prolonged period, or the woman has been exposed to an infectious substance/situation), skilled attendants can also monitor women after delivery, educate women and their families on the signs of infection, and if sepsis develops, administer antibiotics. Skilled attendants can also recognise sepsis due to unsafe abortion

Pre-eclampsia and eclampsia: Skilled attendants can identify elevated blood pressure and proteinuria as signs of pre-eclampsia. Such cases should be provided with emergency care and referred for higher-level care. If eclampsia occurs during delivery, skilled attendants can provide potentially life-saving care: administering anticonvulsant drugs, inducing labor by rupturing membranes, and correctly positioning an unconscious woman for delivery. Skilled attendants should also be able to administer anticonvulsant drugs and stabilize a woman to prevent her condition from worsening, and refer her for higher-level care.

Prolonged or obstructed labor: A skilled attendant can use a partograph to monitor the progress of labor, identify prolonged or obstructed labor, and take appropriate and timely action. If labor is long or difficult, skilled attendants provide supportive care throughout the process. If prolonged labor is due to ineffective contractions, careful augmentation with oxtocin is an option. For other causes, such as shoulder dystocia or prolapsed cord, skilled attendants can provide emergency care. In some cases, experienced providers can use a vacuum extractor to save the lives of both mother and infant. In all cases of prolonged and obstructed labor, skilled attendants must be able to refer severe cases promptly to higher-level care.

Addressing abortion complications: A skilled attendant can play an important role in facilitating women’s access to the appropriate measures for managing unsafe abortion. These include providing treatment for or referring women who present with signs of inevitable, incomplete, and septic abortions, according to the attendant’s level of skill. In circumstances where abortion is not against the law, skilled attendants have a role to play in protecting women’s health. While not promoting abortion as a method of family planning, they may advocate to ensure that services are safe and accessible. Family planning counseling and methods should be provided in the postabortion period, as well as other reproductive health counseling as needed.

Preventing neonatal deaths: A skilled attendant can take appropriate measures to prevent neonatal death: tetanus toxoid immunization during pregnancy, assessing the baby’s condition at birth, and resuscitating, if necessary. Preventing neonatal hypothermia, taking appropriate measures



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