 | Care in Normal Birth (WHO, 1996, 60 p.) |
 |  | (introduction...) |
| | ACKNOWLEDGEMENTS |
|  | 1. INTRODUCTION |
| | 1.1 Preamble |
| | 1.2 Background |
| | 1.3 Risk Approach in Maternity Care |
| | 1.4 Definition of Normal Birth |
| | 1.5 Aim of the Care in Normal Birth, Tasks of the Caregiver |
| | 1.6 The Caregiver in Normal Birth |
| | 2. GENERAL ASPECTS OF CARE IN LABOUR |
| | 2.1 Assessing the Well-being of the Woman during Labour |
| | 2.2 Routine Procedures |
| | 2.3 Nutrition |
| | 2.4 Place of Birth |
| | 2.5 Support in Childbirth |
| | 2.6 Labour Pain |
| | (introduction...) |
| | 2.6.1 Non-pharmacological methods of pain relief |
| | 2.6.2 Pharmacological pain relief in labour |
| | 2.7 Monitoring the Fetus during Labour |
| | (introduction...) |
| | 2.7.1 Assessment of amniotic fluid |
| | 2.7.2 Monitoring the fetal heart rate |
| | 2.7.3 Fetal scalp blood examination |
| | 2.7.4 Comparison of auscultation and electronic fetal monitoring |
| | 2.8 Cleanliness |
| | 3. CARE DURING THE FIRST STAGE OF LABOUR |
| | 3.1 Assessing the Start of Labour |
| | 3.2 Position and Movement during the First Stage of Labour |
| | 3.3 Vaginal Examination |
| | 3.4 Monitoring the Progress of Labour |
| | 3.5 Prevention of Prolonged Labour |
| | (introduction...) |
| | 3.5.1 Early amniotomy |
| | 3.5.2 Intravenous infusion of oxytocin |
| | 3.5.3 Intramuscular oxytocin administration |
| | 4. CARE DURING THE SECOND STAGE OF LABOUR |
| | 4.1 Physiological Background |
| | 4.2 The Onset of the Second Stage |
| | 4.3 The Onset of Pushing during the Second Stage |
| | 4.4 The Procedure of Pushing during the Second Stage |
| | 4.5 Duration of the Second Stage |
| | 4.6 Maternal Position during the Second Stage |
| | 4.7 Care of the Perineum |
| | (introduction...) |
| | 4.7.1 “Guarding the perineum” during delivery |
| | 4.7.2 Perineal tear and episiotomy |
| | 5. CARE DURING THE THIRD STAGE OF LABOUR |
| | 5.1 Background |
| | 5.2 Prophylactic use of Oxytocics |
| | 5.3 Controlled Cord Traction |
| | 5.4 Active Versus Expectant Management of the Third Stage |
| | 5.5 Timing of Cord Clamping |
| | 5.6 Immediate Care of the Newborn |
| | 5.7 Care of the Mother Immediately after Delivery of the Placenta |
| | 6. CLASSIFICATION OF PRACTICES IN NORMAL BIRTH |
| | (introduction...) |
| | 6.1 Practices which are Demonstrably Useful and Should be Encouraged |
| | 6.2 Practices which are Clearly Harmful or Ineffective and Should be Eliminated |
| | 6.3 Practices for which Insufficient Evidence Exists to Support a Clear Recommendation and which Should be Used with Caution while Further Research Clarifies the Issue |
| | 6.4 Practices which are Frequently Used Inappropriately |
| | 7. REFERENCES |
| | 8. LIST OF PARTICIPANTS |
| | SAFE MOTHERHOOD RESOURCE LIST |
| | BACK COVER |
3.5.3 Intramuscular oxytocin administration
Use of any intramuscular oxytocic before the birth of the infant is generally regarded as dangerous, because the dosage cannot be adapted to the level of uterine activity. Hyperstimulation may result and is harmful to the fetus. An increase in the incidence of ruptured uterus, with corresponding grave sequelae, has also been linked to this practice (Kone 1993, Zheng 1994). Nevertheless intramuscular oxytocin administration is still practised, sometimes at the request of pregnant women or her family expecting a more rapid delivery. In some developing countries the drug can be bought on the market. This harmful practice should be abandoned. The same holds true for the administration of other oxytocics, like prostaglandins, at any time before delivery in such a way that their effect cannot be controlled.
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