Course Syllabus ©National College of Midwifery 2012
01/2012
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
MANA Core Competencies:
I. Guiding Principles of Practice.
The midwife provides care according to the following principles:
1 C. Midwives work as autonomous practitioners, collaborating with other health and social service
providers when necessary.
1 J. Midwives synthesize clinical observations, theoretical knowledge, intuitive assessment and
spiritual awareness as components of a competent decision making process.
II. General Knowledge and Skills
The midwife provides care incorporating certain concepts, skills and knowledge from a variety of
health and social sciences including, but not limited to:
2 C. Community standards of care for women and their developing infants during the childbearing
cycle, including midwifery and bio-technical medical standards
2 J. The grieving process.
2 M. The ability to develop, implement and evaluate an individualized plan for midwifery care.
2 N. Woman-centered care, including the relationship between the mother, infant and their larger
support community.
2 O. Knowledge and application of various health care modalities as they apply to the childbearing
cycle
IV. Care During Labor, Birth and Immediately Thereafter
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Course Syllabus ©National College of Midwifery 2012
01/2012
The midwife provides health care, support, and information to women throughout labor, birth and
the hours immediately thereafter. She determines the need for consultation or referral as
appropriate. The midwife uses a foundation of knowledge and/or skill which includes the following:
4 B. Parameters and methods for evaluating maternal and fetal well-being during labor, birth and
immediately thereafter, including relevant historical data.
4 K. Emergency measures and transport procedures for critical problems arising during labor, birth
or immediately thereafter.
4 L. Understanding of and appropriate support for the newborn's transition during the first minutes
and hours following birth.
4 M. Familiarity with current bio-technical interventions
Learning Activities:
A. Student reads appropriate sections from the Learning Materials/Resources.
B. 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.
C. Student presents answers the questions listed in the Learning Objectives for review by
preceptor.
D. Student participates in preceptor elaboration/discussion of Learning Objectives.
E. In the case that the required texts are more than 5 years old, 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.
F. 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.
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Course Syllabus ©National College of Midwifery 2012
01/2012
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.
2005.
2. Fraser, DM, et al. Myles Textbook for Midwives. 15th ed. Churchill Livingstone Press.
2009.
3. Tharpe, Nell and Farley, Cindy. Clinical practice guidelines for midwifery and women’s
health. 3rd ed. Jones and Bartlett publishers. 2009
4. Varney, Helen. Varney’s Midwifery. Fourth Edition. Jones and Bartlett Publishers. 2004
rd
5. F. Cunningham, et al. William’s Obstetrics. 23 Edition. McGraw-Hill Professional. 2009.
6. Frye, Anne. Holistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth
Practice, Vol. 2: Care of the Mother and Baby from the Onset of Labor Through the First
Hours After Birth. Labrys Press. 2004.
th
7. Weaver, Pam and Evans, Sharon K. Practical Skills Guide for Midwifery, 4 Edition.
Morningstar Publishing Co. Wasilla. 2007.
8. MEAC Abbreviated NARM Skills Form.
9. MANA Core Competencies for Midwives
10. Midwives Model of Care®.
11. Students must find 1 article/study less than 5 years old. Recommended internet links
as needed for latest developments in midwifery care:
The Cochrane Collaboration
EBSCO
National Library of Medicine
PubMed
Medline
SCIRUS
Medscape
World Health Organization
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Course Syllabus ©National College of Midwifery 2012
01/2012
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 80-90% 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. Summary of current journal article / study counts for 10% of the final grade in the case that
other scholarly resources used are more than five years old.
C. Exam counts for 10% of the final grade.
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. Describe the special management that may be needed by a newborn born as a twin.
2. Briefly describe the physiology of twin-to-twin transfusion.
3. Describe the signs and symptoms of Rh isoimmunization in the newborn.
4. Describe what special care is needed by newborns born to Rh sensitized mothers.
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Course Syllabus ©National College of Midwifery 2012
01/2012
5. Discuss the neonatal problems faced by preterm infants born between 30 and 34 weeks
gestation.
6. Discuss the neonatal problems faced by preterm infants born after 34 weeks.
7. Discuss problems that can arise for infants that are born post-dates.
8. Discuss the why infants that are large for gestational age are more likely to sustain
traumatic birth injuries.
9. Describe the neonatal problems that can arise for babies that are born large for
gestational age.
10. Discuss the underlying causes that can lead to the birth of a baby that is small for
gestational age (SGA).
11. Discuss the complications that can arise for SGA during the newborn period.
12. Discuss the long term outcomes for infants that are born SGA.
13. Describe the clinical presentation of a neonate with Group B strep infection.
14. Describe the clinical presentation of a neonate with Chlamydia infection.
15. Describe the clinical presentation of a neonate with Gonorrhea infection.
16. Describe the clinical presentation of a neonate with congenital syphilis infection.
17. Describe the clinical presentation of a neonate with congenital tuberculosis.
18. Describe the signs and symptoms displayed by infants with RDS.
19. Describe the common underlying causes of respiratory distress syndrome.
20. Describe the clinical presentation of neonatal meconium aspiration.
21. Describe the physiology of why meconium aspiration is dangerous to neonatal
respiratory system.
22. Describe the signs and symptoms displayed by infants with a pneumothorax.
23. How can a pneumothorax be identified in an infant that is does not display respiratory
distress?
24. Describe the management of an infant with upper airway obstruction.
25. Describe the symptoms and management of an infant with diaphragmatic hernia.
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Course Syllabus ©National College of Midwifery 2012
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26. Describe the various types of seizure activity that may be observed in the neonate.
27. Describe the underlying causes for neonatal seizures.
28. Describe the signs and symptoms of pathological jaundice.
29. Describe the underlying causes for pathological jaundice.
30. Describe the signs and symptoms of congenital heart defects in the newborn.
31. Describe the factors that contribute to congenital heart defects in the newborn.
32. Describe the signs and symptoms of an infant with intestinal obstruction.
33. Describe how to identify an infant with imperforate anus
34. Describe the signs and symptoms exhibited by infants with hirschsprung's disease.
35. Discuss the signs and symptoms exhibited by infants with meconium ileus.
36. Discuss the underlying cause of meconium ileus.
37. Describe the signs of a neural tube defect at birth.
38. What are the underlying causes of neural tube defects?
39. Describe the signs and symptoms of hydrocephalus.
40. Describe the physiology of how hydrocephalus occurs.
41. Describe the signs and symptoms displayed by infants that are undergoing withdrawal
from narcotics.
42. Describe the signs and symptoms displayed by infants that are undergoing withdrawal
from cocaine and amphetamines.
43. Describe the signs and symptoms of fetal alcohol syndrome.
44. Describe the defects that are most commonly associated with fetal alcohol syndrome.
45. Describe the signs and symptoms of hydrops fetalis.
46. Describe the underlying causes of hydrops fetalis.
47. Describe the signs and symptoms of developmental hip dysplasia.
48. What are the underlying causes of hip dysplasia?
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Course Syllabus ©National College of Midwifery 2012
01/2012
49. Describe the signs of club foot (talipes).
50. Discuss the underlying causes of club foot.
51. Discuss the physiology of a cleft lip and/or palate.
52. Discuss the underlying causes of cleft lip and/or palate.
53. Discuss the physical characteristics associated with a neonate with Down’s syndrome.
54. Discuss the management of infants born with atypical genitalia. What factors should be
taken into consideration?
55. Describe the most common presentations of atypical genitalia.
56. Describe the presentation of omphalocele.
57. What are the underlying causes of an omphalocele?
58. What is the presentation of a limb reductions anomaly in the neonate?
59. What is most likely the underlying cause of a limb reduction anomaly in the neonate?
60. Describe the signs of hypospadias in the newborn.
61. What are the underlying causes of hypospadias in the neonate?
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