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To prevent pushing at the end of first stage of labour, teach her to pant, to breathe with an open mouth, to take in 2 short breaths followed gir a long breath out. Measure blood pressure.

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DO NOT give artificial teats or pre-lacteal feeds to the newborn: no water, sugar water, or local feeds. Counsel on nutrition D Feel the uterus. If blood or meconium, wipe off with wet cloth and dry. Allow her to push as she wishes with contractions. Measure temperature every gidl hours. After delivery of the shoulders allow the baby to hang until next contraction. Constant pain between contractions.

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Next: Respond to obstetrical problems on admission. Pain and discomfort relief Suggest change of position.

If late labour. Receiving any medicine.

Have you had any bleeding? Pulse normal. If feet are cold to touch or mother and baby are separated: Ensure the room is warm. Talk to family members such as partner and mother-in-law, to encourage them to help ensure the woman eats enough and avoids hard physical work.

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If she and her partner want more children, advise that waiting at least 2 years before trying to become pregnant again is good for the mother and for the baby's health. Repeat check every 5 minutes.

If HIV-infected mother has chosen replacement feeding, feed accordingly. If unable to pass urine and bladder is full, empty bladder B Give Supportive care D6-D7 Never leave the woman alone. Use this chart for advising on postnatal care after delivery in health facility on D21 or E2. How frequent are contractions? If bleeding, see B5.

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Delivery care Follow the labour and delivery procedures D2 - D28 K Ask the woman to lie on her back while gripping her legs tightly flexed against her chest, with knees wide apart. Refer the woman urgently to hospital B In settings with high s mortality apply chlorhexidine to the umbilical stump daily for the first week of life.

Support the woman's choice of position left lateral, squating, kneeling, standing supported by the companion for each stage of labour and delivery. Help her to establish or re-establish breastfeeding as soon as possible. Monitor intensively.

Reassess for discharge D21 Continue any treatments initiated earlier. Change gloves.

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If, after 30 minutes of spontaneous expulsive efforts, the perineum does not begin to thin and stretch with contractions, do a vaginal examination to confirm full dilatation of deliery. Is it hard and round?

Transverse lie. Prepare for newborn resuscitation. Counsel on safer sex including use of condoms G2.

Severe anaemia. Feel gently around baby's neck for the cord. Incinerate the placenta or bury it at least 10 m away from a water source, in a 2 m deep pit.

Recent Activity. Advise the family about danger s and when and where to seek care K Deliver the first baby following the usual procedure. Check tetanus toxoid TT immunization status. Flr is your baby? Prepare for newborn resuscitation K Advise on the first postnatal contact for the mother and the baby lucy spokane valley escort should be as early as possible within 24 hours of birth K See if liquor was meconium stained.

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Next: Give supportive care throughout labour. FHR returns to normal. If early labour, refer urgently to hospital E Arrange for a helper to assist you with the births and care of the babies. Look for sunken eyes, dry mouth.

A breastfeeding woman can also choose any other family planning method, either to use alone or together with LAM. If no third baby is felt, go to third stage grl labour.

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