(3) Encourage the patient to pant or blow through contractions to slow the
delivery process and to decrease the force of expulsion.
Provide for privacy, but do not leave the patient alone.
NURSING CARE FOR MANAGEMENT OF PRECIPITATE DELIVERY
See figure 3-1.
a. Check for Presence of an Intact Amniotic Sac.
(1) If the membranes do not break spontaneously, they should be ruptured
just prior to or with the delivery of the head.
(2) Caution must be taken to prevent the membranes from covering the
infant's mouth as the first breath is taken, otherwise aspiration of amniotic fluid can
b. Support the Perineum and Infant's Head.
(1) Apply support to the perineum with your dominant hand (usually right
hand) using a towel or cloth. When available, turn your hand with your palm facing the
fetal head and fingers pointed downward, and apply firm pressure against the perineum
with the flattened fingers.
(2) Apply support to the fetal head with your nondominant hand. Spread
your middle three fingers; place your fingers against the anterior aspect of the head.
(3) Increase the pressure of the dominant hand in a downward motion
against the perineum as the fetal head extends. This will assist in "sliding" the
perineum over the fetal face. If the perineum is not flexible enough to deliver the fetus
without lacerations, maintain firm pressure. This will help to minimize the extent of
(4) Provide mild downward pressure with the nondominant hand against the
fetal head as the fetal head extends. This will guide the head away from the anterior
vulva and minimize lacerations around the urethra.
(5) Take special care to avoid excessive pressure on the fetal head. Never
attempt to delay delivery by applying pressure on the fetal head.
(6) Combine efforts of the right and left hand. This will result in a slow,
controlled extension of the fetal head.