• Bettercare
  • Intrapartum Care
← Menu

We have taken every care to ensure that drug dosages and related medical advice in this book are accurate. However, drug and disinfectant dosages can change and are updated often, so always double-check dosages and procedures against a reliable, up-to-date formulary and the given drug’s documentation before administering it.

Intrapartum Care: An advanced-midwife’s guide to labour and delivery

First published in 2009 by Bettercare. Updated February 2011, February 2015 (layout), July 2017 (significant changes), August 2020. This version produced on 26 February 2025.

Text © Perinatal Education Trust 2009
Illustrations by Anne Westoby

ISBN (paperback): 978-1-920218-38-6
ISBN (international paperback edition): 978-1-717898-08-1
ISBN (reflowable edition): 978-1-928313-04-5

Excluding content explicitly credited to others, this book is published under a Creative Commons Attribution Non-Commercial No Derivatives License. For details, see creativecommons.org/licenses/by-nc-nd/4.0.

This licence means you may share, copy and redistribute the material in any medium or format under the following terms:

  • Attribution — You must give appropriate credit, provide a link to the licence, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • Non-Commercial — You may not use the material for commercial purposes.
  • No Derivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.

For any other uses, please contact Bettercare.

← Title page
Contents →
Bettercare
Bookmarks
    Tap or select text, and then tap the bookmark icon to save a bookmark. Bookmarks are saved in your browser cache. Clearing your cache will remove them.
    Your last visit
      The last time you visited, you stopped reading here.
      Close
      • Twitter
      • Facebook
      • LinkedIn
      • WhatsApp
      • Reddit
      • Email
      • Link
      1. Home
      1. How to use our books
      2. Buy printed books
      3. About Bettercare
      4. FAQs
      5. Contact us
      1. Acknowledgements
      2. Introduction
        1. About Bettercare
        2. Why decentralised learning?
        3. Free Bettercare Online Learning Platform
        4. Learning programmes
        5. Format of the courses
        6. Contributors
        7. Updating the course material
        8. Contact information
        9. Registration
      3. 1 Monitoring the condition of the mother during the first stage of labour
        1. Objectives
        2. Monitoring labour
        3. Assessing the general condition of the patient
        4. Assessing the temperature
        5. Assessing the pulse rate
        6. Assessing the blood pressure
        7. Assessing the urine
        8. Maternal exhaustion
        9. Case studies
      4. 2 Monitoring the condition of the fetus during the first stage of labour
        1. Objectives
        2. Monitoring the fetus
        3. Fetal heart rate patterns
        4. The liquor
        5. Case studies
      5. 3 Monitoring and managing the first stage of labour
        1. Objectives
        2. The diagnosis of labour
        3. The two phases of the first stage of labour
        4. Monitoring of the first stage of labour
        5. Management of a patient in the latent phase of the first stage of labour
        6. Management of a patient in the active phase of the first stage of labour
        7. Poor progress in the active phase of the first stage of labour
        8. Cephalopelvic disproportion
        9. Inadequate uterine action
        10. The referral of patients with poor progress during the active phase of the first stage of labour
        11. Prolapse of the umbilical cord
        12. Women living with HIV
        13. Case studies
      6. Skills: Examination of the abdomen in labour
        1. Objectives
        2. Abdominal palpation
        3. Assessing contractions
        4. Assessing the fetal heart rate
      7. Skills: Vaginal examination in labour
        1. Objectives
        2. Preparation for a vaginal examination in labour
        3. Procedure of examination
        4. The vulva and vagina
        5. The cervix
        6. The membranes and liquor
        7. The presenting part
        8. Moulding
      8. Skills: Recording observations on the partogram
        1. Objectives
        2. The partogram
        3. Recording the condition of the mother
        4. Recording the condition of the fetus
        5. Recording the progress of labour
        6. Exercises on the correct use of the partogram
        7. Case studies
      9. 4 The second stage of labour
        1. Objectives
        2. The normal second stage of labour
        3. Managing the second stage of labour
        4. Episiotomy
        5. Prolonged second stage of labour
        6. Management of impacted shoulders
        7. Managing the newborn infant
        8. Case studies
      10. Skills: Performing and repairing an episiotomy
        1. Objectives
        2. Repairing an episiotomy
      11. 5 The third stage of labour
        1. Objectives
        2. The normal third stage of labour
        3. Managing the third stage of labour
        4. Examination of the placenta after birth
        5. The abnormal third stage of labour
        6. Managing postpartum haemorrhage
        7. Protecting the staff from HIV infection
        8. Case studies
      12. Skills: Inserting and using intra-uterine balloon tamponade to treat postpartum haemorrhage
        1. Objectives
        2. Unique features of the Ellavi intra-uterine balloon
        3. Prerequisites for use
        4. Preparation prior to use
        5. Insertion into the uterus
        6. Antibiotic prophylaxis
        7. Transfer
        8. Intra-uterine pressure control
        9. Monitoring for bleeding
        10. Abdominal discomfort
        11. Removal
        12. Cautions and warnings
      13. 6 Managing pain during labour
        1. Objectives
        2. Pain relief in labour
        3. Use of analgesics in labour
        4. Naloxone
        5. Sedation during labour
        6. Inhalational analgesia
        7. Local anaesthesia
        8. Epidural anaesthesia
        9. General anaesthesia
        10. Case studies
      14. 7 The puerperium
        1. Objectives
        2. The normal puerperium
        3. Management of the puerperium
        4. The six week postnatal visit
        5. Puerperal pyrexia
        6. Genital tract infection
        7. Urinary tract infections
        8. Thrombophlebitis
        9. Respiratory tract infection
        10. Puerperal psychiatric disorders
        11. Secondary postpartum haemorrhage
        12. Self-monitoring
        13. HIV positive mothers
        14. Case studies
      15. 8 Family planning after pregnancy
        1. Objectives
        2. Contraceptive counselling
        3. Case studies
      1. How to use our books
      2. Buy printed books
      3. About Bettercare
      4. FAQs
      5. Contact us

      Managed by Electric Book Works

      Buy books

      Did you know? Training and learning can be easier on paper. Buy our books now, or order in bulk at low cost.

      Find out more