NMHS10370 Labour and Birth

Academic Year 2022/2023

The aim of this module is to introduce the student to the midwife's role in the provision
of evidence-based midwifery care. The purpose of the module is to develop the
student's understanding and knowledge of the provision of intrapartum
care and the role of the midwife. The midwifery care of the woman in the first, second
and third stage of labour is examined in detail. The role of the support person in labour
is discussed along with the midwife's role in a partnership of care with the woman and
other health care personnel. In this module indicators of fetal well-being and electronic
fetal monitoring will be further enhanced. Related anatomy and physiology is explored
throughout the module. Students will be encouraged to critically examine the evidence
underpinning midwifery care provided in the intrapartum period. An
exploration of concepts relating to the well-woman, normal midwifery, partnership,
informed choice and the options available for maternity care will be introduced.
Development of clinical skills integral to the provision of effective
intrapartum midwifery care will be incorporated into the module.

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Curricular information is subject to change

Learning Outcomes:

On completion of this module students should be able to:
● Discuss the choices for intrapartum care currently available to women and their
partners, in the Irish context.
● Critically assess the role of the midwife in the provision of safe, effective
midwifery care to women and their partners during uncomplicated pregnancy and
labour.
● Evaluate how the midwife facilitates women informed choice in relation to non-
pharmacological and pharmacological methods of analgesia during labour,
nutrition in labour, fetal monitoring in labour, positions for labour and birth,
second stage labour care and management.
● Critically examine evidence based guidelines for provision of intrapartum care
● Recognise normal findings and provide appropriate information to the woman
regarding findings.
• Describe the care required for a woman requiring a vaginal examination in labour
● Differentiate between normal findings and deviations from normal, and
report/refer/respond appropriately.

Indicative Module Content:

History taking in midwifery practice
Physical assessment of the pregnant woman and assessment of maternal wellbeing in the intrapartum period

Anatomy & Physiology:

Anatomy of female pelvis
Anatomy of fetal skull
Anatomy of external genitalia- for Vaginal Examination theory and skills
Relationship of the presenting part to the female pelvis
Mechanism of normal labour
Observational signs of labour progression and full dilation of the cervix
Physiology of labour-all stages
Structure and function of placenta, cord and membranes
Amniotic fluid composition
3rd Stage of labour – physiological and managed

Care and Management (Including Evidence base)
Evidenced based guidelines for intrapartum care
Assessment of fetal well-being in labour (intermittent and electronic fetal monitoring)
Review "application of CTG and basic interpretation of CTG lecture and skills, and interpretation NICE guidelines, and K2 chapters already completed i.e. Intrapartum Intermittent Auscultation; aspects of Antenatal CTG; aspects of Fetal Physiology"- theory and skills covered in autumn trimester "Essence of Midwifery Practice" module.
Relevant aspects of K2 chapters to be completed by students: Intrapartum CTG; Errors & Limitations in Fetal Monitoring; Cord Blood Gas.
Care of the woman in labour-all stages
Assessment of progress in labour
Support and comfort measures for the woman in labour
Supporting the birthing partner in labour
Promoting active birth
Non pharmacological and pharmacological methods pain relief in labour
Introduction to theory regarding oral, sub-cutaneous, and intramuscular routes of administration of medications relevant to physiological Labour & Birth (shared lecture content for all Stage 1 midwifery & nursing students).

Clinical skills:
Initial midwifery assessment of a woman presenting in labour including:
Diagnosis and assessment of progress in labour skills-Vaginal examination
Birthing positions for labour and birth
Preparation for birth
Assisting with birth of infant in alternate birthing positions
Review application and interpretation of a CTG
The third stage of labour – physiological and managed

Student Effort Hours: 
Student Effort Type Hours
Lectures

26

Practical

6

Specified Learning Activities

38

Autonomous Student Learning

55

Total

125

Approaches to Teaching and Learning:
Modified lecture, group work, group discussions, videos, clinical skills, simulation. 
Requirements, Exclusions and Recommendations
Learning Exclusions:

None

Learning Recommendations:

None


Module Requisites and Incompatibles
Not applicable to this module.
 
Assessment Strategy  
Description Timing Open Book Exam Component Scale Must Pass Component % of Final Grade
Assignment: You will be given a question to choose from and will be asked to look at the evidence and write a literature review on same. Coursework (End of Trimester) n/a Standard conversion grade scale 40% No

50

Multiple Choice Questionnaire: Multiple choice quesstionairre End of trimester MCQ n/a Alternative linear conversion grade scale 40% No

30

Group Project: Group project on methods of pain relief Throughout the Trimester n/a Standard conversion grade scale 40% No

20


Carry forward of passed components
Yes
 
Remediation Type Remediation Timing
In-Module Resit Prior to relevant Programme Exam Board
Please see Student Jargon Buster for more information about remediation types and timing. 
Feedback Strategy/Strategies

• Feedback individually to students, post-assessment
• Group/class feedback, post-assessment

How will my Feedback be Delivered?

Not yet recorded.

An Bord Altranais (2007) Guidance to Nurses & Midwives on Medication Management.Dublin: An Bord Altranais.

Baston, H. and Hall, J. (2017) Midwifery Essentials: Basics. 2nd revis Edition, Elsevier Health Sciences, Edinburgh.

Baston, H. and Hall, J. (2017) Midwifery Essentials: Antenatal. 2nd revis Edition Elsevier Health Sciences, Edinburgh.

Baston, H. and Hall, J. (2017) Midwifery Essentials: Labour, 2nd revis Edition Elsevier Health Sciences, Edinburgh.

Baston, H. and Hall, J. (2017) Midwifery Essentials: Postnatal. 2nd revis Edition, Elsevier Health Sciences, Edinburgh.

Begley, C., Devane, D. et al (2011) Comparison of midwife-led and consultant-led care of healthy women at low risk of childbirth complications in the Republic of Ireland: a randomized trial, BMC Pregnancy and Childbirth, 11: 85.

Downe, S. (2008) Normal Childbirth: Evidence and Debate, 2nd Edition, Churchill Livingstone, London

Davey, L. and Houghton, D. (2013) The Midwife’s Pocket Formulary, 3rd ed. London: Churchill Livingstone.

Department of Health (2016) Creating a Better Future Together, National Maternity Strategy (2016-2026) available online at: www.health.gov.ie/wp-content/uploads/2016/01/Final-version-27.01.16.pdf
Department of Health (2016) Position paper one: Values for Nurses and Midwives in Ireland. Office of the Chief Nursing Officer. Available online at: https://www.nmbi.ie/NMBI/media/NMBI/Position-Paper-Values-for-Nurses-and-Midwives-June-2016.pdf

Department of Health and Children (2013) Healthy Ireland: A framework for improved health and wellbeing, 2012-2015.Available online at http://health.gov.ie/wpcontent/uploads/2014/03/HealthyIrelandBrochureWA2.pdf

Gibb, D. and Arulkumaran, S. (2008) Fetal Monitoring in Practice. 16th ed. London: Churchill Livingstone.

HIQA (2016) National standards for safer, better maternity care. Available online at:https://www.google.ie/webhp?sourceid=chromeinstant&rlz=1C1SFXN_enIE498IE535&ion=1&espv=2&ie=UTF-8#q=HIQA+maternity+standards

Hunter, B. and Leap, N. (2016) Supporting Women for Labour and Birth: A Thoughtful Guide, Routledge, London.

Johnson, R. and Taylor, W. (2016) Skills for Midwifery Practice. 4th ed. London: Elsevier

Marshall, J. and Raynor, M. (2014) Myles Textbook for Midwives.16th ed. London: Churchill Livingstone.

McDonald, S. and Magill-Cuerden, J. (2012) Mayes Midwifery: A Textbook for Midwives. (14th ed). London: Balliere Tindall.

Nursing and Midwifery Board of Ireland (2014) Code of Professional Conduct and Ethics for Registered Nurses and Midwives. Dublin: Nursing and Midwifery Board of Ireland. Available online at: https://www.nmbi.ie/nmbi/media/NMBI/Publications/Code-of-professional-Conduct-and-Ethics.pdf?ext=.pdf.

Nursing and Midwifery Board of Ireland (2015) Practice Standards for Midwives. Dublin: Nursing and Midwifery Board of Ireland. Available online at: https://www.nmbi.ie/nmbi/media/NMBI/Publications/Practice-Standards-for-Midwives-2015.pdf?ext=.pdf, p. 12.

Nursing and Midwifery Board of Ireland (2015) Scope of Nursing and Midwifery Practice Framework Dublin: Nursing and Midwifery Board of Ireland. Available online at: https://www.nmbi.ie/nmbi/media/NMBI/Publications/Scope-of-Nursing-Midwifery-Practice-Framework.pdf?ext=.pdf.

Nursing and Midwifery Board of Ireland (2015) Recording professional practice professional guidance. Available online at : https://www.nmbi.ie/nmbi/media/NMBI/Publications/recording-clinical-practice-professional-guidance.pdf?ext=.pdf.

Stables, D. and Rankin, J. (2010) Physiology in Childbearing: With Anatomy and Related Biosciences. Balliere-Tindall.

Tiran, D and Sullivan, A (2008) Bailliére’s Midwives’ dictionary, 11th Edn, Bailliére Tindall Elsevier, Edinburgh

Further readings, research articles, national guidelines and other resources will be recommended to students at the end of each lecture as appropriate.
Name Role
Dr Lorraine Carroll Lecturer / Co-Lecturer
Dr Carmel Davies Lecturer / Co-Lecturer
Ms Jennifer Dempsey Lecturer / Co-Lecturer
Ms Margaret Folan Lecturer / Co-Lecturer
Ms Elizabeth Greene Lecturer / Co-Lecturer
Dr Aoife Claire MacCormac Lecturer / Co-Lecturer