Decision Points

Question 1

Summary points: The Antenatal Visits should be multidimensional and include:

Accepted Answer

Health promotion and education, Information sharing, active decision making, Assessment and screening

Question 2

The fourth decision point in labour - The second stage

Accepted Answer

Collaboration & communication between any other care providers. Birth plan, Assessment of mum and baby, VE?, additional care? women's wellbeing?, Midwifery Support Provided. Plan, position, partner, Info and reassurance

Question 3

The fifth decision point in labour - The third stage

Accepted Answer

Assessment and observation of the baby., Assessment and observation of the woman. Outcomes ie timing, EBL, placenta, Facilitate birth of the placenta. Skin2skin, cord cut, birthplan

Question 4

Does the decision point correlate or reflect the number of consultations/visits?

Accepted Answer

False

Question 5

The first decision point in pregnancy - within the first 12 weeks of pregnancy. The booking visit.

Accepted Answer

Assessment and plan of care. Incl. order investigations., Information sharing. Incl. support, EDD, cultural, feelings, expectations, Health information and education. Incl. commence pregnancy and birth plan.

Question 6

Initial contact is generally by phone and the overall intention is to determine compatibility between woman and midwife:

Accepted Answer

Interpersonal - comfortable personal connection incl. at a cultural level, Professional - Establish context/scope of care ie: Caesarean vs Homebirth, Practical - Availability, time and place of care, back up etc

Question 7

Fourth decision point. 30 - 36 weeks. Discuss baby movement. What can you expect?

Accepted Answer

Key theme: Normal pattern of your baby, Hiccups, Feeling small movements from fingers and toes., Change of movements from kicks to rolls and pressure.

Question 8

The fourth decision point in pregnancy - 30-36 weeks

Accepted Answer

Assessment and Plan of Care., Health info and education. Fetal mvmnt, signs of labour, maternity facility, History - Womens wellbeing and baby's movements.

Question 9

How many decision points in pregnancy?

Accepted Answer

6

Question 10

What decision points postnatally does 522 focus on?

Accepted Answer

First point in the postnatal period - immediately pp (up to & incl. 24hrs)

Question 11

Which Acts, Regulations and relevant policies are the decision points based on? (15 in total)

Accepted Answer

HDC = Code of Health and Disability Services Consumers Rights Regulations, MOH = Guidelines for consultation with OB and Related Medical Services, MCNZ =Competencies for Entry to Register of Midwives & Scope of Practice., MCNZ = Statement of cultural competence & Code of Conduct.

Question 12

First point in postnatal period - immediately postpartum (up to and including the first 24 hours)

Accepted Answer

Reflect., Obs of baby. Discuss outcomes, ongoing plan of care with woman., Assessment and observation of the woman and her baby., Infor sharing. Feeding, self care (chest/bleeding/perineum) safe sleep

Question 13

Which Acts, Regulations and relevant policies are the decision points based on? (cont. 15 in total)

Accepted Answer

ICM = Essential Competencies for basic midwifery practice., ICM = Standards for Basic Midwifery Education, ICM = Global standards for Midwifery Education., ICM = Definition of a Midwife & Bill of Rights for Women and Midwives.

Question 14

All Midwifery actions are based on what?

Accepted Answer

On current and reliable knowledge and in accordance w/ Acts, Regs, policies

Question 15

Sixth Decision Point. 40 - 42 weeks.

Accepted Answer

Review EDD and OB referral, Review tests, Discuss additional assessments

Question 16

The third decision points in labour - when the woman wants continuous support from the midwife

Accepted Answer

Collaboration & communication between any other care providers. Birth plan, Midwifery Support Provided. Refer to plan, eat/drink/position, partner, Assessment and plan of care. VE? Additional care. Assessment of woman &baby

Question 17

The fifth decision point in pregnancy - 38-40 weeks

Accepted Answer

Health info & educ. Emotional/social aspects birth, skn2skn, postnatal plan, Assessment and Plan of Care., History - Womens wellbeing and baby's movements.

Question 18

Which Acts, Regulations and relevant policies are the decision points based on? (cont. 15 in total)

Accepted Answer

NZCOM = Code of Ethics, NZCOM = Consensus Statements, NZCOM = Standards for Practice, Turanga Kaupapa

Question 19

What are the decision points in pregnancy?

Accepted Answer

Provide a guide to MW to identify times where an assessment may be required

Question 20

Absolute vs Relative Risk in relation to Post Term / Prolonged Pregnancy

Accepted Answer

Consider risk vs chance as a concept. Whos risk is it to take?, Absolute: Actual risk of something happening to you, Relative: Risk of something happening to you in comparison to someone else

Question 21

Preconception: Why might a woman seek advice pre-conceptually?

Accepted Answer

About becoming pregnant, Address any health issues (personal, family, mental), As a source of information

Question 22

Complications, conditions and discomforts of late pregnancy and birth planning relate to decision points.....

Accepted Answer

4,5,6

Question 23

Fifth Decision Point. 38 - 40 weeks.

Accepted Answer

Touch on what may be expected if you go post dates., Confirm birth and postnatal plan, Discuss first feed / b/feeding, Potentially visit back up midwife

Question 24

How many decision points in labour?

Accepted Answer

5

Question 25

Birthplanning

Accepted Answer

B - Benefits. R - Risks. A - Alternatives. I - Intuition. N - Doing nothing, B.R.A.I.N

Question 26

Where can you find the information regarding Midwifery Decision Points?

Accepted Answer

Grigg, C. Working with women in pregnancy. Midwifery Prep for Practice, New Zealand College of Midwives, Midwives Handbook for Practice

Question 27

The sixth decision point in pregnancy - 41-42 weeks

Accepted Answer

Assessment and Plan of Care., Health info and education. Induction, Increased assessment discuss, History - Womens wellbeing and baby's movements.

Question 28

The second decision point in pregnancy - by 24 weeks

Accepted Answer

History - Womens wellbeing and baby's movements., Health information & education. Preg & parenting edu. options. Infantfeedin, Assessment and plan of care.

Question 29

The third decision point in pregnancy - 24 - 30 weeks

Accepted Answer

History - Womens wellbeing and baby's movements., Assessment and plan of care., Health information and education. Begin discussing childbirth/parenting

Question 30

Fourth decision point. 30 - 36 weeks. Assess fetal growth. What do you do?

Accepted Answer

Refer for scan if required, Check symphysiofundal height is increasing, Plot on customised chart, Symphysiofundal height (cm does not need to align with gestation)

Question 31

The first decision points in labour - when the woman begins her labour

Accepted Answer

Info sharing. Frequency? show? Membranes? Fetal mvmnt & HR, Support level?, Stay home whilst labour establishes, From history & records. Review, doc., labs, scans, plans, referral outcome

Question 32

The second decision points in labour - when the woman wants intermittent support from the midwife

Accepted Answer

Midwifery support provided. Encourage eat, drink, position. Involve partner, Info sharing and examinations. History, wellbeing, behaviours, VE?, Assess birth plan.

Question 33

What topics might a women discuss with a women pre-conceptually?

Accepted Answer

healthy lifestyles and the need to optimise health prior to conception, availability of midwifery and maternity services, issues from past pregnancy, labour, birth and postnatal experiences, blood tests/other investigations

Question 34

Define a Midwife's Scope of Practice.

Accepted Answer

Don't include pre conception

Decision Points

Questions 34

Decision Points

Questions 34