2011 General Midwifery/New Starters Quiz (Sept 2011)

1 Describe the different stages of labour
Latent phase – the early part where the cervix softens and effaces and starts to dilate, contractions may be irregular
1st stage – where the cervix dilates from 4cm to fully open
Transition – the bit between the 1st and 2nd stages, may only be a few contractions, may be longer, woman may become irrational or contractions may have a break
2nd stage – the cervix is fully dilated and the baby is pushed out
3rd stage – from the birth of the baby until the placenta is out and bleeding is under control

2 Every midwife has their own Supervisor of Midwives. What is their role and how often must you meet with them?
To protect the public and to support the midwife. Have to meet at least once a year.

3 Name 5 people (job roles, not Mary, John, Mike, Sarah and Sally) who work on a labour ward.
Midwife
Obstetrician (SHO, registrar, consultant)
Anaesthetist
Paediatrian
Operating Department Assistant (ODA/ODP)
Scrub Nurse
Nursing/Midwifery Assistant (NA/MCA/HCA)

4 Who must midwives be registered with and how often do you need to pay for this priviledge?
The Nursing and Midwifery Council (NMC) and pay yearly

5 As a midwife you need to risk assess the women you are caring for and refer to the appropriate lead maternity care. Name 5 reasons a woman may need to go under consultant led care.
Previous LSCS
Multiple pregnancy
Pre-eclampsia
Prematurity
Cholestasis
IUGR
Diabetics
Blood disorders (including HIV)
Previous stillbirth
Placenta Previa plus any others you can think of

6 How many births/deliveries do you need to qualify as a midwife and what must these consist of?
40, must conduct the delivery of the baby (a spontaneous birth) and the placenta

7 Stacey has come in thinking she is in labour at 40 weeks gestation. She agrees to be examined internally to confirm this. When performing a vaginal examination what information are you trying to find?
Effacement of the cervix (how thin it is)
Position of the cervix
Dilation of the cervix
Presenting part of the fetus (head or bum)
Whether the membranes have gone
Position of the fetus (OA etc)
How far into the pelvis the fetus is (engagement)

8 Why is pregnant women’s urine tested at antenatal appointments?
Protein in the urine can be a sign of pre-eclampsia
Glucose can be a sign of diabetes
Leucocytes etc may indicate urine infection
Ketones can show a lack of nutrition

9 Sarah is 31 weeks pregnant with her 1st child, she comes into the maternity unit and tells you she hasn’t felt her baby move today. What do you do?
Basic obs, palpate. Listen in with a pinard/fetoscope to find the fetal heart (sonicaids and dopplers can pickup and double maternal pulse) CTG to check fetal wellbeing if there is a heartbeat, USS if you can’t

10 Name different places where a woman may chose to give birth.
Consultant unit, alongside midwifery unit, standalone birth centre or home

Bonus
How far after the birth does a woman remain under midwifery care
28 days (more or less dependent on midwife’s judgement)

Thanks to our question writer this month, Iolaus