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MDWF 2030 Labor, Birth, and Immediate Postpartum - 4 Cr.
DESCRIPTION:
Physiology and management of first, second and third stages of Labor are taught in this class. Students also learn about the mechanism of labor for occiput anterior, transverse, posterior, face, brow, military and breech presentations. Case studies are utilized to demonstrate the application of clinical judgment and management within the scope of care of the Certified Professional Midwife.
LEARNING OBJECTIVES:
1. Provide client education using a shared decision-making model
2. Understand and identify components of the physiologic process of labor
a. Identify and understand 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. Understand the stages of labor
c. Provide physical and psychological support for the laboring person and family
d. Support the laboring person using culturally sensitive care
e. Facilitates the presence of a support person
f. Monitor maternal and fetal vital signs
g. Evaluate the well-being of the laboring person
h. Assess the progress of labor, including Leopold’s maneuvers, cervical exam, and partograph
3. Understand 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. Is familiar 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. Understands common labor interventions
a. AROM
b. Pharmaceutical pain management
c. Induction/augmentation of labor
d. Increased surveillance including fetal and contraction monitoring
6. Understands principles of infection control, universal precautions, and reporting requirements for:
a. Birth
b. Death
c. Infectious disease
d. Abuse
7. Understand and identify 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. Is familiar with complications of the second stage
a. Arrest of descent/deep transverse arrest
b. Maternal fatigue
c. Shoulder dystocia
d. Malpresentation
i. Breech
ii. Occiput Posterior
iii. Deflexion
e. Placental abruption
9. Understand interventions for the second stage
a. Assisted vaginal delivery (forceps and vacuum extraction)
b. Cesarean section
10. Understand indications for intrapartum transport
11. Understand and identify components of the third stage
a. Mechanism of placental detachment
b. Estimation of blood loss
c. Fundal massage
12. Supports expectant management of the third stage
13. Understands indications and procedures for active management of the third stage
14. Is familiar with complications of the third stage
a. Perineal lacerations
b. Postpartum hemorrhage
c. Hematoma
d. Placenta accreta
e. Inversion of the uterus
15. Understand 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. Understands and identifies components of immediate postpartum care for the birthing person
a. Vital signs and maternal stability
b. Comfort and safety
i. Nutrition
ii. Fluid replacement
iii. Elimination
c. Laceration assessment and repair
17. Understand indications for postpartum maternal transport
18. Understands and identifies 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. Supports the “golden hour” as a mechanism to promote bonding
20. Is familiar with IPP complications of the neonate
a. Respiratory distress
b. Hypoglycemia
c. Anatomical anomalies
d. Neurologic/reflexive deficits
21. Provides evidence-based client education for the postpartum period
22. Understand indications for postpartum neonatal transport
23. Understands importance of interprofessional collaboration
ASSIGNMENTS
Client Handouts
Charts
Documents
Flashcards
Practice Protocols
Reflective Journal
Final Reflective Journal Entry 9 and Complete Journal (6.2)
Other
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