University of Technology Sydney

92368 Keeping the Normal in Birth

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Subject handbook information prior to 2024 is available in the Archives.

UTS: Health
Credit points: 6 cp
Result type: Grade and marks

There are course requisites for this subject. See access conditions.

Description

This subject explores how midwifery skills optimise physiological processes in labour and birth for all women and birthing people, including those with complications and risk factors. A review of the principles of anatomy and physiology that underpin these processes enables an understanding of how models of care, the birth environment, freedom of movement, technology mediation, woman centred language and debriefing techniques can positively affect the course of labour and birth.

Subject learning objectives (SLOs)

Upon successful completion of this subject students should be able to:
A. Analyse strategies on how midwifery knowledge and skills can be utilised to keep birth normal
B. Appraise evidence on how optimising the birth environment supports the normal physiology of labour and birth, and how to actively incorporate these elements into practice
C. Explain how work patterns and workplace culture can promote midwives working to the full scope of practice and promote normal birth
D. Discuss how care provision by the most appropriate clinician can affect the course of labour and birth
E. Determine strategies on how to reframe practice to ensure elements of normality are included in the care of all women, including those women with complexities
F. Explain how debriefing and language can affect women’s experiences and perceptions of labour and birth

Course intended learning outcomes (CILOs)

This subject also contributes specifically to the following graduate attributes:

  • Demonstrate woman centred care acknowledging the physiological, psychological, cultural and spiritual needs of women, their babies and family members (1.1)
  • Appreciate the centrality of the relationship with each woman to the practice of midwifery (1.2)
  • Are professionally competent midwives who provide safe and effective midwifery care using intelligent kindness (2.0)
  • Demonstrate critical thinking and sound clinical judgment that is based on evidence and reflects appropriate reasoning within the relevant professional codes and guidelines (2.2)
  • Communicate effectively using spoken, written and non-verbal language across a range of contexts and to diverse audiences (2.3)
  • Participate effectively as a member of an interdisciplinary healthcare team (3.3)
  • Practise midwifery within a primary health care philosophy (5.1)
  • Critique and reflect upon the impact of ongoing colonisation and its pervasive discourse on Indigenous Australians and their health and wellbeing (7.2)

Teaching and learning strategies

In this subject, students participate in a range of teaching and learning strategies.

ONLINE LEARNING MATERIALS
Online materials including scenario-based learning develop students’ clinical judgement. Online materials support students to prepare for in-class learning activities. Students are invited to reflect on the diversity of women's birthing experiences and the different ways in which the normal experience of ‘having a baby’ is articulated for individual women and birthing people.

Video clips and photographs are used to critique conventional labour rooms using optimal birth design principles. Students are required to reflect on ways that they can alter the birth environment in which they work to optimise experiences for women.

COMMUNICATION AND SIMULATION
Students participate in simulated practice of midwifery skills, in particular the use of language and simulated debriefing techniques. Students learn and practise interpersonal skills with case studies in the classroom, in particular ways to support women through labour and birth.

SIMULATED IN-CLASS ROLE PLAY
Role plays provide a simulated environment for students to practise new skills learnt through theory and knowledge development. Scenarios from relevant situations are used to depict real life experiences in primary health care. Students interact, observe and provide feedback within the facilitated debriefing, and reflect on their own skills, values and experiences. Simulations also explore communication skills in supporting women who experience unexpected outcomes.

COLLABORATIVE LEARNING ACTIVITIES
The majority of the face-to-face time in this subject involves collaborative group activities, discussions and workshops. Students are supported to engage in content prior to attending class, and class time focuses on group learning and mentored activities to support learning. Small groups brainstorm ways of working with women and birthing people to ‘keep the normal in labour and birth’ and students have opportunities to present their ideas to one another in a safe space.

CASE STUDIES
Case studies are used to help students explore pregnancy and birth scenarios that are commonly encountered. These encompass women and birthing people with complex pregnancies in hospital and the community setting. Students use these cases to learn concepts, interpret information, form clinical judgements and develop creative solutions to maintain physiological processes in labour and birth. Students develop critical and creative thinking through analysis, interpretation of and reflection on various clinical situations.

ACADEMIC WRITING
Students demonstrate their information literacy and technology skills by searching and synthesising the professional literature. Students comply with academic writing practices and use information ethically, legally and respectfully.

Content (topics)

Keeping the normal in labour and birth

  • Different perceptions of ‘normality’
  • Use of knowledge and skills to keep birth normal
  • The importance of woman-centred care and continuity of care for all women and birthing people
  • Skills in debriefing and language when working with families
  • Models of care to support optimal birth

Altering the birth environment

  • Development of strategies to alter the birth space
  • Optimisation of the environment for women including in complex situations

Supporting one another

  • Reflection on midwifery practice
  • The importance of workplace culture and work patterns
  • Development of skills to support students in the future

Assessment

Assessment task 1: DISCUSSION PAPER ON PROMOTING ‘NORMALITY’ IN LABOUR AND BIRTH

Objective(s):

This assessment task addresses subject learning objective(s):

A, B, C, D and F

This assessment task contributes to the development of graduate attribute(s):

1.1, 2.0, 2.2, 2.3 and 3.3

Type: Essay
Groupwork: Individual
Weight: 60%
Length:

2000 words

Assessment task 2: DEBRIEFING A WOMAN FOLLOWING AN EMERGENCY CAESAREAN SECTION

Objective(s):

This assessment task addresses subject learning objective(s):

E and F

This assessment task contributes to the development of graduate attribute(s):

1.2, 2.3, 5.1 and 7.2

Type: Presentation
Groupwork: Group, group assessed
Weight: 40%
Length:

5 minutes (vodcast) and 1000 word paper

Required texts

Buckley, S.J. (2015). Hormonal Physiology of Childbearing: Evidence and Implications for Women, Babies, and Maternity Care. Washington, D.C.: Childbirth Connection Programs, National Partnership for Women & Families. (Publicly available online).

Recommended texts

Downe, S. (ed.) (2008). Normal childbirth: evidence and debate (2nd edition). Elsevier Edinburgh.

Leap, N. and Hunter, B. (2016). Supporting women for labour and birth:a thoughtful guide. Routledge London.

Page, L., McCandlish, R. (eds.) (2006). The new midwifery: Science and sensitivity in practice (2nd edition). Elsevier Edinburgh.

Pairman, S. (ed.) (2019). Midwifery?: preparation for practice (Fourth edition). Elsevier Australia. (Available as eBook in UTS Library)

Walsh, D. (2012), Evidence and skills for normal labor and birth: A guide for midwives. Routledge London.

Walsh, D. and Downe, S. (eds.) (2010). Essential midwifery practice: intrapartum care. Wiley-Blackwell Oxford.

References

Catling, C., Cummins, A. and Hogan, R. (eds.) (2016). Stories in midwifery: Reflection, inquiry, action. Elsevier Australia.

Downe, S. (ed.) (2008). Normal childbirth: evidence and debate (2nd edition). Elsevier Edinburgh.

Downe, S. Focussing on physiological processes in labour and birth, accessed on February 19, 2019 at http://betterbirths.rcm.org.uk/resources/watch/focussing-on-physiological-processes-in-labour-and-birth-2

Leap, N. and Hunter, B. (2016). Supporting women for labour and birth:a thoughtful guide. Routledge, London.

Olza, I. Leahy-Warren, P., Benyamini, Y., Kazmierczak, M., Karlsdottir, S. I., Spyridou, A., Crespo-Mirasol, E., Takács, L., Hall, P. J., Murphy, M., Jonsdottir, S. S., Downe, S., & Nieuwenhuijze, M. J. (2018). Women’s psychological experiences of physiological childbirth: a meta-synthesis. BMJ Open, 8(10), e020347–e020347. https://doi.org/10.1136/bmjopen-2017-020347

Page, L., McCandlish, R. (eds.) (2006). The new midwifery: Science and sensitivity in practice (2nd edition). Elsevier Edinburgh.

Pairman, S. (ed.) (2019). Midwifery?: preparation for practice (Fourth edition). Elsevier Australia. (Available as eBook in UTS Library)

Renfrew, M., McFadden, A., Bastos, M. H., Campbell, J., Channon, A. A., Cheung, N. F., Silva, D. R. A. D., Downe, S., Kennedy, H. P., Malata, A., McCormick, F., Wick, L., & Declercq, E. (2014). Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care. The Lancet (British Edition), 384(9948), 1129–1145. https://doi.org/10.1016/S0140-6736(14)60789-3

Walsh, D. (2012). Evidence and skills for normal labor and birth: A guide for midwives. Routledge London.

Walsh, D. and Downe, S. (eds.) (2010). Essential midwifery practice: intrapartum care. Wiley-Blackwell Oxford.

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