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You are watching: The only indications for placing your gloved fingers in the vagina during delivery are:

Pregnancy, Childbirth, Postpartum and Newborn Care: A overview for essential Practice. 3rd edition. Geneva: people Health Organization; 2015.


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Pregnancy, Childbirth, Postpartum and also Newborn Care: A overview for important Practice. Third edition.

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D2. Examine THE woman IN work OR v RUPTURED MEMBRANES

First execute Rapid assessment and managementB3-B7. Then use this graph to assess the woman"s and also fetal status and also decide phase of labour.


Any front caesarean section, forceps, or vacuum, or various other complication such together postpartum haemorhage?

contractions frequency, duration, any consistent contractions?

fetal lie—longitudinal or transverse?

fetal presentation—head, breech, other?

more 보다 one fetus?

fetal movement.


Count variety of beats in 1 minute.

If less than 100 beats per minute, or more than 180, revolve woman on her left side and count again.


Next: perform vaginal examination and decide stage of labour


bulging perineum

any visible fetal parts

vaginal bleeding

leaking amniotic fluid; if yes, is that meconium stained, foul-smelling?

warts, keloid organization or scars that may interfere with delivery.

Perform vaginal examination

Next: Respond come obstetrical problems on admission.


D4-D5. RESPOND come OBSTETRICAL troubles ON ADMISSION

Use this graph if abnormal findings on assessing pregnancy and fetal standing D2-D3.


OBSTRUCTED LABOURFOR ALL situations IN RED BELOW, REFER URGENTLY to HOSPITAL IF IN early LABOUR, manage ONLY IF IN late LABOUR

Fever >38˚C

Foul-smelling quality discharge.

UTERINE and FETAL INFECTION
Labour prior to 8 completed month of pregnant (more than one month before estimated day of delivery).
Routine shipment by caesarean section for the purpose of improving preterm child outcomes is not recommended, regardless of cephalic or breech presentation.
Conduct delivery an extremely carefully as little baby may pop out suddenly. In particular, regulate delivery of the head.

thirsty

sunken eyes

dry mouth

skin pinch goes ago slowly.

DEHYDRATION

Next: give supportive treatment throughout labour


D6-D7. Offer SUPPORTIVE treatment THROUGHOUT LABOUR

Use this chart to provide a supportive, encouraging setting for birth, respectful of the woman"s wishes.


Wash her hands with soap before and also after every examination. Use clean gloves because that vaginal examination.
Support the woman"s selection of place (left lateral, squating, kneeling, standing sustained by the companion) for each stage of labour and also delivery.
If she feels dizzy, unwell, is emotion pins-and-needles (tingling) in her face, hands and feet, encourage she to breathe an ext slowly.
To prevent pushing at the finish of first stage of labour, teach her to pant, to breathe v an open up mouth, to take in 2 short breaths followed by a long breath out.

massage the woman"s ago if she finds this helpful.

hold the woman"s hand and sponge her face in between contractions.


Always be v the woman.

Encourage her.

Help she to breathe and relax.

Rub her back, wipe she brow v a wet cloth, do other supportive actions.

Give support using regional practices which execute not disturb work or delivery.

Encourage mrs to move approximately freely as she wishes and also to take on the position of her choice.

Encourage her to drink fluids and eat as she wishes.

Assist she to the toilet when needed.


The mrs is bearing down v contractions.

There is quality bleeding.

She is suddenly in much an ext pain.

She loses consciousness or has actually fits.

There is any other concern.

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D8. Very first STAGE the LABOUR: no IN energetic LABOUR

Use this chart for treatment of the woman as soon as NOT IN energetic LABOUR, when cervix dilated 0-3 cm and contractions are weak, less than 2 in 10 minutes.