Course Syllabus ©National College of Midwifery 2017 11/2017

Course Title: Postpartum Diagnostic Lab Tests & Procedures

Credits: 0.5

Course Description: An introduction to the lab tests and procedures performed during the postpartum period. Student learns how to obtain samples of urine, lochia, breast milk, and the reasons for testing each of these. 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

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

(7)-I G. Applies the principles of informed consent

(8)-I H. Provides individualized care

II. General Healthcare Skills

D. Demonstrates the use of instruments and equipment including:

(47)-II D 24. Vacutainer/blood collection tube

(48)-II D 25. Vaginal culture equipment

V. Postpartum

(131)-V A. Performs postpartum reevaluation of mother and baby at appropriate intervals (136)-V *F. Performs thorough and appropriate maternal four- to six-week postpartum check-up

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. Practice filling out a lab requisition for a Rhogam workup on a postpartum woman and corresponding labwork for newborn cord blood.
  2. Practice venipuncture.
  3. Practice obtaining a vaginal culture and ordering appropriate tests.
  4. Practice obtaining a Pap Smear, gonorrhea and Chlamydia cultures.
  5. Describe the appropriate blood drawing tubes for the CBC, Antibody Screen, Type and RH factor for your instructor.

Learning Materials / Resources:

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

Frye, Anne. Understanding diagnostic tests in the childbearing year: A wholistic approach. Seventh edition. Labrys Press. 2007

1.Tharpe, Nell and Farley, Cindy. Clinical Practice Guidelines for Midwifery and Women’s Health. 4th edition. Jones and Bartlett Publishing. 2012

2.Johnson, Ruth and Taylor, Wendy. Skills for Midwifery Practice. 4th edition. Elsevier Churchill Livingston. 2016.

3.Weaver, Pam and Evans, Sharon K. Practical Skills Guide for Midwifery, 5th Edition. Morningstar Publishing Co. Wasilla. 2012.

4.Davis, Elizabeth. Heart and Hands: A midwife’s guide to pregnancy and birth. 5th Edition. Celestial Arts Press. 2012

5.Varney, Helen. Varney's Midwifery, 5th Edition. Jones and Bartlett Publishers. 2014.

Resources for all Courses:

MEAC Abbreviated NARM Skills Form:

MEAC Essential Competencies:

Midwives Model of Care®:

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.

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

  1. How do maternal vital signs relate to the decision making process about what diagnostic tests might be necessary postpartum?
  1. What is the purpose of performing a complete blood count with differential postpartum?
  1. Discuss the significance of a white blood cell count in identifying infection postpartum.
  1. What tests would be ordered to identify white blood cells?
  1. How are the samples used to test for white blood cells obtained?
  1. Explain when is the best time to evaluate a postpartum woman's HCT/Hgb.
  1. Why would it be necessary to evaluate HCT/Hgb postpartum?
  1. Discuss why it is important to draw an antibody screen on an Rh-negative mother postpartum.
  1. Explain the purpose of obtaining a clean catch urine sample postpartum.
  1. Describe how a sample of lochia is obtained for culture postpartum and what the purpose of this test is.
  1. Describe how a sample of breast milk is obtained for culture and what the purpose of this test is.
  1. Discuss which bacteria cause the majority of breast infections.
  1. When is appropriate to test for sexually transmitted infections postpartum?
  1. When is a pap test usually performed during the postpartum period?
  1. What is the reason for performing a pap test postpartum?
  1. Discuss how the principles of informed consent related to diagnostic testing in the postpartum period.
  1. Discuss the use of ultrasound postpartum. When might it be necessary to refer a client for an ultrasound during the postpartum period?
  1. Briefly discuss the importance of universal precautions when obtaining lab samples during the postpartum period.
  1. What diagnostic test can be done by the midwife before referring a client for hormonal birth control?
  1. What diagnostic test can be done by the midwife before referring a client for an IUD?
  1. When should a fetal cell screen be ordered as part of a Rhogam workup?
  1. Describe the use of the REEDA scale postpartum.
  1. How can the information gathered using the REEDA scale help a midwife to understand which diagnostic tests should be performed postpartum?
  1. When is it important to perform diagnostic tests related to thyroid function postpartum?
  1. When is it important to evaluate maternal blood sugar postpartum?
  1. What diagnostic test would be used to evaluate maternal blood sugar postpartum?
  1. When is it important to perform a maternal metabolic panel postpartum?
  1. Describe the Edinburgh postnatal depression scale.
  1. How can midwives use the Edinburgh scale as a diagnostic tool during the postpartum period?

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