Stage 2 is 40 minutes in duration with reasonable progress. A normal pattern of second-stage labour, fetal heart interpretation. Clinical courage, commitment to optimize health of both baby and mother, and willingness to use local resources. A second doctor is called to ensure neonatal resuscitation tools are in working order, and appropriate medications are drawn up. The decision to perform vacuum extraction is discussed with the second doctor and the decision is made to expedite delivery because of the observation of meconium, and deep variables of fetal heart beat with slow recovery and new baseline bradycardia.
Vacuum extraction is performed with easy delivery and intact perineum.
The neonate is suctioned on the perineum but is limp and does not cry upon delivery. The neonate is given to the second family doctor who uses a laryngoscope to view the cords and suction the oropharynx for a small amount of meconium. No meconium is visualized below the cords. Management of stage 2. Cooperation of both doctors with one another, good communication between doctors and registered nurses and with the neonate's parents.