Course Syllabus ©National College of Midwifery 2012
01/2012
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 checkup
MANA Core Competencies:
I. Guiding Principles of Practice.
The midwife provides care according to the following principles:
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 and the rationale
for and limitations of such standards
V. Postpartum Care
The entry-level midwife provides health care, support and information to women
throughout the postpartum period. She determines the need for consultation or referral
as appropriate. The midwife uses a foundation of knowledge and/or skill, which
includes, but is not limited, the following:
5 F. Causes of, evaluation of, and treatments for problems arising during the postpartum
period.
5 G. Support, information and referral for family planning methods, as the individual woman
desires.
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Course Syllabus ©National College of Midwifery 2012
01/2012
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. 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.
1. Frye, Anne. Understanding diagnostic tests in the childbearing year: A wholistic
approach. Seventh edition. Labrys Press. 2007
2. Tharpe, Nell and Farley, Cindy. Clinical practice guidelines for midwifery and women’s
health. 3rd ed. Jones and Bartlett publishers. 2009
3. Johnson, Ruth and Taylor, Wendy. Skills for Midwifery Practice. Second edition.
Elsevier Churchill Livingston. 2006.
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Course Syllabus ©National College of Midwifery 2012
01/2012
4. Weaver, Pam and Evans, Sharon K. Practical Skills Guide for Midwifery, 4th Edition.
Morningstar Publishing Co. Wasilla. 2007
5. Davis, Elizabeth. Heart and Hands: A midwife’s guide to pregnancy and birth. 4th
Edition. Celestial Arts Press. 2004
6. Varney, Helen. Varney’s Midwifery. Fourth edition. Jones and Bartlett Publishers. 2004
7. MEAC Abbreviated NARM Skills Form.
8. MANA Core Competencies for Midwives
9. Midwives Model of Care®.
10. 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
Evaluation Tools / Methods:
Minimum passing grade for all courses 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.
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Course Syllabus ©National College of Midwifery 2012
01/2012
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. How do maternal vital signs relate to the decision making process about what diagnostic
tests might be necessary postpartum?
2. What is the purpose of performing a complete blood count with differential postpartum?
3. Discuss the significance of a white blood cell count in identifying infection postpartum.
4. What tests would be ordered to identify white blood cells?
5. How are the samples used to test for white blood cells obtained?
6. Explain when is the best time to evaluate a postpartum woman's HCT/Hgb.
7. Why would it be necessary to evaluate HCT/Hgb postpartum?
8. Discuss why it is important to draw an antibody screen on an Rh-negative mother
postpartum.
9. Explain the purpose of obtaining a clean catch urine sample postpartum.
10. Describe how a sample of lochia is obtained for culture postpartum and what the
purpose of this test is.
11. Describe how a sample of breast milk is obtained for culture and what the purpose of
this test is.
12. Discuss which bacteria cause the majority of breast infections.
13. When is appropriate to test for sexually transmitted infections postpartum?
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Course Syllabus ©National College of Midwifery 2012
01/2012
14. When is a pap test usually performed during the postpartum period?
15. What is the reason for performing a pap test postpartum?
16. Discuss how the principles of informed consent related to diagnostic testing in the
postpartum period.
17. Discuss the use of ultrasound postpartum. When might it be necessary to refer a client
for an ultrasound during the postpartum period?
18. Briefly discuss the importance of universal precautions when obtaining lab samples
during the postpartum period.
19. What diagnostic test can be done by the midwife before referring a client for hormonal
birth control?
20. What diagnostic test can be done by the midwife before referring a client for an IUD?
21. When should a fetal cell screen be ordered as part of a Rhogam workup?
22. Describe the use of the REEDA scale postpartum.
23. How can the information gathered using the REEDA scale help a midwife to understand
which diagnostic tests should be performed postpartum?
24. When is it important to perform diagnostic tests related to thyroid function postpartum?
25. When is it important to evaluate maternal blood sugar postpartum?
26. What diagnostic test would be used to evaluate maternal blood sugar postpartum?
27. When is it important to perform a maternal metabolic panel postpartum?
28. Describe the Edinburgh postnatal depression scale.
29. How can midwives use the Edinburgh scale as a diagnostic tool during the postpartum
period?
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