a. Assist the mother into a comfortable position with her legs extended.

b. Provide a clean surface under the patient’s buttocks.

c. Check uterine fundus every 10 to 15 minutes during the first hour to assure contraction of myometrium and normal lochial flow.

(1) Gently massage the uterus if the fundus is soft or boggy.

(2) Avoid overstimulation as myometrium will fatigue and result in severe atony.

d. Assess the amount of blood loss from the delivery. Normally, blood loss is less than 500 cc. Save all evidence of blood loss.

e. Assess for intactness of the placenta.

f. Provide for comfort and warmth of both patients. Promote fluids in the mother as tolerated.

g. Encourage the mother to void to prevent bladder distention.

h. Make notations about the birth to include:

(1) Fetal position and presentation.

(2) Presence of nuchal cord and method of reduction.

(3) Color, character, and amount of amniotic fluid.

(4) Time of delivery.

(5) Sex of infant.

(6) APGAR scores; need for stimulation or resuscitation.

(7) Approximate time of placental expulsion, appearance, and completeness.

(8) Maternal condition (affect, amount of bleeding, and status of uterine contraction).

(9) Any unusual occurrences during the delivery.