• Make a rapid evaluation of the general condition of the woman including vital signs (pulse, blood pressure, respiration, temperature).
• Assess fetal condition:

- Listen to the fetal heart rate immediately after a contraction:

- Count the fetal heart rate for a full minute at least once every 30 minutes during the active phase and every 5 minutes during the second stage;
- If there are fetal heart rate abnormalities (less than 100 or more than 180 beats per minute), suspect fetal distress.

- If the membranes have ruptured, note the colour of the draining amniotic fluid:

- Presence of thick meconium indicates the need for close monitoring and possible intervention for management of fetal distress

- Absence of fluid draining after rupture of the membranes is an indication of reduced volume of amniotic fluid, which may be associated with fetal distress.