Chapter 11: Opening – stage 1 of labor
Magnesium sulfate for convulsions
• give 10 g magnesium sulfate 50% solution ���������5 g injected deeply
in each buttock
and 5 g
Before giving magnesium sulfate, count how many
x breaths the woman is taking each minute. Do not
give magnesium sulfate if she is taking fewer than
16 breaths a minute. If her breathing slows to
fewer than 16 breaths a minute after giving her
magnesium sulfate, get medical help immediately.
Diazepam for convulsions (if you do not have magnesium sulfate)
During a convulsion, diazepam must be given rectally. It will not work well injected
in the muscle, and the woman will not be able to swallow pills.
To prepare the medicine:
Wash and dry your hands and then put
on plastic gloves.
Fill a syringe with the injectable drug and
take the needle off the barrel.
Put the whole barrel of the syringe through
the anus and push the plunger in to empty it
inside the mother’s rectum.
Keep the barrel of the syringe in the rectum for at
least 5 minutes. It will act as a plug to keep the
medicine from coming out.
• give 20 mg injectable diazepam ����������������������������������in the rectum, after the first
then if there are other convulsions
• give 10 mg injectable diazepam ����������������������������������in the rectum, at least 20 minutes
after the first dose.
If you cannot get injectable diazepam
• crush 20 mg of diazepam pills into a fine powder and mix them with clean, cool
water (the pills will not dissolve, but mix them with water anyway).
First take the needle off of a syringe barrel. Then fill the barrel with the crushed
pills and water and put the whole barrel of the syringe up into the rectum —
the same as above.
(If some fluid leaks out of the rectum, it is OK to give 5 mg more diazepam.)
A Book for Midwives (2010)