Nursing Component Task
Nursing procedures & clinical learning

Midwifery (RM)

Examination of a New Born Baby at the Labour Ward

The immediate newborn examination assesses adaptation after birth, gestation, physical condition, injuries, congenital abnormalities, feeding readiness, and danger signs. It is performed after stabilization and alongside warmth, skin-to-skin, and timely breastfeeding.

Purpose

  • Assess newborn transition and detect abnormalities
  • Identify conditions requiring resuscitation, treatment, or referral
  • Establish baseline findings and support parent education

Indications

  • Every newborn after birth
  • Any newborn with abnormal breathing, colour, tone, temperature, feeding, or injury
  • Before transfer from the labour ward

Equipment

  • Warm examination area and towels
  • Newborn stethoscope, thermometer, scale, tape, and clock
  • Cord and identification materials
  • Resuscitation equipment
  • Newborn record and referral materials

Preparation

  • Check resuscitation and examination equipment, identification bands, and newborn records.
  • Review maternal infections, medications, gestation, and birth events.

Procedure steps

  • Confirm identity, birth time, gestation, maternal history, and initial transition; initiate resuscitation if needed.
  • Maintain warmth and skin-to-skin when stable, assess breathing, colour, tone, temperature, heart rate, and activity.
  • Perform a systematic head-to-toe examination including head, eyes, mouth, chest, heart, abdomen, cord, spine, limbs, hips, genitalia, anus, and skin.
  • Assess gestational maturity, weight, length, head circumference, and feeding readiness according to policy.
  • Check for birth injury, bleeding, congenital anomaly, infection risk, hypoglycaemia risk, and abnormal observations.
  • Support early breastfeeding and observe attachment when stable.
  • Give prophylaxis or screening according to current national policy and orders.
  • Explain findings to the parent and escalate abnormal signs or inability to maintain warmth or feeding.
  • Identify and label the newborn correctly before transfer.
  • Document findings, interventions, screening, education, referrals, and handover.

Precautions

  • Stabilize breathing and circulation before a detailed examination.
  • Prevent hypothermia and unnecessary separation.
  • Use clean technique and safe cord care.
  • Escalate respiratory distress, cyanosis, seizures, severe lethargy, hypothermia, or poor feeding.

Aftercare

  • Continue routine observations, feeding, warmth, and danger-sign surveillance.
  • Provide clear postnatal handover and follow-up.

Nursing considerations

  • Use a systematic examination and compare findings with gestational age.
  • Keep the parent informed and involved whenever clinically safe.

Patient education

  • Teach warmth, feeding, cord care, hygiene, and newborn danger signs.
  • Encourage prompt review for poor feeding, fever or coldness, difficulty breathing, jaundice, or abnormal activity.

Documentation

  • Record transition, physical findings, measurements, screening, prophylaxis, feeding, education, referral, and handover.
  • Document the examiner and time.

References and further reading

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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