Assisting in the delivery of a baby

Question 1

What is in the maternity pack?
Name at least 3 items.

Answer 1

Hats (2 sizes)
Wristbands (1 for mum and 1 for baby)
Cord Clamps
Cord Cutters
2x Towels
Nappy
Incontinence pad
Sanitary pads
Clinical waste bag
Plastic bag (for baby)
Maternity Memoir card
Tin foil blanket
Gauze
Apron

Question 2

What is gravida

Answer 2

Number of times the woman has been pregnant, including current pregnancy. - Regardless of outcome of pregnancy (miscarriage)

Question 3

What does parity mean

Answer 3

Number of live births a woman has had
Eg ( G5 P2 ) = Fifth pregnancy but Two live births

Question 4

What is gestation

Answer 4

• Written as weeks plus days (35+2 is 35 weeks plus 2 days since conception)

Question 5

What does EDD stand for

Answer 5

Estimated Due Date

Question 6

What is the cephalic/vertex

Answer 6

Babies Head

Question 7

What information is in the pregnancy notes
(G P G+ EDD )

Answer 7

Gravida
Parity
Gestation
Estimated Due Date

Question 8

What is the first stage of labour

Answer 8

.Dilation of the cervix from 0cm to 10 cm
.Contraction increase in length, strength and frequency as the 1st stage progresses.
.Can range from minutes to hours

Question 9

What are Braxton Hicks

Answer 9

Braxton Hicks are when the womb contracts and relaxes, they are IRREGULAR, CHANGE, WEAK and UNCOMFORTABLE. Sometimes they are known as false labour pains

Question 10

Inspection of vagina in birth. What should you do?

Answer 10

1.CONSENT
2.Visual inspection
-Any bleeding
-Is the baby visible
3. Is there a prolapsed loop of cord (when umbilical cord goes in front of baby)
4.Does the perineum (douche) bulge with each contraction.
5.Environment (are the waters broke)

Question 11

What are the signs of the second stage of labour

Answer 11

Contractions are more expulsive
More frequent contractions
Mum has the urge to push
Baby head may be visible at introitus (entry)
Anus will be dilated

(CONTRACTIONS CAN BE IRREGULAR)

Question 12

How do you prepare the environment for birth

Answer 12

Call for second crew and midwife
Ensure privacy
Offer entonox
Make sure its warm
Lay down clean blanket with incontinence pads
Get warm blankets for newborn
Open maternity pack
Prepare resus area

Question 13

What is the resuscitation area in childbirth

Answer 13

BVM, blankets and a pad to out under a babies shoulders. Have a stethoscope to hand.
Keep baby warm

Question 14

Top tips to assist in normal delivery

Answer 14

.Support woman in position of comfort ( not flat on back)
.Provide support and reassurance
.Encourage mum to breathe slowly - give entonox
.Allow babies head to be born slowly - encourage panting rather than pushing
.Once the head is born, the rest is usually complete in the next 2 mins
.Avoid touching umbilical cord. If tight around neck or obstructing birth, then you can unloop it.

Question 15

If you ‘catch’ baby in a towel after the mum has given birth to it what should you do?

Answer 15

1.Support baby and dry baby with towel.
2.Take off wet towel and replace with clean dry warm towel.
3. Quickly assess baby - if no need for resus then give straight to mum for skin to skin
4. Delay cord cutting

Question 16

What is radiant heat loss that a new born baby can experience

Answer 16

Radiant heat loss - bare skin exposed to an environment containing objects of a cooler temperature.

Question 17

What is evaporative heat loss that a baby can experience?

Answer 17

Neonates are wet with amniotic fluid (which is cold)

Question 18

What is conductive heat loss that a neonate can experience?

Answer 18

When neonates are placed in contact of a cool object or surface.

Question 19

What is Convective heat loss that a neonate can experience?

Answer 19

A flow of cooler ambient air carries heat away from the neonate.

Question 20

For ever 1 degree decrease of temperature of a neonate, what is the associated mortality rate?

Answer 20

28%

Question 21

Why is skin to skin contact from neonate to mother so important?

Answer 21

Regulates babies temperature
Regulates babies heart rate and breathing
Stimulates release of oxytocin
Provides protection against infection

Question 22

What should you assess when you assess the neonate

Answer 22

Colour, tone, heart rate and resp rate.
A baby that is floppy is likely to be unconscious and has hypoxia.
Babies are usually born blue an turn pink, however, if they are white they may have a serious cardiovascular compromise

Question 23

What does APGAR stand for when assessing a neonate

Answer 23

Appearance
Pulse
Grimace
Activity (movement)
Respiration

Question 24

Steps of Cord Cutting

Answer 24

Delay until cord has stopped pulsating
Would mum/dad like to do it

1.Apply two cord clamps (about 3 cm apart and 15 cm from the babies umbilicus)
2.Cut between two clamps ensuring that babies fingers and genitals are out of the way.

Question 25

What is involved within the third stage of labour

Answer 25

Delivery of placenta and membranes

Question 26

What are the signs of the third stage of labour

Answer 26

Contractions return
Cord lengthens
Urge to push
Sometimes a small gush of blood

Question 27

What should we do as paramedics during the third stage of labour?

Answer 27

DO NOT PULL ON CORD
Encourage mother to pass urine
Offer entonox
Once delivered keep placenta and give to midwife to inspect - put in bowl and in clinical waste bag
Assess and record blood loss
If bleeding continues follow PPH protocol

Question 28

what is PPH protocol in childbirth

Answer 28

PPH is a protocol followed after a postpartum haemorrhage.

It involves manual removal of the placenta, manual removal of clots, uterine tamponade, and uterine artery embolisation.

Question 29

Top tips for normal delivery

Answer 29

Birth is natural and therefore not necessarily an emergency.
Most babies deliver themselves without an intervention.
Keep the baby warm.
Skin to skin.
Delay cord clamping and cutting
Keep calm :)