Skills Checklist Apprenticeship Level II
Obtain a complete history including family, general medical, gynecological, obstetric and current pregnancy.
Identify clients with special needs which require further follow up, e.g. risk of genetic disorder, environmental hazards, FAS, parenting disorders
Demonstrate use of hemoglobinometer (see instructions with meter)
Perform pelvic measurements and assess pelvic shape and size and cervical ripeness
Take an adequate diet history, demonstrate good grasp of general nutritional needs and of individual factors influencing such needs during pregnancy.
Interpret urine test stick results
Obtain and interpret appropriate/adequate laboratory data for initial assessment
Perform home non-stress test and assess FHR patterns
Perform finger puncture
Check for CVA tenderness
Elicit and assess DTR’s and Clonus (+1 – +4)
Check blood glucose
Is familiar with community resources and utilize networking skills in meeting needs of client and family beyond the scope of midwifery practice.
Identify signs and symptoms of possible emergent complications. Follow up on needs assessment and abnormal findings with appropriate further investigation, treatment, counseling, consultations, or referral.
Understand the principles of informed consent
Chart all information neatly and thoroughly
Determine dilation, effacement and position of cervix, and station of presenting part
Locate, count, and interpret FHT’s during and in between contractions and respond appropriately.
Demonstrate immediate response to fetal distress
Demonstrate management of prolapsed cord
Perform controlled delivery of head and shoulders with minimal trauma or lacerations of maternal tissues (i.e. offers perineal support, maintains flexion of head, anticipates position of head.) Check for nuchal cord and demonstrate several different responses
Understand the concept of ongoing risk assessment
Observe and maintain sterile technique appropriately
Recognize abnormal second stage labor patterns and respond appropriately
Recognize dehydration or full bladder, understand significance of these in progress of labor
Identify when hospital transport is necessary; communicate rationale to client and support persons; organize transport effectively including making necessary phone calls and gathering necessary equipment
Communicate with hospital staff clearly and accurately regarding client’s history, labor progress and significant findings.
Birth, Third and Fourth Stage:
Perform adult CPR
Observe expectant management of third stage, recognizing signs of placental separation, with readiness to handle third or fourth stage emergencies
Massage uterus properly if necessary
Assist with birth of placenta by gentle cord tractions and guarding of uterus, and immediate attention to fundus after expulsion. Performing Brandt- Andrews maneuver
Recognize signs of retained or partially retained placenta and/or membranes, summoning medical aide when indicated.
Perform thorough inspection of placenta, membranes and cord, recognizing abnormalities
Assess degree of laceration and assists repair
Monitor maternal vital signs and respond appropriately. Recognize and list signs of maternal shock.
Estimate blood loss accurately and respond appropriately
Determine knowledge of management of postpartum hemorrhage, including appropriate use of pitocin, in an emergent situation.
Perform intramuscular injection
Determine need for and perform bimanual compression
Respond to nutritional and hydration needs.
Induce urination within appropriate time period
Encourage immediate postpartum breastfeeding and bonding. Facilitate bonding between parents, baby and other family members.
Complete birth registration records appropriately and on time. (Including records of birth, postpartum, birth certificate, and any other records State demands).
Use a De Lee trap
Resuscitate baby with bag and mask
Resuscitate baby with mouth-to-mouth method
Perform cardiac massage on baby
Perform general newborn exam and follow-up
Assess gestational age accurately
Advise parents on normality and danger signs of the newborn
Recognize respiratory distress
Recognize signs of cardiac disorder/distress
Promote temperature regulation
Assist mother in establishment of breastfeeding when mother or baby has special needs: cleft lip and palate, premature baby, twins,Downssyndrome, after a cesarean
Consult /refer appropriately when deviations from normal are identified
Collect specimens appropriately: (HCt, PKU, cord blood, ect.)
Do appropriate lab work for Rh – mothers
Administer eye prophylaxis or informed consent signed
Administer Vitamin K or informed consent signed
Instruct clients in self-care such as monitoring vaginal bleeding, signs of postpartal infections, perineal hygiene, breast care / immediate changes, degree of activity, baby care; cord stump, temperature, jaundice, bowel movements, nursing patterns, and sexuality
Recognize the need for medications when appropriate
Recognize problems in postpartal psychological adjustments and offer appropriate support and/or referrals.
Recommend administration of RhoGam when appropriate
Assess site of lacerations for infection
Offer counsel about family spacing methods