Signs for the midwife to check in stage 1
What to do
Look at the waters. If they are a very light yellow or green and there are no other
warning signs, the stool is old, and the baby is probably OK. Listen to the baby’s
heartbeat throughout the labor and watch for other warning signs.
If the waters are darker, thick, or have lumps of meconium in them, get medical
help. A medical center should have tools to clear the baby’s mouth and lungs
when he is born, and can treat him if there is a problem with his lungs.
If you cannot get medical help, be prepared to help the baby breathe after the
birth (see page 241).
Note: If the baby is breech, it is normal for him to pass stool while he
is being born. This stool will not usually cause problems.
Think about how long the waters have been broken
Once the bag of waters breaks, germs can move quickly into the womb. To avoid
infection, the baby should be born within one day and one night (24 hours) after
the waters break. This means that labor should start within 12 hours after the
waters break.
While waiting for labor, help the mother keep germs out of her vagina:
• Do not do vaginal exams.
• Do not put anything into
the mother’s vagina.
• Make sure the mother does
not sit in water to bathe.
• Make sure the mother does
not have sex or put
anything in her vagina.
• Ask the mother to clean her
genitals from front to back
after urinating or
passing stool.
• Regularly change the
woman’s underclothes or
the bedding she is lying
on.
Her waters broke
around sunrise. It’s
almost sunset and
labor still hasn’t
started. Time to go
to the hospital.
You can try a home method to help labor start or get stronger (see page 191).
Do not give the mother medicines like oxytocin or misoprostol at home to start
labor. These medicines should only be used in a medical center.
175
A Book for Midwives (2010)