Tips on...Your obstetrics rotation
Meet the lead midwife
or nurse - They are in
charge of the labour
ward. Get some hands
on experience by asking
to shadow one of the
midwives.
PHOTOS.COM
Talk to midwives - They
are hugely knowledgeable about deliveries -
doctors sometimes lack
their breadth of experience. They can teach
you to fill in and read a partogram, to interpret
cardiotocograms, and to correctly deliver a baby and check the placenta.
Clerk patients - Talk to as many patients as possible - in antenatal clinics,
in postnatal clinics, and in triage. Speak to postnatal mothers, and ask
about their experiences - was childbirth as they had expected, and would
they have done anything differently?
Spend a day doing obstetrics triage - You'll see mothers with acute problems, such as abdominal pain, bleeding, and discharge. Some might be in
labour. Try to follow the mother to be into the labour ward (with her permission, of course) to observe or even to deliver the baby.
Visit the early pregnancy assessment unit - Also known as the pregnancy support unit, this nurse led service deals with first trimester problems, such as failing pregnancies. The unit provides early assessment of
patients who have had miscarriages. This is usually the only time you see
these problems.
Shadow the community midwifes - You will be able to see midwife led
antenatal clinics and postnatal home visits for normal pregnancies. Community midwifery provides a contrast to consultant led antenatal clinics,
where most time is spent observing the management of high risk groups.
Work a night shift on the labour ward - Doing night shifts often pays
dividends despite the unsociable hours. It will be easier for you to get
deliveries as the ward is usually less busy, with fewer student midwifes.
Always have an obstetrics book in hand - When the ward is quiet or a
patient has asked that you sit out of the consultation, use the free time to
look up things you didn't understand.
Hang around the ward - Get to know the staff, doctors and midwifes, by
name. They're more likely then to inform you if something interesting is
going on - for example, a forceps or ventouse delivery.
Find out the times of ward rounds - These help you to find out quickly
what is going on. Always ask if there's something you don't know.
Be alert - Try to see if any mothers are in labour. It is usually easier for you
to deliver the baby if you have been with the mother for the whole time.
Be in the room before they come up, introduce yourself, and ask for permission to stay to help out.
Shadow the senior house officers - You can often get a first hand account
of incoming patients with acute conditions. You may even get some
impromptu teaching when they're are not too busy.
Kar Hao Teoh, fourth year medical student, University of Edinburgh
Email: k.h.teoh@sms.ed.ac.uk
studentBMJ 2006;14:309-352 September ISSN 0966-6494
