NMHS33030 Complexities of Pregnancy, Labour and Birth

Academic Year 2023/2024

The student midwife will be introduced to the complications that women may experience in pregnancy, labour, birth and the postnatal period, and will gain an awareness of the midwife’s role, when complications emerge. The module will enable the student to assess, plan, provide and evaluate midwifery care in partnership with the woman who is experiencing altered health states at any time during the childbearing cycle. The midwifery student will appreciate the boundaries of midwifery practice, and the importance of collaborative practice with obstetric colleagues in the provision of care for women experiencing such complications. Key values of midwifery care such as partnership, holism and provision of individualised, and the importance of evidence based care midwifery care will underpin the application of module content to practice. Relevant medication management and patient safety issues will be incorporated throughout the module. The importance of clear and contemporaneous documentation in the provision of quality midwifery care will be emphasised.

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Curricular information is subject to change

Learning Outcomes:

On successful completion of this module students should be able to:

Articulate the midwife’s role in the care and management of women who experience complications, whether pre-existing or arising in pregnancy, labour, birth and the postnatal period.

Demonstrate knowledge of and utilisation of best practice in the provision of midwifery care for women experiencing complications during pregnancy, intrapartum and postnatal periods.

Articulate the boundaries of midwifery practice in caring for women with complications, and discuss the referral, consultative and collaborative pathways midwives utilize, in conjunction with midwifery colleagues (AMP, CMS), medical colleagues and other members of the multidisciplinary team in the provision of care.

Critically discuss the appropriate management in acute situations, which may compromise the well-being of woman, fetus or both.

Critically evaluate the value and limitations of technology in the care of women with complications during the childbearing cycle;
Appreciate the possible psychosocial effects of the experience of complexities in and of pregnancy, birth and puerperium and altered health states on the woman and her family, which may require specialist referral.

Critically evaluate the effectiveness of midwifery care in the context of the care provided by the multidisciplinary team

Indicative Module Content:

Infertility
Infections in pregnancy and childbirth: Sexually Transmissible Infections, streptococcal infections, Influenza, Hepatitis, Measles, Mumps, Rubella, Pertussis, Varicella, Shingles, Cytomegalovirus, Listeriosis, Toxoplasmosis, Parvovirus B19, Malaria
Hyperemesis Gravidarum
Bleeding in Early Pregnancy: Implantation bleeding, ectopic pregnancy, miscarriage, gestational trophoblastic disease
Intrauterine death and stillbirth
Hypertensive Disorders: Chronic Hypertension, Gestational Hypertension, Pre-Eclampsia
Renal Disorders: Cystitis, Pyelonephritis, Renal Failure
Cardiac Disorders
Rhesus Disease
Haematological Disorders: Anaemia, haemoglobinopathies, thalassaemia, thrombocytopenia, von willebrand disease
Placental Complications: Placenta Praevia, Morbidly adherent placentae, Vasa Praevia
Complications of Amniotic Fluid: Oligohydramnios and Polyhydramnios
Ultrasonography in complex pregnancies: Monitoring of complex pregnancy, prenatal diagnosis
Vascular Disorders: Deep Vein Thrombosis and Pulmonary Embolism
Endocrine Disorders: Pathophysiology of Diabetes, Type I Diabetes, Type 2 Diabetes, Gestational Diabetes.
Endocrine Disorders: Abnormalities of Thyroid Function
Hepatic Complications: Acute Fatty Liver of Pregnancy, Intrahepatic Cholestasis of Pregnancy, Gallstones, Viral Hepatitis
Respiratory Disorders: Asthma, Tuberculosis, Acute bronchitis, Cystic fibrosis
Neurological Disorders: Epilepsy, Peripheral Nerve disease, Multiple Sclerosis, Myasthenia Gravis, Headache/migraine, Cerebrovascular accident, subarachnoid haemorrhage
Autoimmune Disorders: Rheumatoid arthritis, Systemic Lupus Erythematosus, Antiphospholipid syndrome
Obesity
Prolonged Pregnancy
Prolonged Rupture of Membranes at term
Induction of Labour
Preterm: Preterm Spontaneous Rupture of Membranes, Preterm Labour and Birth
Multiple Pregnancy: Diagnosis, antenatal care and management, intrapartum care and management
Malpositions and Malpresentations: Occipito posterior position, Face and brow presentation, Oblique, transverse and unstable lie, Breech presentation, Obstructed Labour
Delay in first stage of labour: Active management of labour, artificial rupture of membranes, safe use of oxytocin in labour, precipitate labour
Delay in second stage of labour: Recognition and management of delay in second stage of labour
Operative Delivery: Ventouse, Forceps, Caesarean Section
Vaginal Birth after Caesarean Section
Delay in the Third stage of labour: Retained placenta, manual removal of placenta
Severe Perineal Trauma
Perineal Suturing
Urinary Complications: Urinary retention, urinary incontinence
Fetal Monitoring: Application of fetal scalp electrode, Fetal Blood Sampling and Interpretation of results, K2 training elearning modules: cord blood gas, errors and limitations in fetal monitoring , CTG interpretation case studies
Intravenous Cannulation: HSELand elearning, online quiz

Associated Clinical Skills and Simulations: Hypertensive disorders, perineal management workshop, diabetes skills Artificial rupture of membranes, application of fetal scalp electrode, Twins in labour and birth, breech birth, IV cannulation, miscarriage and stillbirth

Student Effort Hours: 
Student Effort Type Hours
Lectures

28

Laboratories

14

Specified Learning Activities

60

Autonomous Student Learning

130

Online Learning

18

Total

250

Approaches to Teaching and Learning:
Lectures, online lectures, flipped classroom, case study review, small group work, e-learning, demonstration, simulation. 
Requirements, Exclusions and Recommendations
Learning Requirements:

Registration with the Nursing and Midwifery Board of Ireland (NMBI) as Registered General Nurse is required


Module Requisites and Incompatibles
Not applicable to this module.
 
Assessment Strategy  
Description Timing Open Book Exam Component Scale Must Pass Component % of Final Grade
Continuous Assessment: Online Quiz 1 Throughout the Trimester n/a Alternative linear conversion grade scale 40% No

5

Continuous Assessment: Online Quiz 3 Throughout the Trimester n/a Alternative linear conversion grade scale 40% No

5

Continuous Assessment: Online Quiz 4 Throughout the Trimester n/a Alternative linear conversion grade scale 40% No

5

Practical Examination: Completion of Perineal Suturing Programme which includes:
1) Completion of elearning
2) Video assessment of perineal suturing skills
3) Clinical skills lab assessment fo perineal suturing skills
Unspecified n/a Pass/Fail Grade Scale Yes

10

Examination: Take-Away Examination
Coursework (End of Trimester) Yes Graded No

65

Continuous Assessment: Online Quiz 2 Throughout the Trimester n/a Alternative linear conversion grade scale 40% No

5

Assignment: Mandatory elearning and HSEland certifications Throughout the Trimester n/a Pass/Fail Grade Scale No

5


Carry forward of passed components
Yes
 
Resit In Terminal Exam
Summer No
Please see Student Jargon Buster for more information about remediation types and timing. 
Feedback Strategy/Strategies

• Feedback individually to students, on an activity or draft prior to summative assessment
• Feedback individually to students, post-assessment
• Online automated feedback

How will my Feedback be Delivered?

Feedback on online quizzes given throughout the trimester Individualised feedback on written examination within 20 days

Core
Wylie, L. and Bryce, H. (2016) The midwives' guide to key medical conditions: pregnancy and childbirth. 2nd edn. Edinburgh: Elsevier.

Marshall, J.E. and Raynor, M.D. (eds.)(2020) Myles textbook for midwives, 17th edn, Churchill Livingstone, Edinburgh.

Johnson, R. and Taylor, W. (2022) Skills for midwifery practice. 5th edn. Edinburgh: Elsevier.

Rankin, J. (2017) Physiology in childbearing: with anatomy and related biosciences. 4th edn. Edinburgh: Elsevier.

Davey, L. and Houghton, D. (2020) The Midwife's Pocket Formulary. 4th edn. Edinburgh:Elsevier.

Raynor, M., Marshall, J. and Jackson, K. (eds.) (2012). Midwifery practice: critical illness, complications and emergencies casebook. Maidenhead: Open University Press

Recommended
.

Gibb, D.M.F. and Arulkumaran, S. (2017) Fetal monitoring in practice. 4th edn. Edinburgh: Butterworth-Heinemann/Elsevier.

Further up-to-date, topic-specific, research articles, national guidelines and other resources will be recommended to students throughout delivery of the module.
Name Role
Dr Lorraine Carroll Lecturer / Co-Lecturer
Assoc Professor Barbara Coughlan Lecturer / Co-Lecturer
Ms Mary Curtin Lecturer / Co-Lecturer
Ms Elizabeth Greene Lecturer / Co-Lecturer
Ms Ciara Kirwan Lecturer / Co-Lecturer
Timetabling information is displayed only for guidance purposes, relates to the current Academic Year only and is subject to change.
 
Spring
     
Lecture Offering 1 Week(s) - 20, 21, 22, 23, 24, 25 Tues 14:00 - 15:50
Lecture Offering 1 Week(s) - 20, 21, 22 Thurs 11:00 - 12:50
Lecture Offering 2 Week(s) - 20, 21, 22, 23, 24, 25 Thurs 09:00 - 10:50
Spring