60 Steps Normal Delivery I. SEES TWO SIGNS AND SYMPTOMS OF SICKNESS 1.

Observing the signs and symptoms of second stage labor. - She has the desire to meneran. - She felt increasing pressure on the rectum and / or vagina. - Perineum prominent. - Vulva-vaginal and anal sphincter to open. II. PREPARING THE LABOR HELP 2. Ensure equipment, materials and essential drugs ready for use. Break the ampoule of oxytocin 10 units and put the syringes in a sterile disposable sets parturition. 3. Wearing clothes that cover or clean plastic apron. 4. Removing all jewelry is worn below the elbow, wash hands with soap and clean running water and drying hands with a disposable towel / clean person. 5. Wearing a glove with DTT or sterile for all examinations in. 6. Sucking oxytocin 10 units into the syringe (with gloves on high-level disinfection or sterile) and putting it back in parturition sets / high-level disinfection or container without contaminating the sterile syringe). III. ENSURING FULL OPENING WITH FETAL WELL 7. Clean the vulva and perineum, wipe it carefully from front to back by using a cotton or gauze soaked with water high-level disinfection. If the mouth, vagina, perineum or anus mothers contaminated by dirt, clean it thoroughly by wiping from front to back. Disposing of contaminated cotton or gauze in the proper containers. Replace gloves if contaminated (put both gloves correctly in the decontamination solution, step # 9). 8. Using aseptic technique, perform the checks in to ensure that the opening of the cervix is complete. - When the amniotic membranes have ruptured, while the opening is complete, do the amniotomy. 9. Mendekontaminasi gloves by dipping the hand that was still wearing dirty gloves into a 0.5% chlorine solution and then release it in reverse as well eadaan soak in 0.5% chlorine solution for 10 minutes. Washing your hands (as above). 10. Checking the Fetal Heart Rate (FHR) after the contraction ends to ensure that the FHR within the normal range (100-180 beats / min). - Take appropriate action if the FHR is not normal. - Documenting the results of the examination, FHR and all the results of assessments and other care in partograf. IV. PREPARING TO HELP MOM & FAMILY PROCESS LEADER MENERAN. 11. Told my mom opening the fetus is complete and good condition. Helping the mother is in a comfortable position as he wishes.

- Waiting until the mother has the desire to meneran. Continuing monitoring of the health and comfort of the mother and fetus in accordance with the guidelines active labor and document findings. - Explain to family members how they can support and give encouragement to the mother when the mother began meneran. 12. Ask for help families to prepare position utuk meneran mother. (In his time there, help the mother in half-sitting position and make sure he feels comfortable). 13. Doing leadership meneran when Mom has a strong incentive to meneran: - Guiding the mother when the mother has to meneran keinganan to meneran - Supporting and encouraging the efforts to meneran mother. - Helping the mother to take a comfortable position appropriate choice (do not ask the mother lying on your back). - Encourage the mother to rest in between contractions. - Encourage families to support and encourage the mother. - Encourage oral fluid intake. - Assess FHR every five minutes. - If the unborn child or baby's birth will not occur immediately within 120 minutes (2 hours) meneran for primiparous mothers or 60/menit (1 hour) to pregnant multiparous, refer immediately. If the mother does not have a desire to meneran - Encourage the mother to walk, crouch or take a safe position. If mother has not wanted meneran in 60 minutes, refer mothers to start meneran on peak contractions and rest in between contractions. - If the unborn child or baby's birth will not occur immediately After 60 minutes meneran, referring to the mother immediately. V. BABY BIRTH PREPARATION HELP. 14. If the baby's head has been opened vulva with a diameter of 5-6 cm, laid on a clean towel to dry the baby's mother's abdomen. 15. Putting a clean cloth folded third section, under the mother's buttocks. 16. Opening partus sets. 17. Wearing gloves or sterile DTT on both hands. VI. HELP THE BIRTH OF A BABY Birth of coconut 18. When the baby's head to open the vulva with a diameter of 5-6 cm, protect the perineum with one hand was covered with cloth, put your other hand on the baby oil and gentle pressure and do not hinder the baby's head, let's head out slowly. Encourage the mother to meneran breathe slowly or quickly when the head was born. - If there is meconium in the amniotic fluid, suction mouth and nose immediately after birth using a suction head DeLee mucus or sterile high-level disinfection or rubber balls and a new vacuum cleaner. 19. Gently wipe the face, mouth and nose with a clean cloth or gauze.

20. Checking the cord winding and take appropriate action if it happens, and then continue the process of childbirth immediately: - If the umbilical cord wrapped around the neck of the fetus with a loose, let go over the top of the head. - If the umbilical cord wrapped around baby's neck tightly, mengklemnya in two places and cut it. 21. Wait until the baby's head to pivot round out spontaneously. Born shoulder 22. After doing the rounds pivot head outside, place both hands on each side of the baby's face. Encourage the mother to meneran when the next contraction. By gently pulling downward and towards the exit until the anterior shoulder appears under the pubic arch, and then gently pull upward and outward to give birth to the posterior shoulder. Birth weight and leg 23. After both shoulders were born, ran a hand start the baby's head is located at the bottom of the hand toward the perineum, allowing the shoulders and arms into the hands of the posterior birth. Birth control elbows and hands the baby as it passes through the perineum, use the forearms to support the baby's body at birth. Using the hand anterior (top) to control the elbow and hand at both the anterior baby is born. 24. After the birth of the body of the arm, ran hand on the top (anterior) from the back towards the baby's legs to support it during the stage of the legs was born. Holding the baby's ankles carefully helped birth the foot. VII. HANDLING OF A NEW BORN BABY 25. Assess the baby quickly, then put the baby on the mother's abdomen with the position of the baby's head slightly lower than the body (when the umbilical cord is too short, put the baby in place that allows). 26. Immediately dry the baby, wrap the baby's head and body except for the center. 27. Clamping the umbilical cord using a clamp approximately 3 cm from the center of the baby. Perform the sequence at the start of clamping the umbilical cord to the mother and put the second clamp 2 cm from the clamp first (toward mother). 28. Holding the umbilical cord with one hand, protecting the baby from the scissors and cut the umbilical cord between the clamps. 29. Replacing a wet towel and wrap the baby in a cloth or blanket clean and dry, cover the head, leaving open the umbilical cord. If the baby has trouble breathing, take appropriate action. 30. Giving the baby to the mother and encourage her to embrace her baby and begin breastfeeding if the mother wishes. VIII. HANDLING OF A NEW BORN BABY Oxytocin 31. Putting a clean, dry cloth. Palpate the abdomen to eliminate the possibility of a second baby. 32. Told his mother that he would be injected.

33. Within 2 minutes after birth, giving an injection of oxytocin 10 units IM at 1 / 3 mother's right thigh on the outside, after mengaspirasinya first. Controlled cord tension 34. Move the clamp on the umbilical cord 35. Put one hand over the fabric that is in the mother's abdomen, just above the pubic bone, and use this hand to palpate uterine contractions and stabilize. Holding and clamping the umbilical cord with the other. 36. Waiting for the uterus to contract and then do a downward tension on the cord gently. Perform the pressure in the opposite direction at the bottom of the uterus by pressing the uterus upward and backward (dorso cranial) carefully to help prevent the occurrence of inversio uteri. If the placenta is born after 30-40 seconds, stop the tension in the cord and wait until the next contraction starts. - If the uterus does not contract, ask the mother or a family member to do the nipple stimulation. Mengluarkan placenta. 37. After the placenta is detached, ask the mother to meneran while pulling the rope toward center down and then upward, following the curve of the birth canal while continuing pressures opposite direction of the uterus. - If the umbilical cord grew longer, move the clamp up is about 50-10 cm of the vulva. - If the placenta can not be separated after the tension in the umbilical cord for 15 minutes: Repeating oxytocin 10 units IM. Assess bladder and bladder mengkateterisasi using aseptic techniques if necessary. Asking the family to prepare a referral. Repeating the tension in the umbilical cord for 15 minutes. Referring to the mother if the placenta was not born within 30 minutes since the birth of a baby. ACTIVITIES 38. If the placenta is visible at the vaginal introitus, went on the birth of the placenta with using both hands. Hold the placenta with two hands and a heartrotate the placenta to the liver membranes twist. Gently slowly giving birth these membranes. - If the membranes tear, wear gloves or a sterile high-level disinfection and examine the mother's vagina and cervix closely. Using your fingers or a clamp or forceps or a sterile high-level disinfection to remove the selapuk left. Uterine Massage 39. Immediately after birth the placenta and amniotic membranes, perform uterine massage, laying palms in the fundus and perform massage in a circular motion with gently until the uterus to contract (fundus becomes hard). VIII. ASSESSING THE BLEEDING 40. Check both sides of the placenta is attached to both mother and fetus and membranes membranes to ensure that complete and intact membranes. Leaving the placenta in a plastic bag or a special place.

- If the uterus does not contract after doing massage for 15 seconds to take the appropriate action. 41. Evaluating a laceration of the vagina and perineum, and immediately sew lacerations experiencing active bleeding. IX. POST PROCEDURE TO LABOUR 42. Re-assess and verify the uterus to contract properly. Evaluate bleeding vaginal delivery. 43. Dip both hands gloved hand into a 0.5% chlorine solution, rinse hands are still gloved hands with water disinfection high level and dry with a clean cloth and dry. 44. Placing clamp the umbilical cord of high-level disinfection or sterile or high-level disinfection tie with a square knot around the cord about 1 cm from the center. 45. Tying one more knot center section opposite to the first knot. 46. Removing the surgical clamps and put it into a 0.5% chlorine solution. 47. Baby back wrap and cover the head. Ensuring a clean towel or cloth or dry. 48. Encourage mothers to initiate breastfeeding. EVALUATION 49. Continuing monitoring of uterine contractions and vaginal bleeding: 2-3 times within the first 15 minutes postpartum. Every 15 minutes on a first hour postpartum. Every 20-30 minutes in the second hour after delivery. If the uterus does not contract properly, perform the appropriate treatment for uterine atony menatalaksanaan. If found lacerations requiring sutures, suturing done with local anesthesia and using appropriate techniques. 50. Teach in the mother / family how to massage the uterus and check uterine contractions. 51. Evaluating blood loss. 52. Checking blood pressure, pulse and condition of the bladder every 15 minutes during the first hour after delivery and every 30 minutes during the second hour after delivery. - Checking the mother's body temperature once every hour during the first two hours postpartum. - Perform action appropriate for abnormal findings. Hygiene and safety 53. Putting all the equipment in the 0.5% chlorine solution for decontamination (10 minutes). Washing and rinsing equipment after decontamination 54. Dispose of contaminated materials into the appropriate bins.

55. Cleaning the mother by using a high-level disinfection of water. Cleaning the amniotic fluid, mucus and blood. Helping women wear clothing that is clean and dry. 56. Ensure that the mother comfortable. Helping mothers to breastfeed. Encourage the family to give mom drinks and food is desired. 57. Mendekontaminasi region used to give birth with 0.5% chlorine solution and rinse with clean water. 58. Soiled gloves dipped into a solution of chlorine 0.5%, reversing the inside out and soaked in 0.5% chlorine solution for 10 minutes. 59. Washing your hands with soap and running water. Documentation 60. Completing partograf (front and back page) New! Click the words above to view alternate translations. Dismiss Google Translate for my:Searches Videos Email Phone Chat Business:Translator Toolkit Global Market Finder Website Translator About Google TranslateTurn off instant translationPrivacyHelp