Labour and Delivery Care

Topic outline

• 

  General

  • About/License Page
  • Pre-test Quiz
• 

  Topic 1

  Recognition of Normal Labour

  • Introduction Page

    

  • Learning Outcomes Page

    

  • The indefinite nature of labour Page

    The indefinite nature of labour

  • Normal labour Page

    Normal labour

  • How do you know that true labour has begun? Page

    How do you know that true labour has begun?

  • What is adequate uterine contraction? Page

    What is adequate uterine contraction?

  • Show and leakage of amniotic fluid Page

    Show and leakage of amniotic fluid

  • Distinguishing true labour from false labour Page

    Distinguishing true labour from false labour

  • Helping the mother recognise a true labour Page

    Helping the mother recognise a true labour

  • Stages of labour Page

    Stages of labour

  • First stage of labour Page

    First stage of labour

  • Second stage of labour Page

    Second stage of labour

  • Third stage of labour Page

    Third stage of labour

  • Fourth stage of labour Page

    Fourth stage of labour

  • Mechanisms of normal labour Page

    Mechanisms of normal labour

  • Engagement Page

    Engagement

  • Descent Page

    Descent

  • Flexion Page

    Flexion

  • Internal rotation Page

    Internal rotation

  • Extension Page

    Extension

  • External rotation (restitution) Page

    External rotation (restitution)

  • Expulsion Page

    Expulsion

  • In conclusion Page

    In conclusion

  • Summary Page

    

  • Quiz

    

• 

  Topic 2

  Assessing the Woman in Labour

  • Introduction Page

    

  • Learning Outcomes Page

    

  • Rapid evaluation of a woman in labour Page

    Rapid evaluation of a woman in labour

  • What you must do for a rapid assessment Page

    What you must do for a rapid assessment

  • History-taking in labour Page

    History-taking in labour

  • The importance of woman-friendly care Page

    The importance of woman-friendly care

  • Recording socio-demographic data Page

    Recording socio-demographic data

  • History of past and present pregnancy Page

    History of past and present pregnancy

  • Danger signs and symptoms Page

    Danger signs and symptoms

  • Physical examination in labour Page

    Physical examination in labour

  • Inspection of the abdomen Page

    Inspection of the abdomen

  • Palpation of the abdomen Page

    Palpation of the abdomen

  • Measuring fetal heart rate Page

    Measuring fetal heart rate

  • Measuring contractions Page

    Measuring contractions

  • Vaginal examination Page

    Vaginal examination

  • Assess the external genitalia and vagina Page

    Assess the external genitalia and vagina

  • Summary Page

    

  • Quiz

    

• 

  Topic 3

  Care of the Woman in Labour

  • Introduction Page

    

  • Learning Outcomes Page

    

  • Assessing the needs of the woman in labour Page

    Assessing the needs of the woman in labour

  • Support the labour Page

    Support the labour

  • Guard the labour Page

    Guard the labour

  • Position and mobility Page

    Position and mobility

  • Helping the mother to manage her contractions Page

    Helping the mother to manage her contractions

  • Touch Page

    Touch

  • Sounds Page

    Sounds

  • Breathing Page

    Breathing

  • Drinking fluids during labour Page

    Drinking fluids during labour

  • Bladder care Page

    Bladder care

  • Emotional and psychological support for the woman in labour Page

    Emotional and psychological support for the woman in labour

  • Maternal and fetal monitoring during labour Page

    Maternal and fetal monitoring during labour

  • Video: 10 Steps to a clean delivery Page

    

  • Assessing the progress of labour Page

    Assessing the progress of labour

  • Uterine contractions Page

    Uterine contractions

  • Dilatation of the cervix Page

    Dilatation of the cervix

  • Descent of the presenting part Page

    Descent of the presenting part

  • Discharges from the vagina Page

    Discharges from the vagina

  • Fetal condition Page

    Fetal condition

  • Maternal condition Page

    Maternal condition

  • Preparing to conduct a delivery Page

    Preparing to conduct a delivery

  • Signs of second stage labour Page

    Signs of second stage labour

  • Preparing the birthing place Page

    Preparing the birthing place

  • Equipment and supplies needed to conduct delivery Page

    Equipment and supplies needed to conduct delivery

  • Preventing infection during delivery Page

    Preventing infection during delivery

  • Handwashing Page

    Handwashing

  • Wear protective clothing Page

    Wear protective clothing

  • Clean and high-level disinfect your tools Page

    Clean and high-level disinfect your tools

  • Clean surface for delivery and safe disposal of birth wastes Page

    Clean surface for delivery and safe disposal of birth wastes

  • In conclusion Page

    In conclusion

  • Summary Page

    

  • Quiz

    

• 

  Topic 4

  Using the Partograph

  • Introduction Page

    

  • Learning Outcomes Page

    

  • The value of using the partograph Page

    The value of using the partograph

  • Finding your way around of the partograph Page

    Finding your way around of the partograph

  • Video: How to use a Partograph Page

    

  • The graph sections of the partograph Page

    The graph sections of the partograph

  • The Alert and Action lines Page

    The Alert and Action lines

  • Recording and interpreting the progress of labour Page

    Recording and interpreting the progress of labour

  • Cervical dilatation Page

    Cervical dilatation

  • Descent of the fetal head Page

    Descent of the fetal head

  • Assessing moulding and caput formation Page

    Assessing moulding and caput formation

  • Uterine contractions Page

    Uterine contractions

  • Assessment and recording of fetal wellbeing Page

    Assessment and recording of fetal wellbeing

  • Fetal heart rate as an indicator of fetal distress Page

    Fetal heart rate as an indicator of fetal distress

  • Causes of fetal distress Page

    Causes of fetal distress

  • Recording fetal heart rate on the partograph Page

    Recording fetal heart rate on the partograph

  • Amniotic fluid as an indicator of fetal distress Page

    Amniotic fluid as an indicator of fetal distress

  • Assessment of maternal wellbeing Page

    Assessment of maternal wellbeing

  • Summary Page

    

  • Quiz

    

• 

  Topic 5

  Conducting a Normal Delivery

  • Introduction Page

    

  • Learning Outcomes Page

    

  • Recognising the signs of second stage labour Page

    Recognising the signs of second stage labour

  • What happens during second stage of labour? Page

    What happens during second stage of labour?

  • How does the baby move through the birth canal? Page

    How does the baby move through the birth canal?

  • Help the mother and baby have a safe birth Page

    Help the mother and baby have a safe birth

  • Check the baby's heart beat Page

    Check the baby's heart beat

  • Support the mother's pushing Page

    Support the mother's pushing

  • Watch for warning signs Page

    Watch for warning signs

  • Video: 10 Steps to a Clean Delivery Page

    

  • Conducting delivery of the baby Page

    Conducting delivery of the baby

  • Prevent tears in the vaginal opening Page

    Prevent tears in the vaginal opening

  • Delivery of the head Page

    Delivery of the head

  • Check if the cord is around the baby's neck Page

    Check if the cord is around the baby’s neck

  • Delivery of the shoulders Page

    Delivery of the shoulders

  • Delivery of the baby's body Page

    Delivery of the baby’s body

  • Cutting the cord Page

    Cutting the cord

  • Immediate care of the newborn baby Page

    Immediate care of the newborn baby

  • Clean childbirth and cord care Page

    Clean childbirth and cord care

  • Check the newborn Page

    Check the newborn

  • Warmth and bonding Page

    Warmth and bonding

  • Early breastfeeding Page

    Early breastfeeding

  • Summary Page

    

  • Quiz

    

• 

  Topic 6

  Active Management of the Third Stage of Labour

  • Introduction Page

    

  • Learning Outcomes Page

    

  • The third stage of labour Page

    The third stage of labour

  • Natural processes during the third stage Page

    Natural processes during the third stage

  • Complications occurring during the third stage of labour Page

    Complications occurring during the third stage of labour

  • Active management of third stage of labour (AMTSL) Page

    Active management of third stage of labour (AMTSL)

  • Excessive bleeding (postpartum haemorrhage or PPH) Page

    Excessive bleeding (postpartum haemorrhage or PPH)

  • Retained placenta Page
  • Summary Page

    

  • Quiz

    

• 

  Topic 7

  Neonatal Resuscitation

  • Introduction Page

    

  • Learning Outcomes Page

    

  • Newborn respiration and resuscitation Page

    Newborn respiration and resuscitation

  • Breathing in a healthy newborn Page

    Breathing in a healthy newborn

  • Newborn asphyxia Page

    Newborn asphyxia

  • Types of neonatal resuscitation Page

    Types of neonatal resuscitation

  • Basic equipment needed for newborn resuscitation Page

    Basic equipment needed for newborn resuscitation

  • Before you start resuscitation Page

    Before you start resuscitation

  • Video: Neonatal Resuscitation for Skilled Health Workers Page

    

  • Assessing the degree of asphyxia Page

    Assessing the degree of asphyxia

  • Neonatal resuscitation procedures Page

    Neonatal resuscitation procedures

  • The first five seconds Page

    The first five seconds

  • Checking the newborn's heart rate Page

    Checking the newborn's heart rate

  • The initial actions Page

    The initial actions

  • Dry the baby quickly and keep it warm Page

    Dry the baby quickly and keep it warm

  • Clearing the mouth and nose Page

    Clearing the mouth and nose

  • Apply gentle tactile stimulation to initiate or enhance breathing Page

    Apply gentle tactile stimulation to initiate or enhance breathing

  • If you diagnose asphyxia, start resuscitation! Page

    If you diagnose asphyxia, start resuscitation!

  • Ventilate at 40 breaths per minute Page

    Ventilate at 40 breaths per minute

  • Evaluate the baby during ventilation Page

    Evaluate the baby during ventilation

  • Immediate essential newborn care Page

    Immediate essential newborn care

  • Summary Page

    

  • Quiz

    

• 

  Topic 8

  Abnormal Presentations and Multiple Pregnancies

  • Introduction Page

    

  • Learning Outcomes Page

    

  • Management of women with malpresentation or multiple pregnancy Page

    Management of women with malpresentation or multiple pregnancy

  • Vertex presentation Page

    Vertex presentation

  • Malpresentations Page

    Malpresentations

  • Malposition Page

    Malposition

  • Causes and consequences of malpresentations and malpositions Page

    Causes and consequences of malpresentations and malpositions

  • Breech presentation Page

    Breech presentation

  • Causes of breech presentation Page

    Causes of breech presentation

  • Diagnosis of breech presentation Page

    Diagnosis of breech presentation

  • Types of breech presentation Page

    Types of breech presentation

  • Risks of breech presentation Page

    Risks of breech presentation

  • Face presentation Page

    Face presentation

  • Causes of face presentation Page

    Causes of face presentation

  • Diagnosis of face presentation Page

    Diagnosis of face presentation

  • Complications of face presentation Page

    Complications of face presentation

  • Brow presentation Page

    Brow presentation

  • Possible causes of brow presentation Page

    Possible causes of brow presentation

  • Diagnosis of brow presentation Page

    Diagnosis of brow presentation

  • Complications of brow presentation Page

    Complications of brow presentation

  • Shoulder presentation Page

    Shoulder presentation

  • Causes of shoulder presentation Page

    Causes of shoulder presentation

  • Diagnosis of shoulder presentation Page

    Diagnosis of shoulder presentation

  • Complications of shoulder presentation Page

    Complications of shoulder presentation

  • Multiple pregnancy Page

    Multiple pregnancy

  • Types of twin pregnancy Page

    Types of twin pregnancy

  • Diagnosis of twin pregnancy Page

    Diagnosis of twin pregnancy

  • Consequences of twin pregnancy Page

    Consequences of twin pregnancy

  • Summary Page

    

  • Quiz

    

• 

  Topic 9

  Obstructed Labour

  • Introduction Page

    

  • Learning Outcomes Page

    

  • Defining obstructed labour Page

    Defining obstructed labour

  • Causes of obstructed labour Page

    Causes of obstructed labour

  • Cephalopelvic disproportion (CPD) Page

    Cephalopelvic disproportion (CPD)

  • Abnormal presentations and multiple pregnancies Page

    Abnormal presentations and multiple pregnancies

  • Fetal abnormalities Page

    Fetal abnormalities

  • Abnormalities of the reproductive tract Page

    Abnormalities of the reproductive tract

  • Clinical signs of obstructed labour Page

    Clinical signs of obstructed labour

  • Assessment of clinical signs of obstruction Page

    Assessment of clinical signs of obstruction

  • Bandl's ring Page

    Bandl's ring

  • Evidence from the partograph Page

    Evidence from the partograph

  • Management of obstructed labour Page

    Management of obstructed labour

  • Complications resulting from obstructed labour Page

    Complications resulting from obstructed labour

  • Fistula Page

    Fistula

  • Other common complications of obstructed labour Page

    Other common complications of obstructed labour

  • Prevention of obstructed labour Page

    Prevention of obstructed labour

  • Skilled birth attendance Page

    Skilled birth attendance

  • Using the partograph Page

    Using the partograph

  • Birth preparedeness and complication readiness Page

    Birth preparedeness and complication readiness

  • Nutritional education Page

    Nutritional education

  • Delaying early marriage Page

    Delaying early marriage

  • Summary Page

    

  • Quiz

    

• 

  Topic 10

  Ruptured Uterus

  • Introduction Page

    

  • Learning Outcomes Page

    

  • Predisposing factors for a ruptured uterus Page

    Predisposing factors for a ruptured uterus

  • Uterine scarring Page

    Uterine scarring

  • Scarred cervix Page

    Scarred cervix

  • Previously repaired fistula Page

    Previously repaired fistula

  • Why are multiparous women more at risk of uterine rupture? Page

    Why are multiparous women more at risk of uterine rupture?

  • Uterine inertia Page

    Uterine inertia

  • Traditional abdominal massage Page

    Traditional abdominal massage

  • Inappropriate use of uterotonic agents Page

    Inappropriate use of uterotonic agents

  • Clinical features and consequences of ruptured uterus Page

    Clinical features and consequences of ruptured uterus

  • Warning signs of imminent uterine rupture Page

    Warning signs of imminent uterine rupture

  • Signs that the uterus has ruptured Page

    Signs that the uterus has ruptured

  • Consequences for the mother Page

    Consequences for the mother

  • Interventions in ruptured uterus Page

    Interventions in ruptured uterus

  • Referral criteria for prolonged labour Page

    Referral criteria for prolonged labour

  • Primary prevention: getting to a health facility for emergency care before uterine rupture Page

    Primary prevention: getting to a health facility for emergency care before uterine rupture

  • Secondary prevention: emergency care for a woman in shock Page

    Secondary prevention: emergency care for a woman in shock

  • Summary Page

    

  • Quiz

    

• 

  Topic 11

  Postpartum Haemorrhage

  • Introduction Page

    

  • Learning Outcomes Page

    

  • Video: Prevention and Management of Primary Postpartum Haemorrhage (PPH) Page

    

  • What is postpartum haemorrhage? Page

    What is postpartum haemorrhage?

  • How much bleeding is 'excessive'? Page

    How much bleeding is 'excessive'?

  • Classification of postpartum haemorrhage Page

    Classification of postpartum haemorrhage

  • Atonic postpartum haemorrhage Page

    Atonic postpartum haemorrhage

  • Causes of atonic PPH Page

    Causes of atonic PPH

  • Traumatic postpartum haemorrhage Page

    Traumatic postpartum haemorrhage

  • Reducing the risk of postpartum haemorrhage Page

    Reducing the risk of postpartum haemorrhage

  • Interventions during antenatal care Page

    Interventions during antenatal care

  • Interventions during the second stage of labour Page

    Interventions during the second stage of labour

  • Interventions during and after the third stage of labour Page

    Interventions during and after the third stage of labour

  • Emergency management of postpartum haemorrhage Page

    Emergency management of postpartum haemorrhage

  • Uterotonic drugs and IV fluids to manage atonic PPH Page

    Uterotonic drugs and IV fluids to manage atonic PPH

  • Use two-handed pressure on the uterus Page

    Use two-handed pressure on the uterus

  • Emergency management for traumatic PPH Page

    Emergency management for traumatic PPH

  • A checklist for emergency referral Page

    A checklist for emergency referral

  • Summary Page

    

  • Quiz