39096 - Obstetric Counselling and Antenatal Care (RN)

Learning outcomes

At the end of the module the student has the ability to apply knowledge and understanding in relation to the management of physiological pregnancy, identifying and evaluating preventive and therapeutic protocols during pregnancy. They also know the regulations concerning the control of physiological pregnancy by the midwife as well as communication skills applied to the obstetric care process.

Course contents

- Basic counselling skills for effective communication of the midwife in the professional environment.
- Counselling and risk perception: understanding and knowledge in relation to the management of physiological pregnancy, identifying and adopting national and international guidelines and preventive, therapeutic protocols during pregnancy in order to promote counselling and prevention of maternal and foetal pathologies.

Women's health and well-being
- The midwife and the woman's health during maternity.
- Promoting the health of pregnant women
- Criteria for promoting the health of women and children during breastfeeding: promotion, initiation and support of mothers in continuing breastfeeding, techniques and good management practices in support of UNICEF's Baby Friendly initiative.
- Criteria for the promotion and dissemination of breastfeeding culture and proper nutrition for mother and child through effective communication.

Knowing how to be: relational tools
- Obstetric Health Report: (prenatal, beginning of pregnancy) and postnatal (after childbirth) and clinical competence of the obstetrics specialist
- Health education
- Empowerment
- Communication
- The maieutic relationship
- The therapeutic relationship
- The welcome
- Active listening
- The professional relationship
- Problem solving
- La midwifery care La Midwifery Care: international report and Italian situation.

The midwifery management process
- Midwifery or Midwifery discipline
- The midwifery management process
- Obstetric semeiotics in the investigation
- Data collection tools
- Anamnesis or sociomedical interview
- Traditional clinical approach
- The general physical examination
- Inspection or observation
- Palpation/exploration
- Percussion, Auscultation
- Obstetric diagnosis
- Identification of objectives
- Planning the care plan
- Implementation and evaluation of the care plan.

Pregnancy diagnosis
- Physical changes during pregnancy
- Diagnosis of pregnancy: signs of presumption, probability and certainty
- Obstetric anamnesis
- Parity
- Neagele's rule
- Inspection
- Palpation: Leopold maneuvers
- Listening
- Exploration
- Psychological and emotional changes in pregnancy.

Lifestyles in pregnancy
- Work in pregnancy and health
- Listeriosis
- Salmonellosis
- Toxoplasmosis
- Feeding during pregnancy
- Folic acid
- Iron
- Vitamin A
- Vitamin D
- Alcohol consumption
- Smoking : obstetric antitabagic counselling project "Smoke-Free Mothers".
- Cannabis consumption
- Drugs
- Physical activity
- Sexual activity
- Air travel
- Travelling by car: use of seat belts.

Disorders during pregnancy
- Nausea and vomiting
- Gastric heartburn
- Stipsi
- Hemorrhoids
- Varicose veins
- Vaginal discharge
- Back pain
- Pubic symphysis dysfunction
- Carpal tunnel syndrome

The process of obstetric care in physiological pregnancy:
- Definition of obstetric risk
- Professionals involved and continuity of care
- art. 59 "Outpatient specialist assistance for pregnant women and maternity protection" of the D.P.C.M. 12 January 2017.
- Anemia
- Haemoglobinopathies
- Surveillance and immunoprophylaxis of Rh(D) negative women
- The emotional well-being of the woman before and after childbirth: evaluation of the woman's emotional state through Whooley questions.

The reference regulation:
National Guideline Physiological Pregnancy-SNLG 2011
DGR 533/2008 (21 April 2008) - Emilia Romagna Region
State Regions Agreement 16 December 2010 "Guidelines for the promotion and improvement of the quality of safety and the appropriateness of care interventions in the birth path and for the reduction of Caesarean section".
DGR 1097/2011 - Emilia Romagna Region
DGR 1704/2012 - Emilia Romagna Region
DGR 1377/2013 - Emilia Romagna Region
Legislative Decree no. 15 of 28 January 2016 "Implementation of Directive 2013/55/EC of the European Parliament and of the Council, amending Directive 2005/36/EC on the recognition of professional qualifications and Regulation (EU) no. 1024/2012.
Guidelines for the definition and organisation of self-care by midwives for low risk obstetrics (BRO) pregnancies, 2017.
Circular 35/2017 Guidelines for the definition and organisation of self-care by midwives for low-risk obstetrics (BRO) pregnancies.

Readings/Bibliography

1. Guana M., et al., La disciplina ostetrica: teoria, pratica e organizzazione della professione, McGraw Hill, Milano 2011.
2. Rodriguez Daniele, Professione Ostetrica/o. Aspetti di medicina legale e responsabilità, 2010.
3. SNLG-ISS Linea guida sulla gravidanza fisiologica-2011
4. National Institute for Health and Care Excellence: Clinical guideline “Antenatal care for uncomplicated pregnancies” NICE 2008, aggiornamento 2017.
5. World Health Organization: WHO recommendations on antenatal care for a positive pregnancy experience. WHO, Geneva 2016.

Teaching methods

Frontal lessons
Analysis and discussion of clinical cases with group work
Watching  films.

Assessment methods

In itinere test
Multiple-choice questionnaire examination.

Teaching tools

power point presentation,
Watching educational films

Office hours

See the website of Marina Carfagna