MW 21O6: Midwifery practice 2

Course Description:

Clinical Practical 2 deepens students’ hands-on experience in managing normal labor and childbirth, while enhancing their ability to recognize and assist in the management of common complications of childbearing. Students will practice in diverse clinical settings under the close supervision of skilled midwives and clinical instructors. The course emphasizes improving technical skills, clinical judgment, respectful maternity care, emergency preparedness, and critical communication in labor and delivery environments.

Course Objectives:

Upon completion of this course, students will be able to:

1. Independently manage uncomplicated labor and spontaneous vaginal birth under supervision.
2. Monitor maternal and fetal conditions using appropriate tools (e.g., partograph, fetal heart monitoring).
3. Identify and provide first-line response to complications such as: Prolonged labor, Postpartum hemorrhage (PPH), Hypertensive disorders, Perineal tears, Obstructed labor
4. Provide immediate and essential newborn care, including neonatal resuscitation.
5. Assist in the preparation and referral of high-risk cases.
6. Apply infection prevention and aseptic techniques consistently during all procedures.
7. Communicate effectively and compassionately with laboring women and their families.
8. Accurately document maternal and neonatal care and maintain clinical records.

Clinical Activities:

Students will be expected to perform or assist in the following activities:

Normal Labor and Birth Management:

• Perform and document vaginal examinations (under supervision)
• Monitor labor using a partograph
• Provide continuous support to the woman during all stages of labor
• Manage the second stage of labor and assist in clean, safe delivery
• Manage the third stage of labor using Active Management of Third Stage of Labor (AMTSL)
• Perform and suture minor perineal tears or episiotomies (where competent and supervised)

Complication Management:

• Recognize signs of fetal distress, preeclampsia, PPH, sepsis, or retained placenta
• Assist in administering emergency medications (e.g., oxytocin, magnesium sulfate)
• Participate in team-based response to obstetric emergencies
• Prepare for emergency referrals and support safe transfer protocols

Professional Skills:

• Maintain respectful, non-discriminatory, and culturally sensitive care
• Ensure informed consent and effective communication with clients
• Document care clearly and thoroughly in delivery registers and patient records
• Participate in clinical debriefings and reflective practice sessions

Clinical Rotation Sites:

Students will rotate through the following settings for practical exposure:

1. Labor and Delivery Units (Primary, Secondary, or Tertiary Hospitals)
   • Main site for normal and complicated labor management
2. Emergency Obstetric and Newborn Care (EmONC) Centers
   • Focus: Hands-on experience with obstetric and neonatal emergencies
3. Operating Theatres (Observational or Assistant Role)
   • Focus: Cesarean section observations, surgical births, and emergency procedures
4. Primary Health Care Centers with Delivery Services
   • Focus: Autonomous management of low-risk births, early detection of complications, referrals