MIDW217 - Midwifery Care of the Woman with Complex Needs

Year

Credit points

Campus offering

Prerequisites

For Bachelor of Midwifery: BIOL122 Human Biological Science 2 AND MIDW216 Midwifery Care of the Birthing Woman AND MIDW200 Clinical Midwifery Practice 2 OR MIDW213 Midwifery Professional Practice 3 data-versionlabel=1

For Bachelor of Midwifery (Graduate Entry): MIDW200 Clinical Midwifery Practice 2 OR MIDW213 Midwifery Professional Practice 3 data-versionlabel=1 AND MIDW216 Midwifery Care of the Birthing Woman

Teaching organisation

Unit rationale, description and aim

The aim of this unit is to build on earlier learning about the anatomy and the physiological processes of childbearing and the related midwifery and obstetric management. The unit focuses on the collaborative role of the midwife, referral, use of medical technology and medications, obstetric intervention, and the implications of complications for these women, their families, and care providers. This unit is required by students to assist their ongoing development of midwifery knowledge, specifically in relation to birthing complications and other emergencies in the childbearing continuum.

The aim of this unit is to build on earlier learning about physiological processes of childbirth, and extend students' knowledge of assessment and care planning for women experiencing birthing complications and emergencies in the antenatal, intrapartum and postnatal period.

We recognise that people who access maternity care may have diverse gender identities, that those who do can experience marginalisation and oppression, and that using appropriate terminology can help with these community members’ recognition and visibility, acknowledge the variety of pregnancy and birth experiences people may have, and respect individuals’ preferences. To reflect this, terms such as ‘pregnant person’, ‘birthing person’, ‘childbearing people’, ‘parent’ and ‘chestfeeding’ may be used in the midwifery courses at ACU in addition to ‘woman’, ‘mother’, ‘maternity’, ‘maternal’ and ‘breastfeeding’, which are used not to exclude those who do not identify as a woman, but in recognition that women continue to be marginalised and oppressed in many places around the world and to respect their own individual preferences.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - outline the role of the midwife when caring for the woman with complex needs across the childbearing continuum, as part of a culturally competent collaborative team; (GA7, GA8)

LO2 - identify women at risk of complications that may occur across the childbearing continuum; (GA5) 

LO3 - apply knowledge of anatomy, pathophysiology and pharmacology to plan and evaluate safe, effective, evidence-based, collaborative care utilising current guidelines for consultation and referral; (GA5) 

LO4 - demonstrate sound knowledge of the ethico-legal responsibilities of the midwife related to emergencies and perinatal loss; (GA1, GA3) 

LO5 - design effective evidence-based strategies to support the woman and her family following pregnancy loss. (GA1) 

Graduate attributes

Each unit in your course contributes in some way to the development of the ACU Graduate Attributes which you should demonstrate by the time you complete your course. All Australian universities have their expected graduate attributes. ACU’s Graduate Attributes have a greater emphasis on ethical behaviour and community responsibility than those of many other universities. All of your units will enable you to develop some attributes.

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

GA3 - apply ethical perspectives in informed decision making

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA7 - work both autonomously and collaboratively 

GA8 - locate, organise, analyse, synthesise and evaluate information 

NMBA Midwife Standards for Practice

NMBA (2018) Midwife Standards for Practice developed in this unit are: 

Content

Topics will include: 

Legal and professional practice 

• Consultation and referral 
• Midwifery leadership and delegation in emergencies 
• Documentation in emergencies and use of health informatics and health technology 
• Legal responsibilities related to fetal and/or maternal morbidity and mortality 
• Medication knowledge and administration 
• Assertive communication skills 

Midwifery knowledge and practice 

• Maintaining a woman-centered focus in complex care including emergencies 
• Communication strategies  
• Screening and assessment 
• Infections 
• Hypertension, 
• Gestational diabetes 
• Haematological dyscrasias 
• Pathophysiology and management of complications in pregnancy  
• Hyperemesis gravidarum 
• Abruptio placenta and placenta praevia 
• Hypertensive disorders of pregnancy 
• Pre-eclampsia, HELLP syndrome, DIC 
• Comorbidities: diabetes mellitus, thyroid disease, heart disease, renal disease, obstetric cholestasis, thromboembolic disease, infections, iso-immunisation 
• Multiple pregnancy  
• Deviations in the rhythm and mechanisms of uterine activity 
• Incoordinate uterine activity 
• Malposition 
• Malpresentations including brow, breech and shoulder presentation 
• Cephalo-pelvic disproportion 
• Obstructed labour 
• Preterm labour 
• Risk assessment, prevention and management of life threatening emergencies  
• Trauma in pregnancy 
• Cord prolapse 
• Shoulder dystocia 
• Pulmonary embolism 
• Amniotic fluid embolism 
• Eclampsia 
• Uterine inversion 
• Uterine rupture 
• Grief and bereavement following pregnancy loss 
• The midwife’s role 
• Facilitating family contact and memory creation 
• Resources 
• Self-care 

Midwifery as primary health care 

• Promoting the rights of the woman with complex needs and in an emergency 
• Professional relationships and collaboration in complex care and emergency situations 

Reflective and ethical practice 

• Debriefing for women and care providers following emergencies 

Learning and teaching strategy and rationale

Modes of delivery in this unit include learner-centred resource sessions, tutorials, online classrooms and quizzes. Consistent with adult learning principles, the teaching and learning strategies used within these modes of delivery will provide students with foundational knowledge and skills relevant to professional midwifery practice. These strategies will also support students in meeting the aim, learning outcomes and graduate attributes of the unit and the broader course learning outcomes. Learning and teaching strategies will reflect respect for the individual as an independent learner. Students will be expected to take responsibility for their learning and to participate actively with peers.  Scenario-based learning, case-based learning, problem-based learning and inquiry-based learning are all used to support the development of students' independent learning ability. 

Students at university need to operate effectively as self-sufficient learners who drive their own learning and access the learning supports they require. To guide students in their learning, feedback is required to identify what is being done well, what requires additional work and to identify progress toward required learning outcomes. Located in the second year of the programme, this theory unit includes face-to-face teaching hours and an increasing online component of learning to build life-long learning skills. Learner resource sessions are utilised to convey content and its central principles while tutorials deliver interactive and student-driven learning opportunities which require an increasing reliance on students to extend their community of learners and increase self-reliance. Online materials provide students with the opportunity to undertake  directed, self-motivated study and continue to transition to  independent study and life-long learning.  

Assessment strategy and rationale

A range of assessment procedures consistent with University assessment requirements will be used to meet the unit learning outcomes and develop graduate attributes.

The written assignment provides students with the opportunity to explore the evidence base regarding assessment and care planning for women experiencing birthing complications and emergencies. Online presentations will be used throughout semester to promote learning of the difficult and challenging concepts covered in this unit. The examination enables students to demonstrate a sound knowledge base in addressing content and process questions related to unit content.

These assessments are required to build student knowledge and skills which, by the conclusion of this programme, will enable the student to graduate as a safe and effective midwife.

Overview of assessments

Representative texts and references

Bryant, B., Knights, K., Rowland, A., & Darroch, S. (2018). Pharmacology for Health Professionals (5th ed.). Elsevier. 

Chapman, V., & Charles, C. (2017). The Midwife's Labour and Birth Handbook (4th ed). John Wiley & Sons Ltd. 

Nursing and Midwifery Board of Australia [NMBA]. (2018). Midwife standards for practice. Nursing and Midwifery Board of Australia. 

Nursing and Midwifery Board of Australia [NMBA]. (2013). Code of ethics for midwives. International Confederation of Midwives. 

Pairman, S., Tracey, S., Dahlen, H., & Dixon, L. (2018). Midwifery: Preparation for Practice (4th ed.). Elsevier. 

Rankin, J. (Ed.). (2017). Physiology in Childbearing with Anatomy and Related Biosciences (4th ed.). Elsevier.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists [RANZCOG]. (2019). Intrapartum Fetal Surveillance - Fourth Edition (4th ed.). Royal Australian and New Zealand College of Obstetricians & Gynaecologists.

Walsh, D.,& Downe, S. (Eds.). (2010). Essential Midwifery Practice: Intrapartum Care. Blackwell Publishing Ltd.

Wylie, L. & Bryce, H. (2016) The Midwives' Guide to Key Medical Conditions. (2nd ed.). Elsevier.