Video Pembelajaran Pertolongan Persalinan (Kala II, Kala III dan Kala IV)

Main ideas / lessons from the video

The subtitles outline a training/teaching sequence for assisting childbirth across the 2nd, 3rd, and 4th stages of labor, including:

• Identifying readiness for pushing (Kala II)
• Key midwifery/obstetric steps and monitoring of maternal and fetal status
• Managing delivery of the baby and the placenta (Kala III)
• Immediate post-placental assessment and care (Kala IV), including checks for bleeding and uterine contractions

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Detailed methodology / instruction list (as presented)

A) Before pushing (transition into Kala II)

• Check signs of labor, such as:
  • Urge to push
  • Pressure on the anus
  • Brief opening of the vulva/anus
• Prepare the birth process
  • “Prepare myself first” (implied readiness and positioning)
• Ongoing monitoring
  • Check maternal/fetal status (including references to heart rate and watching the clock)
• Confirm labor progress
  • Ask/check whether cervical dilation is complete

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B) Delivery of the baby (Kala II mechanics)

• How to push properly
  • Mother positioning
    • Mother’s legs bent
    • Positioning described as pressing/placing toward the lower abdomen
    • Hold the mother’s ankles
  • When pushing is needed
    • Push when there is an urge to push (“like someone defecating”)
    • Look toward the stomach area during pushing
  • Breathing/effort technique
    • Open eyes, “bite your teeth”
    • Take a deep breath, hold it, then push
    • Rest between contractions when there are “no contractions”
• Companion support
  • Father/companion can give mother a drink
  • Mother may change positions (subtitles mention options such as tilting, squatting, crawling)
• Prepare for delivery
  • Use gloves
  • Place a sterile drape under the mother’s buttocks
  • Support the perineum:
    • Dominant hand supports the perineum
    • Other hand supports the baby’s head to control extension and prevent uncontrolled stretching
• Crowning and birth assistance
  • Coach mother to “please push”
  • Provide controlled support as the head delivers until birth completes
• After head delivery
  • Umbilical cord check
    • Ensure no cord twist
  • Wait for external rotation
  • Deliver shoulders/body using described “forceps-like” guidance steps, including references to biparietal handling and controlled directional maneuvers
  • Support the baby’s body safely:
    • Protect the head while guiding the body
    • Trace/support the baby’s arms/body/legs to hold toward the toes

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C) Immediate newborn assessment and drying

• Assess baby condition
  • Subtitles mention assessing a “Buga baby with abgas 9 to 10” (likely an Apgar/condition-related score, though the transcription is unclear)
• Drying
  • Dry using a dry towel on the mother’s stomach
  • Dry all parts except palms, then replace the wet towel with a dry one

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D) Delivery of the placenta and third stage management (Kala III)

• Check for uterine/fetal status
  • Check fundus and whether it is a double fetus (subtitles conclude single fetus)
• Uterotonic to stimulate uterine activity
  • Insert oxytocin using sterile principles (later described as an intramuscular injection)
  • Inject in the “outer third” of the mother’s mid-area (location described as transcribed)
• Umbilical cord management
  • Cut cord about 5 cm from the baby’s stomach area
• Controlled cord traction / placental delivery steps
  • Clamp cord and perform “massage” toward the maternal side
  • A “second clamp” is referenced to protect the fetus part; then cut using scissors (“rope scissors” as transcribed)
• Early breastfeeding / skin-to-skin positioning
  • Assist mother: open blanket; position baby “like a frog in a crawling position”
  • Place baby head between mother’s chest
  • Keep warm using swaddle and hat
  • Encourage baby to crawl naturally to the nipple; ensure attention to nose position
• Confirm placental separation (signs mentioned)
  • Globular uterus
  • Small spurt of blood from the birth canal
  • Umbilical cord becomes elongated
• Deliver placenta using steps
  • Dorsocranial movement (described): tighten/traction with one hand while supporting symphysis with the other
  • Place/tension until placenta appears at the vulva
  • Catch placenta when visible, then twist clockwise until it comes out spontaneously
  • If amniotic membrane remains, twist again (clockwise) until expelled spontaneously
• After placenta is born
  • Put placenta on bed
  • Check uterine contractions for the first 15 seconds to confirm contractions and screen for uterine atony
• Finish steps
  • Repeated emphasis on “massage toward maternal part” and ensuring completion

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E) Immediate post-delivery care and assessment (Kala IV)

• Assess bleeding and tears
  • Evaluate the birth canal/perineum for tears:
    • Use gauze and apply gentle pressure to the perineal area
    • Check whether a tear exists
• Assess uterine contraction quality
  • Ensure contractions are “going well” and are hard
  • Subtitles state contractions are hard; location described as “two fingers below the navel”
• Clean and provide reassurance
  • Cleaning is mentioned after assessment
  • “Congratulations” is referenced in the scene

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Speakers / sources featured (from subtitles)

• No clear named individuals are provided.
• The subtitles repeatedly use “Ma’am”, indicating an instructor/clinician addressing staff and the mother.
• Father/companion is referenced as someone who can support the mother (e.g., giving a drink), but no specific name is provided.

Identifiable speaker roles (as per subtitles)

1. Instructor/clinician (“Ma’am” addressing staff and the mother) — unnamed
2. Mother/patient (“mother,” “she”) — unnamed
3. Father/companion — unnamed