care of second

Introducing the Infant

  • Initial Contact After Birth

    • Skin-to-skin contact recommended for bonding.

    • Infant can be placed on birthing parent's abdomen after the cord is cut.

    • If held by others, ensure the infant is dried and wrapped properly to maintain warmth.

    • Handle newborns gently but firmly as they are slippery from amniotic fluid and vernix.

  • Prophylactic Measures

    • Newborns typically receive eye ointment to prevent chlamydia infection, administered after initial family contact.

    • Important to wait until parents see the infant before applying ointment.

  • Breastfeeding Initiation

    • Optimal time to start breastfeeding as infants show hunger cues at birth.

    • Sucking stimulates oxytocin release, promoting uterine contraction and involution (return to prepregnant state).

Environment for Birth

  • Perineal Cleaning

    • Clean perineum with warmed antiseptic before delivery to maintain hygiene.

    • Use a clean compress for each stroke to avoid introducing bacteria.

    • Begin cleaning from the vagina outward.

  • Fetal Presentation and Delivery Techniques

    • Pressure techniques like the Ritgen maneuver may assist in delivering shoulders safely.

    • Ensure head is visible at the vaginal opening before applying pressure and maintain clear record of the time of birth.

    • Announce sex of the infant immediately after birth.

Cutting and Clamping the Cord

  • Timing for Clamping

    • Cord should pulsate unless immediate medical concerns arise (e.g., nuchal cord).

    • Delay cutting allows more blood to pass from the placenta to the infant.

  • Blood Banking

    • Blood samples may be taken for typing or cord blood banking for future stem cell needs.

    • Ensuring three vessels are present in the cord during examination.

  • Security Precautions

    • Some hospitals utilize alarms on clamps to prevent abduction of newborns.

Second Stage of Labor

  • Effective Pushing Techniques

    • Pushing techniques vary; some use open glottis while others hold their breath.

    • Encouragement of natural breathing patterns during pushing is critical to avoid complications like Valsalva effect.

  • Monitoring Fetal Heart Rate

    • Important to assess fetal heart sounds regularly during this stage for any signs of distress.

  • Environmental Safety

    • Maintain cleanliness of the environment where birth occurs, especially in water births.

Positioning for Birth

  • Preferred Positions for Delivery

    • Various positions: hands and knees, squatting, side-lying, or reclining can facilitate comfort and delivery.

    • Avoid prolonged lithotomy position to prevent complications like pelvic congestion.

  • Baby Care Area

    • Designated area equipped for newborn care, warmth maintenance, and necessary equipment for suction or resuscitation.