Normal Labor and Birth Kim Ploch, mn, cnm, arnp


HR, respirations, muscle tone, reflex



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HR, respirations, muscle tone, reflex

irritability, color

  • Umbilical cord care - # of vessels, apply clamp ½-1 “ from abd

  • NB identification and footprints

  • NB physical assessment

Newborn Attachment

  • Keep baby on maternal abdomen for initial procedures

  • Early breastfeeding – within 1st hr

  • Minimal interruptions

  • Delay Vitamin K and eye ointment x 1 hr

  • Dim lights, quiet environment

  • Provide privacy

Fourth Stage

  • Ongoing assessment of maternal bonding & infant stability

  • Comfort measures – peri-care, ice packs, warm blankets

  • Maternal VS & fundal checks q 15 min x 1 hr

  • Fundus should be @ u or lower, firm and ML

  • Assess lochia (scant, moderate, heavy)

  • Assess bladder – full deviates to right

  • Call CNM/MD: hypotension, tachycardia, uterine atony, excessive bleeding, temp> 100




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