Topic Review: Intra-Natal Care (Labor and Delivery) 5.
Administration of Enema
Definition:
1. Care of the Pregnant Client During Labor Introducing fluid into the rectum to stimulate bowel
movement before labor.
Definition:
This refers to the holistic and safe care provided to a
woman during labor — from the beginning of contractions Purpose:
until the delivery of the baby and placenta.
Empty the bowel to avoid fecal contamination during
delivery.
-Ensure safe delivery for both the mother and baby. Promote comfortable pushing.
-Relieve pain and anxiety.
-Monitor vital signs, contractions, fetal heart rate (FHR), and Procedure:
labor progress.
Explain procedure and gain consent.
-Prevent infection or complications.
Position in left lateral position.
-Provide emotional support.
Lubricate tip of enema and insert into rectum.
-Nurse’s Responsibilities:
Slowly squeeze enema bag or bulb.
-Check mother’s BP, pulse, temperature, and contraction -
pattern regularly. Encourage the client to retain it for a few minutes before
defecation.
-Monitor fetal heart rate using a Doppler or fetoscope.
Note: Enemas are not always routine now — based on
-Maintain hygiene and comfort. facility policy or doctor’s orders.
-Encourage proper positioning, breathing exercises, and
hydration.
6. Catheterization Procedure
-Explain procedures to reduce anxiety.
Definition:
Insertion of a urinary catheter to empty the bladder.
2. Monitoring the Progress of Labor Using the Partograph
Definition: A Partograph (or partogram) is a graphical tool
used to monitor labor. It helps track the progress of cervical Purpose:
dilation, fetal condition, and maternal condition. -Prevent bladder distension during labor.
4. Perineal Care Before Delivery -Clear bladder before delivery or cesarean section.
Definition: -Monitor urinary output.
Cleaning the perineal area (between the vagina and anus)
to reduce the risk of infection before childbirth.
Procedure:
-Explain the procedure and provide privacy.
Steps:
-Position the woman in dorsal recumbent or lithotomy
-Explain procedure and provide privacy. position.
-Wash hands and wear gloves. -Perform perineal care.
-Position the client properly (lithotomy or side-lying). -Use sterile gloves and catheter kit.
-Use sterile warm water and antiseptic. -Lubricate the catheter and insert into the urethra.
-Wipe from front to back (vagina to anus) using sterile -Collect urine in a sterile container or drain bag.
gauze.
-Remove catheter if it's intermittent, or secure it if
-Repeat until area is clean. indwelling.
INTRA-NATAL CARE (LABOR AND DELIVERY) – SIMPLE Baby’s head position
TOPIC REVIEW
Contraction pattern
1. CARE OF THE PREGNANT WOMAN DURING LABOR
Mother’s vital signs and urine
Meaning: Care given to the mother while she is in labor
(about to give birth).
How to Fill the Partograph:
What the nurse should do:
Cervix opening is checked and marked every 4 hours
Check mother’s vital signs (BP, temperature, pulse,
breathing) Baby’s heartbeat is recorded every 30 minutes
Listen to baby’s heartbeat Contractions are counted every 30 minutes
Check how labor is progressing Descent of baby’s head is checked
Support the mother emotionally Vital signs like BP and temperature are recorded
Help her change positions to feel comfortable Why It’s Important:
Make sure she uses the toilet regularly Helps see if labor is too slow or difficult
Keep her clean and safe Tells the nurse or doctor when to help or refer
Prepare things needed for the delivery 3. CHECKING UTERINE CONTRACTIONS
2. MONITORING LABOR USING A PARTOGRAPH Meaning: These are the muscle tightenings of the womb
that help push the baby out.
Meaning: A partograph is a chart used to check if labor is
going normally. Things to Check:
Parts of a Partograph: Frequency: How often contractions happen (every 5 mins?)
Mother’s name and pregnancy info Duration: How long each one lasts (30-60 seconds?)
Baby’s heart rate and condition of water (amniotic fluid) Interval: Time between contractions
Cervix opening (dilation) Strength (Intensity): Weak, moderate, or strong (checked by
feeling the belly)
6. CATHETERIZATION DURING LABOR
4. PERINEAL CARE BEFORE DELIVERY
Meaning: Inserting a thin tube into the bladder to remove
urine.
Meaning: Cleaning the private area of the mother before
the baby comes out. Why It’s Done:
Steps: Empty the bladder before or during delivery
Explain the procedure Measure how much urine comes out
Wash hands and wear gloves Steps:
Position mother (lying down) Explain and ask permission
Use clean water and solution Provide privacy
Wipe from front to back Clean the area
Use new cotton each time Gently insert the tube
Dry the area Collect urine
Why It’s Done: Remove or leave tube if needed
Prevent infection Risks: Infection or discomfort if not done properly
Keep area clean for baby’s birth
SIMPLE PARTOGRAPH SAMPLE
5. ENEMA BEFORE DELIVERY Includes these parts:
Time (every 4 hours)
Meaning: Putting liquid in the rectum to remove poop. Cervix opening (0 to 10 cm)
Baby’s heartbeat
Why It’s Done: Contractions (how often and how strong)
Empty the bowel Baby’s head position
Avoid poop during delivery Color of water (amniotic fluid)
How It’s Done: Mother’s pulse, BP, temperature, and urine output
Explain to the mother
Lie on left side REVIEW FOR YOUR TEST:
Insert tube with fluid Know the meaning and steps of each procedure
Ask her to hold it for a few minutes Learn how to check and record contractions
Let her go to the toilet or use bedpan Practice how to read and fill a partograph
Not done if: There's bleeding, early labor, or high risk Understand signs of normal vs. abnormal labor