Level 3

Skills Checklist for Apprenticeship Level III



Prenatal Care:

            Do two tests for cord compression

            Demonstrate external version

            Assess estimated due date accurately with or without LMP

            Use a speculum

            Estimate fetal weight

            Perform a breast examination

            Assess status of membranes in case of questionable spontaneous rupture

            Perform a thorough pelvic exam, including pelvic measurements, status of vaginal and perineal musculature, skin and glands.




            Determine position and attitude of the fetus by palpation of sutures and fontanelles.

            Demonstrate facilitation of a vertex delivery

            Demonstrate emergency breech delivery

            Demonstrate delivery of baby in face presentation

            Demonstrate all techniques in management of shoulder dystocia

            Describe steps to take in emergency delivery of twins.

            Perform amniotomy appropriately and safely

            Demonstrate urinary catherization

            Manage nuchal hand, nuchal arm

            Assess maternal vital signs accurately and respond how to find them appropriately

            Assess FHTs accurately by fetoscope, Doppler and fetal heart monitor (internal and external) and respond to findings appropriately

            Identify malpresentation and respond appropriately

            Assess progress of labor by noting descent, dilation, labor pattern, FHTs and client behavior

            Recognize abnormal labor patterns and identify possible causes

            Utilize necessary equipment appropriately such as oxygen for mother and baby, resuscitation equipment, and sterile instruments

            Chart clearly and thoroughly regarding progress of labor, fetal and maternal vital signs, significant events, significant communications, physician consultations and progression of events in presence of complications

            Universal precautions regarding blood


Birth, Third and Fourth Stage:

            Demonstrate bimanual compression

            Demonstrate manual removal of placenta or clots

            Manage 3rd or 4th stage hemorrhage

            Repair laceration:  1st or 2nd degree or episiotomy

            Use local anesthetic for laceration repair

            Manage maternal shock


Newborn Care:

            Score gestational age of baby

            Do neurological exam of baby

            Demonstrate how to prepare baby with spina bifida, omphalocele, or other major anomaly for transport

            Perform physical examination of newborn at birth and follow up.