This isn’t good either, as the rapid homolysis of the fetal hemoglobin can lead to increased problems with neonatal jaundice. Holding the baby below the level of the placenta results in pooling of placental blood within the newborn. While the cord remains intact, elevation of the fetus above the level of the placenta (for example, resting on the mother’s abdomen) results in some pooling of newborn blood within the placenta and can make the baby somewhat anemic. Once the baby is breathing, then blood is shunted to its lungs where it receives much better oxygenated blood than it was getting from the placenta. Use scissors to cut between the clamps.ĭuring the transition from intrauterine to extrauterine life, the umbilical cord will continue, for a short time, to provide oxygenated blood to the fetus. Once the baby is breathing, put two clamps on the umbilical cord, about an inch (3 cm) from the baby’s abdomen. During this time, keep the baby more or less level with the placenta still inside the mother. Clamp and Cut the Umbilical CordĪfter the baby is born, leave the umbilical cord alone until the baby is dried, breathing well and starts to pink up. This pause also allows the birth canal to squeeze the fetal chest, forcing amniotic fluid out of the baby’s nose and mouth.Īfter a reasonable pause (15-30 seconds), have the woman bear down again, delivering the shoulders and torso of the baby. Delivery of the babyĭuring the delivery, the fetal head emerges through the vaginal opening, usually facing toward the woman’s rectum.Īs the fetal head delivers, support the perineum to reduce the risk of perineal laceration from uncontrolled, rapid delivery.Īfter the fetal head delivers, allow time for the fetal shoulders to rotate and descend through the birth canal. This is called “pushing.” The maternal pushing efforts assist in speeding the delivery.įor women having their first baby, the second stage will typically take an hour or two. At this time she will feel the urge to bear down, holding her breath and performing a Valsalva, to try to expel the baby. Expulsion (shoulders and torso of the baby are delivered.)Īs the fetal head descends below 0 station, the mother will perceive a sensation of pressure in the rectal area, similar to the sensation of an imminent bowel movement.External Rotation (head returns to its’ occiput transverse orientation).Extension (head extends with crowning, passing through the vulva.).Internal Rotation (head rotates from occiput transverse to occiput anterior.).Flexion (head is flexed with the chin to its’ chest.).Descent (fetal head descends past 0 station.).Engagement (fetal head reaches 0 station.). The exact time of delivery is normally taken at the moment the baby’s anterior shoulder (the shoulder delivering closest to the mother’s pubic bone) is out.Īs the fetal head passes through the birth canal, it normally demonstrates, in sequence, the “cardinal movements of labor.” These include: The second stage begins with complete dilatation and ends when the baby is completely out of the mother. Delivery is also known as part of the second stage of labor.
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