Women Centred Midwifery Care

This first midwifery practice unit will provide the foundation knowledge required by midwifery students to effectively care for women during preconception through to early parenting. The focus will be on the role of the midwife as a primary carer in relation to: the preparation of women for pregnancy; physiological and psychological adaptation of women during pregnancy and birth, the first weeks after birth; and care of women and their babies during this continuum. Essential elements of effective woman-centred partnership, including evidence-based assessment frameworks, communication in assessment, strategies for decision making, problem solving and critical thinking for assessment practice, as well as basic psychomotor skills essential for health and pregnancy assessment will be explored. This unit will explore pregnancy, childbirth, care of the mother and baby from the perspective of wellness through to variations of normal. Biomedical and midwifery concepts of childbearing will also be examined. Women-centred continuity of care and midwifery partnerships will be explored in the context of the midwife’s professional responsibilities, scope of practice and role as a member of the maternity multidisciplinary team.

The ANMAC National Accreditation Standards for the Midwife (draft 3 2020); NMBA Midwife Standards for Practice (2018); NMBA Code of Conduct for the Midwife (2018), Code of Ethics for the Midwife (2014) and National Safety and Quality Health Services Standards (2019) have substantially informed the syllabus/content of this unit.   Modules Midwifery theory 1. Pre-conception Pre-conception health  Environmental issues         The female reproductive system  The male reproductive system  Conception 2. The role of the midwife NSQHS Partnering with Consumers Standard Primary health counselling and education  Preparation for parenting roles: mother and father and others  Integration of primary, secondary, tertiary and community services  Maintaining a woman-focus in a multidisciplinary environment  Maintaining continuity of care and/or carer  3. Anatomy and physiology of pregnancy General embryology, fetal growth, development and assessment  The placenta: Maternal-fetal interaction  Physiology of the pelvic floor and uterus  Pregnancy testing and estimation of gestational age  Alteration & adaptation during pregnancy  Principles and practices for screening and diagnosis/referral (maternal, fetal and neonatal)  Promotion of simple measures to manage common discomforts  Maintenance of health  Pregnancy assessment  4. The 1st stage of labour – cervical effacement and dilatation Physiological and psychosocial alteration and adaptation during birthing  Facilitating a physiological process of birth  NSQHS Preventing and controlling healthcare-associated infection standard Assessment of labour progress  The onset and progress of labour: normal onset and duration variations including induction, augmentation and malposition.  Physiology of pain, stress and anxiety  5. The 2nd stage of labour – birth of the baby Second stage of labour; normal and variations  Indications for and performance of episiotomy Mechanisms of birth Assessment and simple resuscitation of the newborn  6. The 3rd stage of labour – Birth of placenta and membranes Third stage of labour; normal and variations Physiological management of third stage Active management of third stage Assessing the woman in third stage Checking the placenta and membranes 7. The 4th stage of labour – The first hour post birth Adaptation of the newborn to extra-uterine life  Newborn circulation Newborn thermoregulation Infant feeding Physiology of the breast and lactation  Skills for promoting initiation and maintenance of lactation  Breast milk substitutes Skin to skin care 8. Care of woman and baby in the postpartum Physiology of the puerperium  Newborn examination; common conditions affecting the newborn  Nutritional needs of woman and baby in the neonatal period  NSQHS Medication Safety Standard Pharmacokinetics, pharmacodynamics & quality use of medicines in the maternity setting  Assessment of mother & baby in the postpartum period  Characteristics of the newborn in the first six weeks Newborn growth and development   Discharge planning  Ongoing health practices including safety and immunisation