skin to skin


  IF enviroment is warm. Regulated HR and BReathing. Oxytocin to help release placenta, Keep baby warm, Bonding.
• Why should we keep babys warm

  Baby is below 36.5 - mortallity rate increases by 28%
• Cord care


  Wait until cord is white to cut.
• Placenta birth


  20 minutes of no placenta - retained placenta and pre alert nearest maternity unit
• Bleeding when giving birth

  250 -500 ml is normal.
• When do we diagnose a PPH?

  500ml or more blood loss - hypovolemic shock. 24hours or 6 weeks excessive bleeding post birth.
• Causes of PPH


  Tone - Lack of tone of uterus prevents the vascular placental interface from clossing off so contiues to bleed. Tissue - TIssue has been retained. Trauma - Tears caused by birth or other trama. Thrombin - knwon by pt.