Conduct normal labour in a health facility and community settings
Help the Mother And Baby to Have a Safe Birth
Check the mother's vital signs as usual and check the fetal heart rate as frequently as every other contraction passed (5 minutes) and evaluate the rate ranging between120-180 beats per minute. During contraction, hearing fetal heartbeat 's hard unless you are experienced. It becomes slow soon after contraction passed.But it should come right back up to the normal rate of contraction is over. You can hear it best very low in the mother's belly (near the pubic bone) (Figure 4.6).
If the baby's heart beat does not come back in normal range within 1 minute, the baby may be in problem. Ask the mother to change the position (to lie on her side), and tell her to take a deep breath. Check the baby's heartbeat again andIf the heart rate still does not come to normal range, refer to the higher health institutions.
Support Mother's Pushing
When the cervix is fully dilated, the mother will push the baby out. Some health care providers get ready and shout at mothers, "Push! Push!" but mothers do not usually need much help to push. Their bodies push naturally, and when they are encouraged and supported, the power of contraction can lead them to push.
If a mother has the difficulty of pushing, do not blame or pressure her and never insult or hit a woman to make her push. This all makes slow the birth. Instead, explain how to push well and admire her for trying. When you see her outer genitals bulge, let tell the mother to touch it. This may encourage her to push better.
The mother can choose the position that she feels good to her. Laying a mother flat for a long period is not good for baby; these can squeeze the blood vessels that bring blood to the baby and will result to fetal dusters, or even death. Figure 4.7 shows the different positions the woman can assume during the second stage of labour.
Check For Warning Signs
Follow the progress of labour. If the birth is taking too long, take the woman to a hospital. This is one of the most important things you can do to prevent serious complication or even death of the mother and the baby. The second stage may take a full 2 hours following a strong uterine contraction and good pushing effort so that the baby is born. Follow how fast the baby's head is moving down through the birth canal.
As long as the baby continues to move down (even very slowly), the baby's heartbeat is normal, and the mother has strength, then the birth will be normal and healthy. In this case, the mother should continue to push down until the head crowns. However, if the mother is pushing down for a long time with no progress, this can cause serious problems, including, maternal distress, fetal distress, vulval edema, uterine rupture and fistula or even death of the baby or mother. If the baby is not moving down at all after 1 hour of pushing, the mother needs a referral to a higher health institution.