University of Technology Sydney

92378 Midwifery in Complex Situations

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Subject handbook information prior to 2020 is available in the Archives.

UTS: Health
Credit points: 6 cp

Subject level:


Result type: Grade and marks

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


This subject prepares students to assess, plan, implement and evaluate midwifery care for women and babies who have complex needs. It examines the legal, ethical and professional responsibilities of the midwife in relation to the provision of care for this group.

Subject learning objectives (SLOs)

Upon successful completion of this subject students should be able to:
A. Identify, describe and explore the evidence in relation to complex situations in the antepartum, intrapartum and postpartum/neonatal period that may be encountered by the woman and her family.
B. Explain the pathophysiology of frequently occurring complexities for both the woman and her baby.
C. Describe the action and safe administration of medications that may be prescribed to women and babies with complex needs
D. Assess, plan, implement and evaluate midwifery care for the woman and her family who have complex needs.
E. Assess, plan, implement and evaluate midwifery care for the unwell neonate.
F. Demonstrate effective communication skills in order to consult, refer and provide a comprehensive and accurate handover in complex situations.
G. Apply legal, ethical and professional responsibilities to midwifery practice.

Course intended learning outcomes (CILOs)

This subject also contributes specifically to the following graduate attributes:

  • Practise woman-centred care (1.0)
  • 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)
  • Have a sound and thorough knowledge base about anatomy and physiology (2.1)
  • Demonstrate competence in all clinical skills at the level of a new graduate midwife and be eligible to apply to the Nursing and Midwifery Board of Australia for registration as a midwife (2.5)
  • Participate effectively as a member of an interdisciplinary healthcare team (3.3)
  • Are resilient, emotionally competent midwives who foster human flourishing (4.0)
  • Communicate and provide effective care for women from diverse backgrounds and needs (5.4)

Teaching and learning strategies

In this subject, students participate in a range of teaching and learning strategies that are designed to encourage them to engage with midwifery care for women with complexities in pregnancy, birth and the puerperium.

Online leearning modules
The subject benefits from the provision of online learning modules as preparation for in-class activities. It is expected students will complete online learning modules on some topics with further discussion and clarification of these topics in the face to face workshops. Students have access to mindfulness apps and online resources. The integration of self-care techniques is important when working with women and/or neonates that experience complexities throughout the perinatal period.

This subject provides face-to-face workshops to enable students to clarify, discuss and develop subject concepts. The lectures are supported by the online learning activities and followed up in the class activities.

Clinical skills, communication and simulation
Students learn and practice clinical and interpersonal skills with case scenarios in the classroom. These practise scenarios incorporate the development of professional communication skills including consultation and referral to medical colleagues. Students also work in groups exploring one complexity of pregnancy and the groups present to the class. There are opportunities for feedback from these group presentations. Students' development of knowledge and clinical skills in providing midwifery care for women with complexities of pregnancy, birth and the puerperium are assessed in a case study format examination.

Content (topics)

Philosophy of midwifery practice

  • Midwifery competencies and codes of practice

Reflection in midwifery practice

  • Student reflection on their developing midwifery practice
  • Exploration of reflective practice tools in application to midwifery practice scenarios

Anatomy and physiology

  • Extension of knowledge from both Midwifery Practice 1 and Midwifery Practice 2 as students explore the anatomy and physiology related to complexities of pregnancy, childbirth, the postnatal period (including lactation) and the neonate.
  • Deeper understanding of the maternal and fetal adaptations in childbirth.

Knowledge and skills

  • Midwifery practice skills focusing on complexity throughout the childbearing continuum and developing students' midwifery practice knowledge, skills and attitudes
  • Understanding of previous trauma experiences and the impact on women in the perinatal period

Quality and safety

  • Communication skills
  • Understanding of Open Disclosure
  • Clinical handover
  • Documentation
  • Use of clinical documentation tools as mandated by the health sector
  • Incident monitoring systems
  • Consultation and referral including escalation of care
  • Recognition of the importance of continuity of care for women with complexities

Responsibility, accountability and leadership

  • The responsibility and accountability that comes with being a midwife
  • The need for responsibility and accountability and how this is articulated in practice
  • Reflection on the leadership role that the midwife plays in health care and that students place in the future of the profession
  • Support for students through adult learning principles and group skills
  • Reflect on on self-care – strategies to maintain resilience and be able to affectively work in the health care system




Students are required to identify a woman from their midwifery continuity of care experiences or clinical practice. The woman will have developed a complexity in pregnancy, birth and/or the puerperium. The student is to research the topic of the complexity and design an information brochure containing information appropriate for a woman to understand. This assessment is designed to give students an opportunity to explore the experience of providing information to a woman in a way that she and her family will understand.


This assessment task addresses subject learning objective(s):

A, B, C and F

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

1.0, 1.1, 1.2, 2.5 and 5.4

Type: Design/drawing/plan/sketch
Groupwork: Individual
Weight: 30%

800-1000 words

Assessment task 2: CASE STUDY REFLECTION


This assessment requires students to reflect on caring for a woman who has developed a pregnancy complexity. Reflection on practice is an integral part of providing safe, informed care to women. The reflection students will undertake in this assessment has the overarching aim to maintain quality and safety for women who experience a deviation from the expected care path during pregnancy. This is achieved through understanding your own experience, feelings and lessons learned by caring for a woman who develops a complexity during or after pregnancy.


This assessment task addresses subject learning objective(s):

A, B, C and D

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

1.0, 1.1, 1.2, 2.0, 2.1, 2.5, 3.3 and 4.0

Type: Reflection
Groupwork: Individual
Weight: 20%

REFLECTION: 500 - 600 words

Assessment task 3: CASE STUDY EXAM


This assessment task addresses subject learning objective(s):

A, B, C, D, E, F and G

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

1.0 and 2.0

Type: Examination
Groupwork: Individual
Weight: 50%

2 hours


Boyle, M. 2017, Emergencies around childbirth: a handbook for midwives, 3rd edn, Boca Raton, FL:CRC Press, Taylor & Francis group British Columbia Provincial Mental Health and Substance Use Planning Council 2013, Trauma-informed practice guide, British Columbia Provincial Mental Health and Substance Use Planning Council, Vancouver.

Catling, C., Cummins, A. & Hogan, R. 2016 Stories in Midwifery, Elsevier Australia, Sydney.

Gray, J., Smith, R. 2018, Midwifery essentials, 2nd edn. Elseivir Australia, Sydney.

Gilbert, E. 2011, Manual of high risk pregnancy and delivery, 5th edn, Mosby, St Louis MS.

MacDonald, S., Magill-Cuerden, J. & Warwick, C. 2011 Mayes' midwifery: A textbook for midwives, 13th edn, Bailliere Tindall, New York.

Marshall, J.E. & Raynor, M.D. 2014, Myles textbook for midwives, 16th edn, Elsevier Health Sciences, Sydney.

Nelson-Piercy, C. 2015, Handbook of obstetric Medicine, 5th edn, Boca Raton, FL. CRC press, LLC.

Nursing and Midwifery Board of Australia 2018, Midwife standards for Practice, NMBA, Melbourne.

Pairman, S., Tracy, S., Dahlen, H. & Dixon, L. (eds) 2019, Midwifery: preparation for practice, 4th edn, Book 1,
Elsevier, Sydney.

Pairman, S., Tracy, S., Dahlen, H. & Dixon, L. (eds) 2019, Midwifery: preparation for practice, 4th edn, Book 2, Elsevier, Sydney.

Poole, N. & Greaves, L. (eds) 2012, Becoming trauma informed, Centre for Addiction and Mental Health, Toronto.

Simpson, M. & Catling, C. 2015, ‘Understanding psychological traumatic birth experiences: A literature review’, Women and Birth, doi:10.1016/j.wombi.2015.10.009

Stables, D. & Rankin J. 2011, Physiology in childbearing: with anatomy and related biosciences, 3rd edn, Elsevier, Edinburgh.

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