EINC
Equipment refer to linear arrangement of instrument.
RATING CRITERIA
4 Correct and independently performs procedure and states rationale.
3 Performs procedure and states rationale with minimal guidance.
2 Satisfactory perform procedure with moderate guidance.
1 Procedure incorrectly done without rationale.
0 Not performed.
PRIOR TO WOMAN’S TRANSFER TO THE DR
Ensured that mother is in her position of choice while in labor.
Asked mother if she wishes to eat/drink or void.
Communicated with the mother – informed her of progress of labor, gave reassurance and
encouragement
WOMAN ALREADY IN THE DR
PREPARING FOR DELIVERY
Checked temperature in DR area to be 25-28 O Celsius; eliminated air draft.
Asked woman if she is comfortable in the semi-upright position (the default position of
delivery table).
Ensured the woman’s privacy.
Removed all jewelry then washed hands thoroughly observing the WHO 1-2-3-4-5
procedure.
Prepared a clear, clean newborn resuscitation area. Checked the equipment if clean,
functional and within easy reach.
Arranged materials/supplies in a linear sequence: Gloves, dry linen, bonnet, oxytocin
injection, plastic clamp, instrument clamp, scissors, 2 kidney basins In a separate sequence,
for after the 1st breastfeed: Eye ointment, (stethoscope to symbolize PE), vit K, hepatitis B
and BCG vaccines (plus cotton balls, etc)
Cleaned the perineum with antiseptic solution
Washed hands and put on 2 pairs of sterile gloves aseptically. (If same worker handles
perineum and cord).
AT THE TIME OF DELIVERY
Encouraged woman to push as desired.
Draped the clean, dry linen over the mother’s abdomen or arms in preparation for drying the
baby.
Applied perineal support and did controlled delivery of the head
Called out time of birth and sex of baby.
nformed the mother of outcome.
FIRST 30 SECONDS
Thoroughly dried baby for at least 30 seconds, starting from the face and head, going down
to the trunk and extremities while performing a quick check for breathing
1 - 3 MINUTES
Removed the wet cloth.
Placed baby in skin-to-skin contact on the mother’s abdomen or chest.
Covered baby with the dry cloth and the baby’s head with a bonnet.
Excluded a 2nd baby by palpating the abdomen in preparation for giving oxytocin.
Used wet cloth to wipe the soiled gloves. Gave IM oxytocin within one minute of baby’s birth.
Disposed of wet cloth properly.
Removed 1st set of gloves and decontaminated them properly (in 0.5% chlorine solution for
at least 10 mins).
Palpated umbilical cord to check for pulsations.
After pulsations stopped, clamped cord using the plastic clamp or cord tie 2 cm from the
base.
Placed the instrument clamp 5 cm from the base.
Cut near plastic clamp (not midway).
Performed the remaining steps of the AMTSL:
Waited for strong uterine contractions then applied controlled cord traction and counter
traction on the uterus, continuing until placenta was delivered.
Massaged the uterus until it is firm
Inspected the lower vagina and perineum for lacerations/tears and repaired
lacerations/tears, as necessary.
Examined the placenta for completeness and abnormalities.
Cleaned the mother: flushed perineum and applied perineal pad/napkin/cloth.
Checked baby’s color and breathing; checked that mother was comfortable, uterus
contracted.
Disposed of the placenta in a leak-proof container or plastic bag.
Decontaminated (soaked in 0.5% chlorine solution) instruments before cleaning;
decontaminated 2nd pair of gloves before disposal, stating that decontamination lasts for at
least 10 mins.
Advised mother to maintain skin-to skin contact. Baby should be prone on mother’s chest/in
between the breasts with head turned to one side.
15 - 90 MINUTES
Advised mother to observe for feeding cues and cited examples of feeding cues.
Supported mother, instructed her on positioning and attachment.
Waited for FULL BREASTFEED to be completed.
After a complete breastfeed, administered eye ointment (first), did thorough physical
examination, then did Vit. K, hepatitis B and BCG injections (simultaneously explained
purpose of each intervention).
Advised OPTIONAL / DELAYED bathing of baby (and was able to explain the rationale).
Advised breastfeeding per demand.
In the first hour: checked baby’s breathing and color; and checked mother’s vital signs and
massaged uterus every 15 minutes.
In the second hour: checked mother-baby dyad every 30 minutes to 1 hour.
Completed all RECORDS
TOTAL
EQUVALENT
