SUBJECT: MIDWIFERY AND OBSTETRICAL NURSING

Course Plan
(Session 2020-2021)
Placement :
Course Planning
Theory :
Practical :
Total :

Objectives : As per course plan

COURSE PLANNING
Faculty Unit to be taught Hours
Mrs. Ramandeep Kaur
Mrs. Neha Vasudev
Ms. Gurpreet Kaur
Mrs. Nidhi
Allocation of Hours Unit Wise
Unit Hours Unit Hours
I 3 VIII 10
II 8 IX 4
III 8 X 10
IV 12 XI 4
V 5 XII 10
VI 6
VII 10
Hours of instruction as per INC
Unit Prescribed Hrs Topic Resource Teaching
hrs by INC Planned person Learning
Activities
I 3 Introduction to midwifery and obstetrical Nursing midwifery
and obstetrical Nursing
 Introduction to concepts of Content and obstetrical nursing
 Trends in midwifery current trends
o Historical perspectives and current trends
o Legal and ethical aspects
o Pre-conception care and preparing for parenthood
o Role of nurse in midwifery and obstetrical care.
o National policy and legislation in relation to maternal
health and welfare.
o Maternal, morbidity, mortality and fertility rates
o Perinatal, morbidity and mortality rates
II 8 Review of anatomy and physiology of female reproductive
system and foetal development
 Female pelvis - general description of the bones joints,
ligaments, planes of the pelvis diameters of the true pelvis,
important landmarks, variations in pelvis shape.
 Female organs of reproduction - external genetalia, internal
genital organs and their anatomical relations, musculature -
blood- supply, nerves, lymphatics, pelvic cellular tissue, pelvic
peritoneum.
 Physiology of menstrual cycle
  Human sexuality
 Foetal development
o Conception
o Review of fertilization, implantation (embedding of the ovum),
development of the embryo and placenta at term functions,
abnormalities, the foetal sac, amniotic fluid, the umbilical chord
o Foetal circulation, foetal skull, bones, sutures and measurements.
o Review of Genetics

III 8 Assessment and management of pregnancy (ante-natal)

 Normal pregnancy
 Physiological changes during pregnancy.
o Reproductive system
o Cardio vascular system
o Respiratory system
o Urinary system
o Gastero intestinal system
o Metabolic changes
o Skeletal changes
o Skin changes
o Endocrine system
o Psychological changes
o Discomforts of pregnancy
 Diagnosis of pregnancy
o Signs
o Differential diagnosis
o Confirmatory tests
 Ante-natal care
o Objectives
o Assessment
- History and physical examination
- Antenatal Examination
- Signs of previous child-birth
o Relationship of foetus to uterus and pelvis: Lie, Attitude, •
Presentation, Position
o Per vaginal examination.
 Screening and assessment for high risk;
 Risk approach
 History and Physical Examination • Modalities of diagnosis; Invasive
&Non-Invasive, ultrasonics, cardiotocography, NST, CST
 Antenatal preparation
o Antenatal counseling
o Antenatal exercises
o Diet
o Substance use
o Education for child-birth
o Husband and families
o Preparation for safe-confinement
o Prevention from radiation
 Psycho-social and cultural aspects of pregnancy
o Adjustment to pregnancy
o Unwed mother
o Single parent
o Teenage pregnancy
 o Sexual violence
 Adoption
IV 12 Assessment and management of intra-natal period.
 Physiology of labour, mechanism labour
 Management of labour.
o First stage
- Signs and symptoms of onset of labour; normal and abnormal
- Duration
- Preparation of
 Labour room
 Woman
- Assessment and observation of women in labour; partogram-
maternal and foetal monitoring Induction of labour
- Pain relief and comfort in labour
 Second stage
o Signs and symptoms; normal and abnormal
o Duration
o Conduct of delivery; Principles and techniques
o Episiotomy (only if required)
o Receiving the new born
- Neonatal resuscitation; initial steps and subsequent resuscitation
- Care of umbilical cord
- Immediate assessment including screening for congenital anomalies
- Identification Bonding
- Initiate feeding
- Screening and transportation of the neonate
 Third stage
o Signs and symptoms; normal and abnormal
o Duration
 o Method of placental expulsion
o Management; Principles and techniques
o Examination of the placenta
o Examination of perineum
 Maintaining records and reports
 Fourth Stage
V 5 Assessment and management of women during post-natal period
 Normal puerperium; Physiology Duration
 Postnatal assessment and management
o Promoting physical and emotional well-being
o Lactation management
o Immunization
 Family dynamics after child-birth.
 Family welfare services; methods, counselling
 Follow-up
 Records and reports

VI 6 Assessment and management of normal neonates

 Normal Neonate
o Physiological adaptation
o Initial & Daily assessment
o Essential new born care; Thermal control
o Breast feeding. prevention of infections
 Immunization
 Minor disorders of new born and its management
 Levels of Neonatal care (level 1, II, & III)
  At primary, secondary and tertiary levels
 Maintenance of Reports and Records
VII 10 High-risk pregnancy -assessment & management
 Screening and assessment
o Ultrasonics, cardiotomography, NST, CST, non-invasive &
invasive
o Newer modalities of diagnosis
 High-risk approach
 Levels of care; primary, secondary and tertiary levels
 Disorders of pregnancy
o Hyper-emesis gravidarum, bleeding in early pregnancy,
abortion, ectopic
o Pregnancy, vesicular mole
o Ante-partum haemorrhage.
 Uterine abnormality and displacement.
 Diseases complicating pregnancy
o Medical and surgical conditions
o Infections, RTI (STD), UTI, HIV, TORCH
o Gynaecological diseases complicating pregnancy
o Pregnancy induced hypertension & diabetes, Toxemia of
pregnancy, hydramnios
o Rh incompatibility a Mental disorders
 Adolescent pregnancy, Elderly primi and grand multipara
 Multiple pregnancy
 Abnormalities of placenta & cord
 Intra-uterine growth-retardation
  Nursing management of mothers with high-risk pregnancy
 Maintenance of Records and Report
VIII 10 Abnormal Labour - assessment and. Management
 Disorders in labour
o CPD and contracted pelvis
o Malposition’s and malpresentations
o Premature labour, disorders of uterine actions- precipitate
labour, prolonged labour
o Complications of third stage: injuries to birth canal
 Obstetrical emergencies and their management;
o Presentation and prolapse of cord, Vasa praevia, amniotic
fluid embolism, rupture of uterus, shoulder dystocia,
obstetrical shock
 Obstetrical procedures and operations
o Induction of labour, forceps, vacuum version, manual
removal of placenta, caesarean section, destructive
operations
 Nursing management of women undergoing Obstetrical
operations and procedures

IX 4 Abnormalities during Postnatal Periods

 Assessment and management of woman with postnatal
complications
o Puerperial infections, breast engorgement & infections,
UTI, thrombo-Embolic disorders, post- partum haemorrage,
Eclampsia and subinvolution,
 o Psychological complications:
- Post partum Blues
- Post partum Depression
- Post partum Psychosis

X 10 Assessment and management of High risk new born

 Admission of neonates in the neonatal intensive care units-
protocols
 Nursing management of:
- Low birth weight babies
- Infections
- Respiratory problems
- Haemolytic disorders
- Birth injuries
- Malformations
 Monitoring of high risk neonates
 Feeding of high risk neonates
 Organisation and management of neonatal intensive care
units
 Infection control in neonatal intensive care units
 Maintenance of reports and records
XI 4 Pharmaco-therapeutics in obstetrics
 Indication, dosage, action, contra indication and side effects
of drugs
 Effect of drugs on pregnancy, labour & puerperium,
 Nursing responsibilities in the administration of drug in
Obstetrics - oxytocin’s, antihypertensives, diuretics,
 tocolytic agents, anti- convulsant
 Analgesics and anesthesics in obstetrics, • Effects of
maternal medication foetus and neonate
IX 4 - Assessment and management of High risk newborn
- Admission of neonates in the neonatal intensive care
units- protocols • Nursing management of: - Low birth
weight babies - Infections - Respiratory probiems -
haemolytic disorders - Birth injuries - Malformations
Monitoring of high risk neonates • Feeding of high risk
neonates • Organisation and management of neonatal
intensive care units • Infection control in neonatal
intensive care units • Maintenance of reports and records
Pharmaco-therapeutics in obstetries• • Indication,
dosage, action, contra indication and side effects of
drugs • Effect of drugs on pregnancy, labour &
puerperium, • Nursing responsibilities in the
administration of drug in Obstetrics - oxytocins,
antihypertensives, diuretics, tocolytic agents, anti-
convulsants; • Analgesics and anesthesies in obstetrics, •
Effects of maternal medication foetus and neonate 133
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