Component Task: Active Management of The 3rd Stage of Labour

This is a technique which is used by the midwife to manage the 3rd stage of labour. It involves the administration of the uterotonic drugs, early cord clamping and controlled cord traction to deliver the placenta and membrane and control haemorrhage.

Aims

·         Prevent delay in the delivery of placenta and membranes

·         Reduce the risk of postpartum haemorrhage

·         Reduce maternal morbidity and mortality

·         Prevent infection

Requirements

Use second stage trolley

Steps

·         Palpate to rule out undiagnosed second twin

·         Explain procedure to client (refer steps)

·         Observe and maintain infection prevention techniques throughout procedure

·         Ensure bladder is emptied

·         Place cut end of cord into a sterile receiver

·         Place the left palm on fundus to feel for contraction and push uterus

·         Release the forceps and clamp cord closer to the vulva

·         Hold the forceps horizontally and apply downward and outward traction on the cord

·         Receive placenta into both hands and tease membranes out

·         Examine placenta and membranes for completeness

·         Rub up uterus to expel clots and to initiate contraction

·         Examine the genital tract for any tears

·         Estimate blood loss

·         Tidy up client, apply clean perineal pad

·         Congratulate her for her effort

·         Make client comfortable or move client into 4th stage room

·         Record findings throughout procedure and report to the in-charge

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