Essential Intrapartum and Newborn Care (EINC) Evidence-based

Standard Practices
The EINC practices are evidenced-based standards for safe and quality care of birthing
mothers and their newborns, within the 48 hours of Intrapartum period (labor and delivery)
and a week of life for the newborn.

Developed and field tested by international and local experts, EINC practices reflect current
knowledge. EINC distinguishes the necessary practices in the delivery and care for the
newborn and the mother, from the unnecessary. In December 2009, the Secretary of the
Department of Health Francisco Duque signed Administrative Order 2009-0025, which
mandates implementation of the EINC Protocol in both public and private hospitals. Likewise,
the Unang Yakap campaign was launched.

The EINC practices during Intrapartum period

Continuous maternal support, by a companion of her choice, during labor and

delivery
Mobility during labor the mother is still mobile, within reason, during this stage
Position of choice during labor and delivery
Non-drug pain relief, before offering labor anesthesia
Spontaneous pushing in a semi-upright position
Episiotomy will not be done, unless necessary
Active management of third stage of labor (AMTSL)
Monitoring the progress of labor with the use of pantograph

Recommended EINC practices for newborn care are time-bound interventions at the time of
birth

Immediate and thorough drying of the newborn

Early skin-to-skin contact between mother and the newborn
Properly-timed cord clamping and cutting
Unang Yakap (First Embrace) of the mother and her newborn for early breastfeeding
initiation

Unnecessary interventions eliminated

The unnecessary interventions during labor and delivery, which do not improve the health of
mother and child, are eliminated. These are enemas and shavings, fluid and food intake
restriction, and routine insertion of intravenous fluids. Fundal pressure to facilitate second
stage of labor is no longer practiced, because it resulted to maternal and newborn injuries
and death.
Likewise, the unnecessary interventions in newborn care which include routine suctioning,
early bathing, routine separation from the mother, foot printing, application of various
substances to the cord, and giving pre-lacteals or artificial infant milk formula or other
breast-milk substitutes.

Government and international Support

Since 2010, WHO supports the DOH in changing practices for safe and quality care of
mothers and newborns for all practitioners and health facilities. It was initially implemented
in 11 selected government hospitals collectively representing about 70,000 annual live
births (around 3% of all national live births). AusAID also provided support through the Joint
Programme on Maternal and Neonatal Health (JPMNH).