MIDW200 - Clinical Midwifery Practice 2

Year

Credit points

Campus offering

Prerequisites

MIDW100 Clinical Midwifery Practice 1 OR MDGE101 Introduction to Midwifery Practice

Teaching organisation

Unit rationale, description and aim

This unit extends and integrates learning from MIDW100 Clinical Midwifery Practice 1 or MDGE101 Introduction to Midwifery Practice, through simulation laboratories and supervised clinical practice, with a focus on normal labour and birth. Students have the opportunity to develop skills to support women during labour and birth and the immediate period following birth in collaboration with midwives and the health care team. The common interventions in labour and birth will be examined within the simulated environment to build confidence and skills prior to the clinical component of the unit. Students will continue to participate in and learn from the Continuity of Care Experience.

This unit is required by students to assist them to develop knowledge and skills to support women during labour and birth and the immediate period following birth, in collaboration with midwives and the health care team.

The aim of this second Clinical Midwifery Practice unit is to provide the foundations on which clinical assessments are based, build on earlier learning about the anatomy and the physiological processes of childbearing, and model the way in which students will contextualise their theoretical knowledge through clinical practice.

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 - Demonstrate comprehensive assessment, planning and provision of safe evidence-based woman-centred care during labour, birthing and the immediate period following birth in collaboration with women, midwives and the health care team; (GA1, GA7) 

LO2 - Apply legal and ethical frameworks, policies and procedures to safe care of women and their babies during labour, birthing and the immediate period following birth within their scope of practice; (GA3, GA5) 

LO3 - Reflect on their learning to initiate and evaluate effective learning and self-care strategies for themselves and others in relation to labour and birthing; (GA4, GA5) 

LO4 - Extend their professional portfolio, demonstrating development towards the NMBA (2018) Midwifery Standards for Practice  using examples of skill development and midwifery practice in labour and birth. (GA4, GA5, GA9) 

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

GA4 - think critically and reflectively 

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

GA7 - work both autonomously and collaboratively 

GA9 - demonstrate effective communication in oral and written English language and visual media 

NMBA Midwife Standards for Practice

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

Content

Topics will include: 

Legal and professional practice 

• Scope of practice 
• Consultation and collaboration including referral 
• Informed consent 
• Documentation including health informatics and health technology 
• Medication knowledge and administration 
• Med+Safe medication calculations
• Assertive communication skills

Midwifery knowledge and practice 

• Assessment skills  
• Interviewing and history taking techniques for women in labour 
• Abdominal examination  
• Vaginal examination  
• Intermittent and continuous fetal monitoring 
• Physical assessment of maternal health 

Midwifery skills 

• Active birth positions and movement during labour 
• Safe use of water for labour and birth 
• Non-pharmacological therapeutics e.g. massage, intradermal water injections 
• Facilitation of normal birth including third stage 
• Perineal assessment and perineal suturing 
• Skin to skin and initiation of breastfeeding 
• Preliminary debriefing of labour and birth experience 

Interventions during labour and birth (collaborative and autonomous) 

• Induction and augmentation  
• Artificial rupture of membranes
• Urinary catheter insertion 
• Episiotomy  
• Epidural, spinal anaesthesia 
• Instrumental birth 
• Caesarean section, including preparation and care during recovery 
• Maternal and neonatal resuscitation techniques 

Risk assessment, prevention and management 

• Intrapartum and postpartum haemorrhage 

Pharmacodynamics and pharmacokinetics 

• Revise IM, Sc and IV and neonatal injections 
• Epidural medications 
• Narcotics 
• Local anaesthetics 
• Review IV management and fluid balance 
• Blood transfusion 
• Drug calculations  

Midwifery as primary health care  

• Cultural safety 
• Involving women and their families in decision making 

Reflective and ethical practice 

• Maintaining professional portfolio 
• Reflective practice  
• Identifying and responding to own and others’ learning needs  
• Evidence-based practice 

Learning and teaching strategy and rationale

Modes of delivery in this unit include group learning activities such as skill demonstrations, simulated practice, online classroom, supervisied clinical practice, participation in the the Continuity of Care Experience (CCE) and self-directed study.  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 nursing 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, they will include hands on methods, story sharing, community linking and other Aboriginal ways of learning. 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 undertaking a tertiary qualification need skills to assist them in managing their individual learning. Feedback and effective self-reflection are 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 clinical unit assists students to link theory with its application and to build life-long learning skills. Group learning activities are utilised to convey content and central principles while laboratories and simulation deliver interactive learning sessions which assist students to apply theory to clinical practice and build self-reflection skills. The supervised clinical practicum of 120 hours provides a safe environment where students can provide assisted woman-centred care essential for successful graduate practice. 

Assessment strategy and rationale

A range of assessment items consistent with University assessment requirements and policy will be used to ensure students achieve the unit learning outcomes and attain the graduate attributes.  

Assessment methods will primarily evaluate the student’s understanding of the discipline-specific knowledge inherent in this unit and its application within a professional context. An on-campus assessment of a clinical skill using the Aboriginal 'hands on' way of knowing will provide the opportunity for feedback for the student in a safe environment reflective of assessment in clinical practice where professional competency is a requirement for the role of a midwife. The continued development of the professional midwifery portfolio will allow the students to showcase their learning experiences (clinical and CCE) in a professional manner ensuring that documentation meets the professional legal requirements for practice experiences. Students must achieve a pass grade in both assessment items to pass this unit. 

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

Cusack, L., & Smith, M. (2019). Portfolios for Nursing, Midwifery and other Health Professions (4th ed.) Elsevier.

Australian College of Midwives [ACM]. (2021). National Midwifery Guidelines for Consultation and Referral (4th ed.). Australian College of Midwives.

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

Johnson, R., & Taylor, W., De-Vitry Smith, S., Bayes, S. (2018). Skills for Midwifery Practice Australian & New Zealand Edition (1st ed.). Elsevier. 

MacDonald, S., & Johnson, G. & Mayes. M. (Eds.). (2017). Mayes' Midwifery (15th edition.). Elsevier.

Marshall, J., & Raynor, M. (Eds.). (2020). Myles Textbook for Midwives (17th ed.). Elsevier.

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.

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