1. The document outlines the 4 core steps of EINC (Essential Intrapartum and Newborn Care): immediate drying, early skin-to-skin contact, properly timed cord clamping, and non-separation of newborn from mother for early breastfeeding.
2. It provides detailed instructions for care during labor, delivery, and the first 1-3 months including drying the newborn, maintaining skin-to-skin contact, delayed cord clamping, and supporting early and exclusive breastfeeding.
3. The document also lists unnecessary interventions that should be avoided both during labor/delivery and newborn care.
1. The document outlines the 4 core steps of EINC (Essential Intrapartum and Newborn Care): immediate drying, early skin-to-skin contact, properly timed cord clamping, and non-separation of newborn from mother for early breastfeeding.
2. It provides detailed instructions for care during labor, delivery, and the first 1-3 months including drying the newborn, maintaining skin-to-skin contact, delayed cord clamping, and supporting early and exclusive breastfeeding.
3. The document also lists unnecessary interventions that should be avoided both during labor/delivery and newborn care.
1. The document outlines the 4 core steps of EINC (Essential Intrapartum and Newborn Care): immediate drying, early skin-to-skin contact, properly timed cord clamping, and non-separation of newborn from mother for early breastfeeding.
2. It provides detailed instructions for care during labor, delivery, and the first 1-3 months including drying the newborn, maintaining skin-to-skin contact, delayed cord clamping, and supporting early and exclusive breastfeeding.
3. The document also lists unnecessary interventions that should be avoided both during labor/delivery and newborn care.
1. The document outlines the 4 core steps of EINC (Essential Intrapartum and Newborn Care): immediate drying, early skin-to-skin contact, properly timed cord clamping, and non-separation of newborn from mother for early breastfeeding.
2. It provides detailed instructions for care during labor, delivery, and the first 1-3 months including drying the newborn, maintaining skin-to-skin contact, delayed cord clamping, and supporting early and exclusive breastfeeding.
3. The document also lists unnecessary interventions that should be avoided both during labor/delivery and newborn care.
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EINC = Essential Intrapartum and Newborn Care
4 core steps of EINC
I. Immediate and thorough drying
II. Early skin-to-skin contact III. Properly timed cord clamping IV. Non-separation of newborn from mother for early breastfeeding
Prior to patients transfer to the DR
Ensure that mother is on her position of choice when in labor
Ask mother if she wishes to eat or drink Communicate with the mother inform her of the progress of labor, give reassurance and encouragement
Patient already in the DR
1. Arrange things in a linear fashion: gloves, dry linen, bonnet, Oxytocin
injection plastic clamp, scissors, 2 kidney basins 2. Clean the perineum with antiseptic solution. 3. Wash hands. 4. Put on 2 pairs of sterile gloves aseptically. (If same worker handles perineum and cord).
AT THE TIME DELIVERY
1. Encourage woman to push as desired
2. Apply perineal support and do controlled delivery of the head 3. Call out time of birth and sex of baby 4. Inform the mother of outcome
First 30 seconds
Place the baby on a clean, dry cloth/towel on the mothers abdomen
Thoroughly dry baby for at least 30 seconds starting from the face and head, going down to the trunk and extremities.
1 3 minutes
Remove the wet cloth
Place baby on skin to skin contact on the mothers abdomen Cover the baby with a clean, dry cloth/towel. Cover the babys head with a bonnet. Exclude a 2nd baby by palpating the abdomen. Use the wet cloth to wipe the soiled gloves. Give IM Oxytocin within 1 minute of babys birth. Dispose of the wet cloth properly. Remove the first set of gloves Decontaminate these properly (by soaking in 0.5% chlorine solution for at least 10 minutes). Palpate umbilical cord to check for pulsations. After pulsations have stopped, clamp cord using the plastic cord clamp at 2 cm from base. Place the instrument clamp 5cm from the base. 2
Cut near plastic clamp (midway).
Perform the remaining steps of the active management of the third stage of labor. wait for strong uterine contractions then apply controlled cord traction and counter traction on the uterus, continuing until placenta is delivered massage the uterus until it is firm Inspect the lower vagina and perineum for lacerations/tears and repair lacerations/tears if necessary. Examine the placenta for completeness and abnormalities. Clean the mother: flush perineum and apply perineal pad/napkin/cloth. Check babys color and breathing; check that mother is comfortable, uterus is contracted. Dispose the placenta in a leak-proof container or plastic bag. Decontaminate (soaked in 0.5% chlorine solution) instruments before cleaning; decontaminate 2nd pair of gloves before disposal. Advise mother to maintain skin-to-skin contact. Baby should be prone on mothers chest/in between the breasts with head turned to one side
15-90 minutes
Advise mother to observe for feeding cues
Support mother, instruct her on positioning and attachment Wait for FULL BREASTFEED to be completed After a complete breastfeed, administer eye ointment (FIRST), do thorough physical examination, give Vit. K, hepatitis B and BCG (simultaneously explain purpose of each intervention). Advise OPTIONAL/DELAYED bathing of the baby (explain the rationale). Advise breastfeeding per demand and about Danger Signs for early referral In the first hour: - check babys breathing and color; and check mothers vital signs and massage uterus every 15 minutes. In the second hour: check mother-baby dyad every 30 minutes to 1 hour Complete all records: admin. of eye ointment, Vit K, hepatitis B and BCG
Intrapartum care - Unnecessary interventions:
1. Enema 2. Shaving 3. Restricted intake of food and fluids 4. Routine intravenous infusion 5. Fundal pressure 6. Early amniotomy and Oxytocin augmentation 7. Routine episiotomy
Newborn care Unnecessary interventions:
1. routine suctioning 2. foot printing 3. early bathing and washing 4. routine separation 5. giving glucose water or artificial milk substitutes