Basic

I. Initial Assessment

Determine presence of labor.
Administer highest concentration of oxygen, as needed.

Obtain information about pregnancy:
Problems or complications.
Any other pregnancies?
Due date.
Assess for vaginal bleeding.
Determine onset and duration of contractions.
Did water break? Describe color of fluid.
Visualize perineum and check for bulging and crowning or if the urge to push or bear down or move bowels is evident. If so, prepare for birth.
Position mother for delivery if normal delivery imminent.
Apply gentle pressure against baby's head to guide and control the delivery.
Support the head and thorax as they appear.
Cut cord only if cord is tightly wound around baby's neck. Apply two clamps and between the clamps.
Assess baby's respiratory status and give APGAR score.
Dry infant, cover its head, and wrap the baby to minimize heat loss.
Assess mother for excess bleeding.

Spontaneous abortion
Bring fetus and tissue to hospital.

Breech birth

Maintain infants airway by inserting gloved fingers into vagina and pushing wall of vagina away from baby's mouth and nose, deliver if necessary.

Prolapsed cord

Place mother in Trendelenburg position.

Insert gloved hand into vagina and push baby's presenting part off the cord.

III. Ongoing Assessment

Monitor mother and baby.