| Effective Term: | 2025/05 |
| Institute / School : | Institute of Health and Wellbeing |
| Unit Title: | Midwifery Care for Women with Complex Needs |
| Unit ID: | MIDGD6203 |
| Credit Points: | 15.00 |
| Prerequisite(s): | (MIDGD6001 or MIDGD6201) |
| Co-requisite(s): | (MIDGD6204) |
| Exclusion(s): | Nil |
| ASCED: | 060303 |
| Other Change: | |
| Brief description of the Unit |
This unit is an introduction to complex pregnancy and childbirth and the role of the midwife in providing care for women experiencing problems. Students will develop their existing knowledge/skills by working with women and collaborating with other members of the healthcare team when problems arise during pregnancy, labour & birth and in the care of the mother in the first weeks after birth. Emphasis is given to the collaborative role of the midwife, consultation and referral, use of medical technology & intervention, and the implications for women, their families, and midwives. |
| Grade Scheme: | Graded (HD, D, C, P, MF, F, XF) |
| Work Experience Indicator: |
| No work experience |
| Placement Component: | Yes - days |
| Supplementary Assessment:Yes |
| Where supplementary assessment is available a student must have failed overall in the Unit but gained a final mark of 45 per cent or above, has completed all major assessment tasks (including all sub-components where a task has multiple parts) as specified in the Unit Description and is not eligible for any other form of supplementary assessment |
| Course Level: |
| Level of Unit in Course | AQF Level(s) of Course | | 5 | 6 | 7 | 8 | 9 | 10 | | Introductory | | | | | | | | Intermediate | | | |  | | | | Advanced | | | | | | |
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| Learning Outcomes: |
| Knowledge: |
| K1. | Describe and identify conditions that contribute to complexity in pregnancy, labour and birth; |
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| K2. | Examine specific medical and obstetric conditions that affect childbearing; |
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| K3. | Explore pathophysiology of at-risk, complex pregnancy, labour and birth and its implications for midwifery practice, |
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| K4. | Demonstrate an appreciation of the family's need for privacy, dignity and respect, as well as their right to be informed and to make decisions regarding their care |
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| Skills: |
| S1. | Demonstrate skills in the management of emergencies in childbearing; |
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| S2. | Utilise critical thinking and clinical reasoning skills to provide safe woman-centred care throughout the childbirth continuum regardless of the complexity; |
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| S3. | Demonstrate the ability to practice within a multidisciplinary team in an environment of complexity; |
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| Application of knowledge and skills: |
| A1. | Utilise knowledge from the biosciences applicable to the woman experiencing a complex pregnancy and childbirth; |
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| A2. | Evaluate the implications of obstetric interventions for the woman and for midwifery practice; |
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| A3. | Utilise the clinical decision making process to demonstrate knowledge and understanding of the care required by the woman, baby and the family; |
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| A4. | Facilitate woman's access to appropriate community resources |
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| A5. | Demonstrate midwifery competency based upon the Nursing and Midwifery Board of Australia (NMBA) Midwife Standards for Practice (2018). |
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| Unit Content: |
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) and Code of Ethics for the Midwife (2014) have substantially informed the syllabus/content of this unit.
The role of the midwife in complex care
• Evidence basis for risk categorization and their application
• Collaborative role of midwife
• Professional responsibilities, consultation and referral
• Referral protocols, practices and procedures
• Working in a multidisciplinary team
• Communication for complex care: written and verbal using established tools e.g. ISBAR
• NSQHS Comprehensive Care Standard
The role of medical technologies in pregnancy and childbirth
• Screening and diagnosis
o Ultrasound
o Pathology
• Cardiotocography
o Fetal scalp electrode
• Induction and augmentation of labour
• Pharmacology of analgesia and anaesthesia
o Epidural analgesia
• Instrumental birth
o Forceps
o Ventouse
• Operative birth
• Manual removal of placenta
Pre-existing conditions complicating pregnancy
• Disorders of the haematological system, including bleeding and anaemic states
• Pre-existing medical and surgical conditions that impact pregnancy, including hypertension, diabetes, obesity, musculoskeletal disorders
• Sexually transmitted infections
• Substance misuse
• Implementing treatment regimens for specific disease process and complications
Conditions arising from the pregnancy
• NSQHS Recognising and responding to acute deterioration standard
• Care of the woman experiencing pregnancy loss
o Stillbirth
o FDIU
o Miscarriage
• Care of the baby at risk in utero
• Disease processes arising from pregnancy, including,
o Hypertensive disorders
o Pre-eclampsia / Eclampsia
o Gestational diabetes
• NSQHS Preventing and controlling healthcare-associated infection standard
• Infectious states in pregnancy
• Antepartum haemorrhage
• Multiple pregnancy
• Alterations to maternal physiology impacting on resuscitation
• Amniotic fluid embolus
Obstacles during labour
• Mal-positions, abnormal lie and mal-presentations of the fetus
• Cascade of intervention
• Preterm labour
• Preterm, pre-labour rupture of membranes (PPROM)
• Abnormalities of uterine action and onset of labour
o In-coordinate uterine action
o Postdates pregnancy
• Obstructed labour
o Cephalo-pelvic disproportion
• Intrapartum haemorrhage, including uterine rupture
• Cord presentation and prolapse
• Fetal distress
Obstacles during birth
• Shoulder dystocia
• Vaginal breech birth
• Perineal trauma, including episiotomy
• Retained placenta
• Maternal shock and collapse
• NSQHS Blood Management standard
• Primary post-partum haemorrhage
Maternal obstacles in first weeks after birth
• Breastfeeding challenges
• Puerperal sepsis including mastitis
• Secondary post-partum haemorrhage
• Haematomas and lacerations
• Interruptions to the urinary system
• Problems with muscles and joints
• Post-caesarean section: extra care
• Interruptions to musculo-skeletal integrity, including failed healing of perineum and back pain
• Retained products of conception and interruption to lactogenesis and lactation |
| Graduate Attributes: |
| | Learning Outcomes Assessed | Assessment Tasks | Assessment Type | Weighting | | 1. | K1, K2, K3, A1, A2, A3 | Theoretical concepts of evidence-based care for the woman with complex needs | Online Activities | 20-40% | | 2. | K1, K2, K3, S1, S2, S3, A1, A2, A3, A5 | Application of theoretical concepts and demonstration of skills of evidence-based care for the woman with complex needs
(Compulsory PASS required) | Part A Written test Part B Objective structured clinical examination (OSCEs) | 30-50%(Part A) 10-30%(Part B). Hurdle requirement | | 3. | K1, K2, K3, K4, S1, S2, S3, A1, A2, A3, A4, A5 | Satisfactory achievement of identified NMBA Midwife Standards for Practice in midwifery practice experiences.
(Compulsory PASS required) | Midwifery practice portfolio
1. Completion of five (5) Midwifery Clinical Assessment Tools (MCAT) to ‘assisted-proficient’ level. 2. Completion of 120 midwifery practice hours. Submit completed AMSAT. | 20% Hurdle requirement |
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