Course Syllabus ©National College of Midwifery 2017 11/2017

Course Title: Newborn Complications

Credits: 1.0

Course Description: This course covers the identification, assessment, and understanding of neonatal problems and abnormalities. Neonatal complications such as pathological jaundice, neonatal infection and congenital defects are covered in detail with emphasis placed on an understanding of underlying causes. 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

(1)-I A. Provides interactive support and counseling and/or referral services to the mother regarding her relationships with her significant others and other healthcare providers

(3)I C. Provides education and counseling based on maternal health/reproductive/family history and on-going risk assessment

(8)-I H. Provides individualized care

(9)-I I. Advocates for the mother during pregnancy, birth and postpartum

I J. Provides education, counseling and/or referral, where appropriate for:

(14)-I J 5. Effects of smoking, drugs and alcohol use

(16)-I J 7. Sexually transmitted diseases

(17)-I J 8. Complications

(18)-I J 9. Environmental risk factors

(19)-I J 10. Newborn care including normal/abnormal newborn activity, responses, vital signs, appearance, behavior, etc

III L. Recognizes and responds to potential prenatal complications by:

(92)-III M. Establishes and follows emergency contingency plans for mother and/or newborn

(134)-V D. Assesses for and treats jaundice

Learning Activities:

  1. Student reads appropriate sections from the Learning Materials/Resources.
  1. 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.
  1. Student presents answers the questions listed in the Learning Objectives for review by preceptor.
  1. Student participates in preceptor elaboration/discussion of Learning Objectives.
  1. The student must research, prepare & present a summary of current best midwifery care/practices appropriate to a topic covered in this course from a current journal article/study, less than 5 years old.
  1. 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:

  1. Arrange to observe/shadow a neonatal nurse practitioner or other neonatal staff in a newborn intensive care unit. Attend rounds. Learn as much as you can about the babies there, including their prognoses and treatments.
  2. Attend a support group for families of special needs children. Learn as much as you can about the children being cared for by the families.
  3. Visit a residence or workplace where people with developmental disabilities live and/or work. Learn as much as you can about Down’s syndrome based on what you learn there.
  4. Role play with your instructor how you would inform parents of symptoms or findings in their newborn that could lead to a diagnosis of an abnormality.
  5. Create a card for your birth kit with symptoms of heart, lung, spinal and intestinal abnormalities. Review the card whenever you practice newborn exams.
  6. Role play or talk through how you would transport a newborn with a neural tube defect.

Learning Materials / Resources:

Please use textbooks less than 5 years old or most recent edition.

  1. Thureen, et al. Assessment and Care of the well newborn. 2nd ed. Elsevier Saunders. 2004.
  1. Cunningham, Kenneth Leveno, Steven Bloom, and John Hauth. William’s Obstetrics. 24th edition. McGraw-Hill Professional. 2014.
  1. Marshall, Jayne E, Raynor, Maureen D(editor). Myles Textbook for Midwives. Churchill Livingstone; 16 edition. 2014.
  1. Varney, Helen. Varney's Midwifery, 5th Edition. Jones and Bartlett Publishers. 2014.
  1. Tharpe, Nell and Farley, Cindy. Clinical Practice Guidelines for Midwifery and Women’s Health. 4th edition. Jones and Bartlett Publishing. 2012
  1. Weaver, Pam and Evans, Sharon K. Practical Skills Guide for Midwifery, 5th Edition. Morningstar Publishing Co. Wasilla. 2012.
  1. MEAC Abbreviated NARM Skills Form:
  1. MEAC Essential Competencies:
  1. Midwives Model of Care®:
  1. Students must find 1 article/study less than 5 years old. Recommended internet links as needed for latest developments in midwifery care:

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.

A-2: Go to this website: and answer the following:

  1. A dad’s role in the NICU
  2. Becoming a parent in the NICU
  3. Becoming an informed parent
  4. Caring for Multiples
  5. Child care after the NICU
  6. Write a brief summary of what you read.

B. Student answers the questions below and cites the sources and page numbers.

  1. Describe the special management that may be needed by a newborn born as a twin.
  1. Briefly describe the physiology of twin-to-twin transfusion.
  1. Describe the signs and symptoms of Rh isoimmunization in the newborn.
  1. Describe what special care is needed by newborns born to Rh sensitized mothers.
  1. Discuss the neonatal problems faced by preterm infants born between 30 and 34 weeks gestation.
  1. Discuss the neonatal problems faced by preterm infants born after 34 weeks.
  1. Discuss problems that can arise for infants that are born post-dates.
  1. Discuss the why infants that are large for gestational age are more likely to sustain traumatic birth injuries.
  1. Describe the neonatal problems that can arise for babies that are born large for gestational age.
  1. Discuss the underlying causes that can lead to the birth of a baby that is small for gestational age (SGA).
  1. Discuss the complications that can arise for SGA during the newborn period.
  1. Discuss the long term outcomes for infants that are born SGA.
  1. Describe the clinical presentation of a neonate with Group B strep infection.
  1. Describe the clinical presentation of a neonate with Chlamydia infection.
  1. Describe the clinical presentation of a neonate with Gonorrhea infection.
  1. Describe the clinical presentation of a neonate with congenital syphilis infection.
  1. Describe the clinical presentation of a neonate with congenital tuberculosis.
  1. Describe the signs and symptoms displayed by infants with RDS.
  1. Describe the common underlying causes of respiratory distress syndrome.
  1. Describe the clinical presentation of neonatal meconium aspiration.
  1. Describe the physiology of why meconium aspiration is dangerous to neonatal respiratory system.
  1. Describe the signs and symptoms displayed by infants with a pneumothorax.
  1. How can a pneumothorax be identified in an infant that is does not display respiratory distress?
  1. Describe the management of an infant with upper airway obstruction.
  1. Describe the symptoms and management of an infant with diaphragmatic hernia.
  1. Describe the various types of seizure activity that may be observed in the neonate.
  1. Describe the underlying causes for neonatal seizures.
  1. Describe the signs and symptoms of pathological jaundice.
  1. Describe the underlying causes for pathological jaundice.
  1. Describe the signs and symptoms of congenital heart defects in the newborn.
  1. Describe the factors that contribute to congenital heart defects in the newborn.
  1. Describe the signs and symptoms of an infant with intestinal obstruction.
  1. Describe how to identify an infant with imperforate anus
  1. Describe the signs and symptoms exhibited by infants with hirschsprung's disease.
  1. Discuss the signs and symptoms exhibited by infants with meconium ileus.
  1. Discuss the underlying cause of meconium ileus.
  1. Describe the signs of a neural tube defect at birth.
  1. What are the underlying causes of neural tube defects?
  1. Describe the signs and symptoms of hydrocephalus.
  1. Describe the physiology of how hydrocephalus occurs.
  1. Describe the signs and symptoms displayed by infants that are undergoing withdrawal from narcotics.
  1. Describe the signs and symptoms displayed by infants that are undergoing withdrawal from cocaine and amphetamines.
  1. Describe the signs and symptoms of fetal alcohol syndrome.
  1. Describe the defects that are most commonly associated with fetal alcohol syndrome.
  1. Describe the signs and symptoms of hydrops fetalis.
  1. Describe the underlying causes of hydrops fetalis.
  1. Describe the signs and symptoms of developmental hip dysplasia.
  1. What are the underlying causes of hip dysplasia?
  1. Describe the signs of club foot (talipes).
  1. Discuss the underlying causes of club foot.
  1. Discuss the physiology of a cleft lip and/or palate.
  1. Discuss the underlying causes of cleft lip and/or palate.
  1. Discuss the physical characteristics associated with a neonate with Down’s syndrome.
  1. Discuss the management of infants born with atypical genitalia. What factors should be taken into consideration?
  1. Describe the most common presentations of atypical genitalia.
  1. Describe the presentation of omphalocele.
  1. What are the underlying causes of an omphalocele?
  1. What is the presentation of a limb reductions anomaly in the neonate?
  1. What is most likely the underlying cause of a limb reduction anomaly in the neonate?
  1. Describe the signs of hypospadias in the newborn.
  1. What are the underlying causes of hypospadias in the neonate?
  1. List the signs and symptoms, indications for referral or transfer for newborn hypoxia.
  1. List the signs and symptoms, indications for referral or transfer for newborn hematoma.
  1. List the signs and symptoms, indications for referral or transfer for newborn molding of the fetal skull.
  1. List the signs and symptoms, indications for referral or transfer for a broken clavical by midwife during a shoulder dystocia.
  1. List indications for referral, transfer, or mandated reporting for suspicious bruising discovered at a routine postpartum visit.
  1. List the signs and symptoms, indications for referral or transfer for newborn hemangioma.
  1. List the signs and symptoms, indications for referral or transfer for newborn hypothermia.
  1. What are the beginning emergency measures for hypothermia?
  1. List the signs and symptoms, indications for referral or transfer for newborn hyperthermia.
  1. What are the beginning emergency measures for hyperthermia?
  1. List the signs and symptoms, indications for referral or transfer for newborn dehydration.
  1. List the signs and symptoms, indications for referral or transfer for newborn infection.
  1. List the signs and symptoms, indications for referral or transfer for newborn failure to thrive.
  1. List the signs and symptoms, indications for referral or transfer for newborn vitamin k deficiency bleeding.
  1. List the signs and symptoms, indications for referral or transfer for newborn polycythemia.

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