CBL 1_Model of practice_dating a pregnancy_history_screening Flashcards
Key things to cover in an ICD about the midwifery model of care (5)
- Philosophy of care (birth as state of health, evidence informed, choice of birthplace, informed choice)
- Scope of practice (normal birth)
- Informed choice
- Continuity of care
- Choice of birthplace
Midwifery model of practice in BC, according to the BCCNM (6)
- AUTONOMOUS, COMMUNITY-BASED PRIMARY CARE
- CONTINUITY OF CARE
- INFORMED CHOICE
- CHOICE OF BIRTH SETTING
- COLLABORATION
- ETHICS, ACCOUNTABILITY AND EVIDENCE-BASED PRACTICE
What is the schedule for antenatal and postpartum visits?
Antenatal:
0-28 weeks - every 4 weeks
28-36 - every 2 weeks
36-birth - every week
Postpartum: 1 visit between each of the following:
- birth-24 hrs
- days 2-4
- days 4-6
- week 2
- week 3-4
- week 6 ish (discharge)
Describe Neageles rule
Neagele’s rule:
subtract by three months from LMP and then add seven days, as well as add or subtract days to account for a longer or shorter cycle.
what are all of the things that a dating ultrasound can assess (5)?
dating (giving an EDD based on size)
fetal viability
number of fetuses
is the pregnancy intrauterine?, if multiples: chorionicity and amnionicity
When is a nuchal translucency test performed?
when the CRL is between 45 and 84 mm, generally scheduled. between 11 and 13+6 weeks GA
when is the detailed ultrasound (t2 ultrasound) performed?
18-20 wks (ideally), but 18-22 overall
which poor health outcomes is interpartner / gender based violence linked to?(4)
miscarriage
IUGR
preterm labour, anxiety/depression
delayed health care access , smoking
cut off for spontaneous abortion vs stillbirth?
<= 21 weeks is a spontaneous abortion
What are some things to include specific to your practice with model of care convo?
- Size of team
- How team works
- How to contact – urgent, non-urgent, in labour
- On call schedule
- Length of appointments
ICD on Homebirth?
- In the midwifery model of care we uniquely offer choice of birth place. This can be in a hospital, home setting, or birth centre.
- As autonomous care providers we are equipped to support low-risk births outside of hospital.
- We are trained and prepared to support physiological birth, immediate postpartum, and newborn care and respond to both risk assess for transfer and respond to any emergencies that may arise.
- If you are a low-risk client and choose to birth in hospital, you will be attended by myself and at least one nurse to care for you and your baby.
- If you choose to birth outside of hospital you will be attended by myself (or someone else on my team) during active labour and we will call another midwife during 2nd stage to assist me and provide care for your infant on arrival.
- For low-risk clients in the care of midwives in Canada planned out of hospital birth has been shown to be as safe as planned hospital births with fewer medical interventions (such as c-section, induction, and forceps delivery).
- In out-of-hospital births midwives do not offer pharmacological support during labour, but are experienced and trained in non-pharmacological support and coping methods.
- Throughout your pregnancy we will be doing risk assessments and recommend where we think the safest place to birth would be, as well as collaborating with other care professionals if needed.
What is the earliest you could do a dating US?
7 weeks or 10 mm of gestation
When is it recommended to use crown-rump length (CRL) for EDD in dating US?
Up to 84 mm
When is it recommended to use biparietal diameter for EDD in dating US?
Greater than 84 mm
When are the biparietal diameter and the crown-rump length are similar in accuracy?
12-14 weeks
