Signs for the midwife to check in stage 1
On the way to a medical center, the woman should lie on her left side and stay
quiet and calm. If possible, the inside of the vehicle should be dark. Her labor may
happen very fast. Stay by her side while you travel in case the baby is born or she
has a convulsion.
Mother has convulsions (fits)
Pre-eclampsia can lead to convulsions. This is called eclampsia.
When a woman has a convulsion, she may have some or all of these signs:
• rolling eyes
• twitching hands and face
• stiff, rigid, or shaking body
• blue skin
• loud, bubbly sound while breathing
She may bite her tongue, urinate, or pass stool. She may have several
convulsions in a row. Then she may sleep for a while. When she wakes up, she may
be confused and not know what happened.
A convulsion may last anywhere from a few seconds to many minutes. Some
convulsions are stronger than others, but all convulsions are very dangerous.
More than half of the women who have convulsions in labor will die, or their
babies will die, or both. Get medical help as soon as possible when the
convulsion is over.
What to do
1. Stay calm.
2. Do not put anything in the mother’s mouth. She must be allowed to
3. Put the mother on her side, so she does not breathe in her spit or vomit.
4. Remove hairpins or other sharp objects which could harm the mother.
5. Give the mother oxygen, if you have it (see page 173).
6. Give the mother medicine.
Medicines for eclampsia
Medicines for eclampsia are best used in a medical center because they have many
dangerous side effects. These medicines can cause the mother to have trouble
breathing, or cause the baby to have trouble breathing after he is born, especially if
the mother is given more than the recommended doses. We explain how to use
these medicines on the next page because in an emergency they can save a
woman’s life. But you should use them only if you have been trained and you are
on the way to a hospital or medical center.
If the mother is having a convulsion, give her magnesium sulfate. If you do not
have magnesium sulfate, give diazepam.
A Book for Midwives