IN CONTINUATION TO LABOUR GUIDE FOR COMMUNITY HEALTH AND MIDWIFE CAREGIVERS

By Dr Peter Onoja


REQUIREMENTS FOR MANAGING LABOUR


To properly manage labour, caregivers should prepare the following:


1. Essential Labour Equipment


Delivery bed


Gloves (sterile and non-sterile)


Cord clamps or ties


Mucus extractor or suction machine


Clean towels


Maternity pads


Sterile scissors or blade


Baby warm clothing


BP machine, fetal stethoscope or Doppler


Delivery pack (kidney dish, forceps, syringes, etc.)



2. Drugs and Supplies


Oxytocin (for managing third stage)


Magnesium sulphate (for pre-eclampsia)


Vitamin K injection for baby


Tetanus toxoid


IV fluids and cannulas


Misoprostol (in emergency)



3. Infection Prevention


Hand washing area or sanitizer


Sterilizer


Clean environment


Sharps box



STAGES AND PROCEDURE OF LABOUR


Labour occurs in three main stages, and here’s how each is managed:


STAGE 1: DILATATION STAGE


Begins with regular contractions and ends when the cervix opens to 10 cm.


Monitor contractions, fetal heart rate, and cervical dilatation using a partograph.


Encourage the mother to walk, urinate regularly, and take fluids.


Do not rush this stage. Observe and reassure the mother.



STAGE 2: EXPULSION STAGE


Starts from full dilatation and ends with the birth of the baby.


Ask the mother to push during contractions.


Support the perineum gently as the baby’s head crowns.


Deliver the baby gently, wipe the nose and mouth, clamp and cut the cord.



STAGE 3: PLACENTAL STAGE


Delivery of placenta within 30 minutes after baby is born.


Give oxytocin 10 IU IM to help deliver the placenta.


Gently pull the cord while supporting the uterus (controlled cord traction).


Check the placenta for completeness.



COMPLICATIONS OF LABOUR TO WATCH FOR


Caregivers must be alert for danger signs:


1. Prolonged Labour


Labour lasting more than 12 hours in first-timers or 8 hours in others.


May lead to exhaustion, fetal distress.



2. Obstructed Labour


Due to small pelvis or big baby.


Needs urgent referral.



3. Postpartum Hemorrhage (PPH)


Heavy bleeding after delivery.


Manage with uterotonics like oxytocin, misoprostol.



4. Fetal Distress


Irregular fetal heartbeat, meconium-stained fluid.


Immediate action or referral needed.



5. Eclampsia


Convulsions in pregnant woman due to high BP.


Give magnesium sulphate and refer.


IMPORTANT NOTES FOR COMMUNITY HEALTH AND MIDWIFE CAREGIVERS


Always use clean gloves and sterile tools.


Record findings clearly and monitor with a partograph.


Educate mothers on signs of labour before delivery.


Know when to refer – delay can cause death.


Support the mother emotionally and physically.


CONCLUSION


Labour is a natural process, but it needs careful attention. As a caregiver, your role is to protect both mother and baby. Be ready, stay alert, and act fast when needed. Proper labour care reduces deaths and improves community trust in healthcare services.

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