Essential Nursing Care: Childbirth, Postpartum, and Newborn Health

Emergency Nursing Care During Childbirth

Effective emergency nursing during childbirth requires quick thinking, a calm demeanor, and precise actions to ensure the safety and well-being of both mother and baby.

Key Principles of Delivery Nursing

1. Serenity: Think and act quickly, remaining calm to convey confidence to the mother and others present.
2. Aseptic Technique: Always use sterile gloves. Any measure taken to provide maximum cleanliness helps prevent infection for both the baby and the mother.
3. Controlled Delivery of the Head: On the birth of the child's head, it is crucial to prevent sudden, hasty expulsion. This control helps prevent brain damage to the child and lacerations to the mother. Never abruptly stop the birth of the child's head to slow expulsion; instead, guide it gently.

Postpartum Recovery Room Nursing Care

In the recovery room, continuous monitoring is essential. Every fifteen minutes, the nurse will review the mother's blood pressure (BP), pulse rate, fundus, lochia, and perineum, along with signs of recovery, especially in patients who received general anesthesia, and assess for nausea.

Postpartum Assessment Parameters

1. Vital Signs:
   • Blood pressure and pulse should be within normal limits.
   • A decrease in BP accompanied by a thready and rapid pulse is a significant sign of bleeding.
   • An increase in BP can be a symptom of preeclampsia.
   • Temperature should remain within normal limits.
2. Uterus: The fundus is reviewed to check its height and tone. Good muscle tone and strong contractions are vital to prevent postpartum hemorrhage.
3. Lochia: The amount should be moderate. Excessive, thick bleeding accompanied by blood clots indicates potential hemorrhage. If lochia flow appears limited, ensure that no clots are accumulating inside the uterus.

Immediate Newborn Care by Nurses

Immediate nursing assistance for the newborn is directed towards ensuring the physical safety, comfort, and emotional well-being of the infant.

Essential Newborn Interventions

1. Airway Clearance: For physical security, the newborn's airways must be completely clear so they can breathe without difficulty. As soon as the head is born, aspirate fluid and mucus from the nose, mouth, and throat to prevent the child from aspirating these fluids when taking their first breath.
2. Cord Clamping: Proper cord clamping is necessary to prevent bleeding from the umbilical cord.
3. Apgar Score Assessment: This is a standardized method for assessing the physical condition of the newborn. It is performed at one minute and five minutes after birth. Five parameters are rated at 0, 1, or 2 points: heart rate (FC), respiratory effort, muscle tone, reflex irritability, and skin color. The total score is the sum of these points, ranging from 0 to 10.
4. Prevention of Cold Stress: One of the most important functions of the nurse in the delivery room is to prevent cold stress in the newborn. Uncontrolled cold stress can lead to serious problems such as apnea, hypoglycemia, acidosis, and respiratory distress syndrome.
5. Medications in the Delivery Room:
   • Ophthalmic antibiotic ointment is administered to prevent eye infections that could be acquired during passage through the birth canal.
   • 0.1 ml of Vitamin K is given to prevent bleeding disorders in the newborn.

Signs of Newborn Stabilization

After initial interventions, a healthy newborn typically exhibits the following signs: breaths are well established, the child cries strongly, their arms and legs are strong, and the color of their skin is pink, except possibly in the hands and feet (acrocyanosis, which is normal initially).