1. Providing client education using a shared decision-making model
2. Understanding and identifying components of the physiologic process of labor
a. Identifying and understanding significance of the 3 P’s of labor, including the mechanisms of uterine contraction, pelvimetry, identification of fetal position using Leopold’s maneuvers, and cardinal movements of labor and birth
i. Powers
ii. Pelvis (including types/adequacy)
iii. Passenger
b. Understanding the stages of labor
c. Providing physical and psychological support for the laboring person and family
d. Supporting the laboring person using culturally sensitive care
e. Facilitating the presence of a support person
f. Monitoring birthing parent and fetal vital signs
g. Evaluating the well-being of the laboring person
h. Assessing the progress of labor, including Leopold’s maneuvers, cervical exam, and pantograph
3. Understanding the mechanisms of labor for the following presentations:
a. occiput anterior
b. transverse
c. occiput posterior
d. face
e. brow
f. military
g. breech
4. Familiarity with common complications of labor
a. preterm labor
b. postdates pregnancy
c. OP positioning
d. pendulous abdomen
e. failure to progress
f. maternal fatigue
g. persistent/edematous cervical lip
h. arrest of descent
i. non-reassuring FHTs
j. meconium stained fluids
5. Understanding common labor interventions
a. AROM
b. Pharmaceutical pain management
c. Induction/augmentation of labor
d. Increased surveillance including fetal and contraction monitoring
6. Understanding principles of infection control, universal precautions, and reporting requirements for:
a. Birth
b. Death
c. Infectious disease
d. Abuse
7. Understanding and identifing components of physiologic second stage, including how to conduct a normal delivery
a. Explain advantages of utilizing passive descent and spontaneous pushing vs. coached pushing
b. Identify ways to manage and conserve the birthing person’s energy during second stage
c. Suggest various positions for delivery
d. Understands how to perform appropriate hand maneuvers for a vertex, face, and breech presentations
e. Understands how to manage a nuchal cord and nuchal arm
8. Familiarity with complications of the second stage
a. Arrest of descent/deep transverse arrest
b. Parent fatigue
c. Shoulder dystocia
d. Malpresentation
i. Breech
ii. Occiput Posterior
iii. Deflexion
e. Placental abruption
9. Understanding interventions for the second stage
a. Assisted vaginal delivery (forceps and vacuum extraction)
b. Cesarean section
10. Understanding indications for intrapartum transport
11. Understanding and identifying components of the third stage
a. mechanism of placental detachment
b. estimation of blood loss
c. fundal massage
12. Supporting expectant management of the third stage
13. Understanding indications and procedures for active management of the third stage
14. Familiarity with complications of the third stage
a. perineal lacerations
b. postpartum hemorrhage
c. hematoma
d. placenta accreta
e. inversion of the uterus
15. Understanding commonly utilized interventions for the third stage
a. antihemorrhagic agents
b. bimanual compression
c. manual extraction of the placenta
d. IV fluids/blood transfusion
e. other tools to prevent excessive blood loss
16. Understanding and identifies components of immediate postpartum care for the birthing person
a. vital signs and Parental stability
b. comfort and safety
i. nutrition
ii. fluid replacement
iii. elimination
c. laceration assessment and repair
17. Understanding indications for postpartum parental transport
18. Understanding and identifying components of immediate postpartum care for the neonate
a. APGAR assessment
b. assessing vitals for the IPP period
c. temperature regulation
d. blood sugar regulation
e. initiating breastfeeding
19. Supporting the “golden hour” as a mechanism to promote bonding
20. Familiarity with IPP complications of the neonate
a. respiratory distress
b. hypoglycemia
c. anatomical anomalies
d. neurologic/reflexive deficits
21. Providing evidence-based client education for the postpartum period
22. Understanding indications for postpartum neonatal transport
23. Understanding importance of interprofessional collaboration
Midwives College of Utah. (2023). MDWF 3030: Complications of Labor, Birth, and Immediate Postpartum. Midwives College of Utah Midwifing Midwives, 2-4. https://midwifery.instructure.com/courses/4121
