ABSTRACT
We have already considered the various risks that the developing fetus may encounter during the antenatal period and how these have relevance for the examination of the newborn baby (see Chapter 3). However, the perfectly healthy term baby may be affected by events during childbirth. Practitioners should therefore possess a thorough knowledge of labour and birth, the difficulties that can arise in childbirth and their possible consequences for the health of the newborn. The events surrounding the birth will be carefully documented in the mother’s records, and these should be scrutinised in advance so that the examination takes into account any increased risk factors associated with a particular birth. It is important that practitioners are fully aware of the events surrounding each labour and birth so that they are able to respond appropriately to parents who may, for a number of reasons, have concerns relating to the birth of their child. Although midwives and neonatal nurses often care for neonates requiring additional care, such as premature infants or those with feeding difficulties, it should be noted that only healthy, full-term neonates should be clinically examined by the midwife or nurse. All other babies should be referred to a medical or advanced nurse practitioner, in line with local policy (see Chapter 7) and professional guidance (Nursing and Midwifery Council 2004). Having ensured that this particular examination of the newborn falls within
the practitioner’s remit, the following questions should be borne in mind:
1. Was the pregnancy prolonged? 2. Was the labour induced or accelerated and, if so, why? 3. How long were the fetal membranes ruptured prior to birth? 4. Were there any anomalies of the fetal heart rate during labour? 5. Was the liquor meconium stained? 6. What were the methods of pain relief used during the labour and birth? 7. What was the presenting part of the fetus during labour? 8. What was the mode of birth? 9. Did the baby require any resuscitation at birth? 10. Were any injuries or abnormalities noted at the birth?
