264 3 2. 8. 2. 10. 2. U 2. 12 2. 13 3. 3. 3. 4. 3. 5. ::?. 7. 5. \\;ipe tl1e baby's face with a dry piece of cloth (or with your hands) to remove I. be l,lood :1nd/or mucus which might be covering the baby's face. Deliver the baby's shoulder : 2. 8. 1. Gr,1sp the head with both bands. 2. 8. 2. Apply a gentle downwa rd pull until one shoulder is delivered. 2. 8. 3. Apply a gentle upward pull to deliver the other shoulder. \Vith the left haod (or right band if you are left banded) support the l,aby's body as it goes out. With the other hand. grasp the baby's legs as soon as they come out. Place the middle finger between the ankles to prevent the baby from fa Uing. Dry th: skin oftb: newborn ";·tl1in 30 seconds of birth. Stimulate the baby to cry 1f he doesn t do so spontaneously. \Vithin the 1irst 60 seconds, pl. ice Lbe baby in a prone position on the mother·s chest. Co\'er his bac. k with a clean dry blanket and his head with a clean dry bonnet. · V\lil h in 3 111 i uu l{'S, after the un1bilical pulsation has stopped, clamp tbe cord: cm from the base ifit has not yel been cul yel. Place another clamp S cm trom the base and cut the con. I between the two clamps. Do not milk tlw cord. Do not pull the cord unless there are signs of placental separation. If there are signs of placental se_paration, deliver it _completely. 3. 2. 1. Pull the cord slowly and gently until t11e placenta spontaneo usly comes 3. 2. 2. 3. 2. 3. out. Rotate the placenta. Place the placenta in a basin or bowl and inspect it as well as its membranes untler a good Ught. Feel if the womb is hard a. nd well contracted or soft and relaxed. If it is soft, massage it gently to make it contract. If ice is available, ice pack can be applied over lhe area belo-.,· the mother's umbilicus. Inspect lhe perineum for any lacerntions (tears). If there are no lacerations, clean the pedn_eum wit J1 cotton and warm water. 3. 6. Remove the pad and the plastic lining under tl1e patient's buttocks and change Mer clothes. Do not apply "bigkis~. 3. 7. Give her nom-ishme. at like soup, milk, tea, etc. 3. 8. AJlow the mother to sleep. 4. 0 Stay with the patient for two bours after the de Hvery of the placenta. Do the following during this period: 4. 1. Oh1:erv<" the pntient for any untowar d signs and symptoms (like bleeding, dizzi11ess, cold,mc J clammy perspiration, etc. ) 4. 2. Attend lo ll1e newborn. 4. 3. Take down data needed for the birth certificates (]ike the mother's age, her maiden name, lter obstetrical history, etc. ) 4. 4. Give cifter care i11s1. ruclio11s like the diet for bol:h U1e motl1er a. nd child, cord care, etc. 5. 0 lf the baby is in breech position ("suhi") and there is no time to bring the patient to a doctor or hospitnl, do the following: 5. 1. Do tl1c :;amc prepnrutio ns dur. ing t J1e 6rst stage of labor. 5. 2. Perform the follm,;ng mnneuvers during the second stage oflabor: 5. 2. 1. Delwer the baby up to the shoulde r. a. Urasp both feet of the baby. 