Additional Care Needs - Antenatal and Intrapartum

Learning Outcomes

Learning Outcomes

Having successfully completed this module you will be able to:

• Analyse the evidence base for the care and management of the woman and her fetus/neonate where variations occur during the childbirth continuum
• Discuss the policies (local, national and international as appropriate) and maternity services systems that influence the provision of maternity care to women with complex needs
• Demonstrate a comprehensive and systematic understanding of the physiology and pathophysiology and the psychosocial factors that predispose the woman to an increased risk of complexity during pregnancy and birth
• Examine the care required for women with specific health or social needs and know how to effectively refer to other professionals or agencies where appropriate
• Evaluate the role of the midwife, in facilitating holistic woman centred care and transition to motherhood for women with complex pregnancies and diverse needs

A range of pre-existing, current or emerging conditions will be covered. Students will explore how additional care needs relate to physical, psychological, social, cultural, and spiritual factors. Interprofessional/inter agency referral and working is encompassed throughout the module.

This list of syllabus content is not exhaustive but will include:

Infertility and assisted conception

Obesity

Polycystic ovaries

Endometriosis

Unplanned pregnancy/Termination of Pregnancy / Miscarriage/ectopic pregnancy

Hydatiform mole

Bleeding in early pregnancy

Medical and surgical conditions (pathological and co-morbidities)

Diabetes and other endocrine disorders such those of the thyroid

Other pre-existing conditions such as Cardiac disease, Asthma, Epilepsy, Acute Kidney Injury, Haemoglobinopathies

Maternal infection – Sexual Transmitted Infection, human immunodeficiency virus, sepsis, Hepatitis A B C, Covid-19

Red flags for non-pregnancy related medical conditions

Pregnancy Related Conditions

Hyperemesis gravidarum

Hypertensive disorders – pre eclampsia, Pregnancy induced hypertension, essential Hypertension, HELLP syndrome

Cholestasis/ Fatty Liver disease

Anaemia

Multiple pregnancy

Abnormal placental implantation

DVT / VTE assessment

Intrapartum Conditions

Mal-presentation, Mal-position

Pre-term labour - diagnosis and management

Post term labour/induction of labour/augmentation of labour

Fetal distress and fetal heart monitoring / CTG interpretation

Caesarean Section and Instrumental birth

End of life care and bereavement support

Skills

Perineal repair

Cannulation

Physiological breech

Programme threads are linked throughout and include:

Infant feeding principles

Medicines management

Mental health and well-being

Values Based Enquiry Journey

Making every contact count

Continuity of carer

Leadership

Coaching

Teaching and learning methods

Lectures

Group work

Practical /skills workshops

Self-directed learning

Technology Enhanced Learning

Online education using both synchronous and asynchronous sessions

Resources & Reading list

Textbooks

Williamson A and Crozier K (2008). Neonatal Care: A Textbook for Student Midwives and Nurses. Banbury: Lantern Publishing Ltd..

Robson S and Waugh J (2013). Medical Disorders in Pregnancy. A Manual for Midwi. Chichester: John Wiley and Sons.

Jackson K and Wightman H (2017). Normalizing Challenging or Complex Childbirth. London: McGraw Hill.

Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakepearce J, Kurinczuk JJ (2019). Saving Lives, Improving Mother’s care; lessons learned to inform maternity care from the Uk and Ireland Confidential enquiries intyo Maternal deaths and Morbidity 2015-17. Oxford: National Perinatal Epidemiology Unit.

Hall M, Smith S, Noble A. (2009). A Foundation for Neonatal Care: A Multi-Disciplinary Guide. Radcliff Publishing.

Rankin J (2017). Physiology in Childbearing. Edinburgh: Elsevier.

James DK; Steer PJ; Weiner CP; Gonik B (2018). High Risk Pregnancy: Management Options. London: Saunders.

Lapham R (2015). Drug Calculations for Nurses: A step-by-step approach. Routeledge.

Hollins C and Forrest E (2013). Bereavement Care for Childbearing women and their Families: An Interactive workbook. Abingdon: Routledge.

Formative

This is how we’ll give you feedback as you are learning. It is not a formal test or exam.

Summative

This is how we’ll formally assess what you have learned in this module.

Referral

This is how we’ll assess you if you don’t meet the criteria to pass this module.

Repeat Information

Repeat type: External