Course Syllabus ©National College of Midwifery 2017 11/2017
Course Title: Postpartum Observation and Charting
Credits: 0.5
Course Description: In this course, the student learns how to evaluate the physiologic and anatomical changes of the mother in the postpartum period, as well as her behavioral and psychological responses to childbearing. Students learn the rationale and appropriate measurement of postpartum vital signs, the importance of chart review and history review at this stage, the charting of additional history, physical and pelvic status, and consults and referrals, and the creation of a postpartum management plan. This course uses current research in midwifery and obstetrics to broaden the student’s understanding of the following NARM skills and MANA core competencies learned under clinical supervision:
NARM Skills
I. Midwifery Counseling, Education and Communication
(7)-I G. Applies the principles of informed consent
(8)-I H. Provides individualized care
V. Postpartum
(131)-V A. Performs postpartum reevaluation of mother and baby at appropriate intervals
(132)-V B. Completes the birth certificate
(133)-V C. Provides contraceptive education and counseling
(136)-V *F. Performs thorough and appropriate maternal four- to six-week postpartum check-up
Learning Activities:
- Student reads appropriate sections from the Learning Materials/Resources.
- Student answers the questions listed in the Learning Objectives by researching the Learning Materials/Resources for the course and correctly cites the sources and page numbers for each of their answers.
- Student presents answers the questions listed in the Learning Objectives for review by preceptor.
- Student participates in preceptor elaboration/discussion of Learning Objectives.
- The student must research, prepare & present a summary of current best midwifery care/practices appropriate to a topic in this course from a current journal article/study, less than 5 years old.
- Recommended Role-playing and/or Clinical Interactions
Note: The clinical requirement of NARM /Clinical Skills is completed at any time throughout the ASM apprenticeship during actual clinical practice and is NOT a requirement to complete this academic course.
Activities specific to NARM skills learned in this section:
- Practice charting your observations postpartum.
- Create a chart listing all of the observations/assessments you would be making in the immediate postpartum and how often you would make them.
- Create another chart listing all of the observations/assessments you would be making in the first few postpartum days.
- Create a chart with all the questions, assessments, and observations you would be making at the six week postpartum visit.
- Practice a chart review with other students, discussing (anonymously) the care given in a situation immediately postpartum.
- Practice filling out a birth certificate with all the appropriate information needed.
Learning Materials / Resources:
Please use textbooks less than 5 years old or most recent edition.
1. Marshall, Jayne E, Raynor, Maureen D(editor). Myles Textbook for Midwives. Churchill Livingstone; 16th edition. 2014
2. Wickham, Sarah. Best Practices in Midwifery. 2nd edition. Springer Publishing Company. 2016.
3. Davis, Elizabeth. Heart and Hands: A midwife’s guide to pregnancy and birth. 5th Edition. Celestial Arts Press. 2012
4. Tharpe, Nell and Farley, Cindy. Clinical Practice Guidelines for Midwifery and Women’s Health. 4th edition. Jones and Bartlett Publishing. 2012
5. Weaver, Pam and Evans, Sharon K. Practical Skills Guide for Midwifery, 5th Edition. Morningstar Publishing Co. Wasilla. 2012.
Resources for all Courses:
MEAC Abbreviated NARM Skills Form: http://www.midwiferycollege.org/AcademicProgram/Downloads/ASM/Clinical/Form-NARMSkills.pdf
MEAC Essential Competencies: http://www.midwiferycollege.org/downloads/worddocs/Curriculum-Checklist-of-Essential-Competencies-rev-2014.pdf
Midwives Model of Care®: http://cfmidwifery.org/mmoc/brochures.aspx
Students must find 1 article/study less than 5 years old. Recommended internet links as needed for latest developments in midwifery care: https://www.midwiferycollege.edu/resources-national-college-of-midwi
Evaluation Tools / Methods:
Minimum passing grade for each course is a cumulative 80% / B-. Students and preceptors are encouraged to work together until the student masters the information.
Final grade for the course is based on preceptor evaluation of the following:
A. Learning Objectives count for 50% of the final grade.
The preceptor evaluates each answer based on three elements:
1. Answers should reflect a thorough review of current literature regarding best current practices in midwifery care.
2. Each answer should be formed in the student’s own words or paraphrased from the text. The answer should be minimal, not a re-write of the entire text, but enough to show appropriate comprehension of the learning objective.
3. Student identification of sources and page numbers for each of the Learning Objectives. (Preceptor should do a random check to determine that sources cited are correctly identified.)
B. Enrichment Activities, including research essays and summaries of articles: 20%
C. Discussions: 15%
D. Tests and Exams: 15%
Course credit:
One Academic credit equals approximately 15 hours of formal time plus 30 hours of additional study or homework. Formal time is defined as the amount of time taken to answer the Learning Objectives to the level of 80% and to complete any learning activities to the preceptor's satisfaction, including any time spent face to face with the preceptor. Informal time includes any time spent actively reading relevant sources and textbook/s, researching Learning Objectives, and studying for examinations.
Learning Objectives:
A. The student must research, prepare & present a summary of an aspect of current best midwifery care/practices appropriate a topic from this course from a current journal article/study.
B. Student answers the questions below and cites the sources and page numbers.
Immediate Postpartum
1. How does immediate postpartum charting differ from that of intrapartum charting?
2. Discuss which maternal vital signs should be evaluated and charted postpartum and why.
3. List the normal range for the above mentioned vital signs.
4. Discuss what physiologic and anatomical changes should be evaluated and charted postpartum and why.
5. What is the appropriate timing of the above evaluations?
6. Discuss what behavioral and psychological responses to childbearing should be evaluated and charted.
7. What is the timing of the above evaluations?
8. Discuss why it is useful to have a person charting who is not the primary midwife during the immediate postpartum period.
9. Discuss the purpose of chart review in postpartum management.
10. Discuss the purpose of history review in postpartum management; what details should be reviewed in particular and why?
11. Discuss the purpose of developing a management plan postpartum based on the synthesis of information from the birth and chart review.
12. What is the timing of this plan, what elements are included, and how is the management plan charted?
13. Discuss the charting at discharge. What details should be included in the chart before the midwife and client part ways?
14. Discuss charting for a transport. How would this chart differ from that of an out-of-hospital birth.
15. Discuss how to maintain confidentiality of a client’s medical records during a transport scenario.
16. Discuss the importance of charting communication between midwife and client about decision-making that occurs postpartum.
17. When is the use of waivers important in charting a client’s decision to decline or accept an aspect of care?
1-6 Weeks Postpartum
18. Explain how a postpartum charting sheet is different than those used during the antepartum period.
19. Explain what maternal vital signs are charted during the weeks after birth.
20. Describe what additional specifics in the physical and pelvic status are charted and why.
21. Describe the details about breast health and breastfeeding that are included in a postpartum chart.
22. Discuss how to chart psychological changes postpartum. How detailed should this documentation be?
23. Discuss how to chart family planning counseling, what details should be recorded?
24. Explain the importance of charting phone communication postpartum.
25. Explain how screening for contraindications to any methods of family planning is this charted.
26. Discuss how to chart when midwifery care is terminated early.
27. Explain how consults and referrals are charted and what follow-up should be charted.
28. Discuss how charting is significant to the process of applying for a birth certificate.
29. Discuss your state’s rules regarding how long medical records must be kept in your state after a client has left care.
30. Discuss the rationale for reviewing the entire chart and history to date after care has ended. How is this type of chart review documented?
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