Basic midwifery care and clinical skills
Safe technique, every time
This domain rewards precision. Expect questions on maternal and fetal observations, infection prevention, medicines management, aseptic technique, perineal and bladder care, infant feeding support, and neonatal assessment.
Observations and monitoring: record blood pressure with the correct cuff size, pulse, respiratory rate, temperature, urinalysis and, where indicated, MEOWS. Fetal wellbeing is assessed by intermittent auscultation (with a Pinard or doppler, counting for a full minute after a contraction) or continuous CTG when indicated; document the baseline, variability, accelerations and decelerations, and act on any non-reassuring feature.
Infection prevention: hand hygiene at the WHO five moments, correct use of personal protective equipment, and aseptic non-touch technique for catheterisation, venepuncture and wound care.
Medicines: midwives work within the NMC standards, using patient group directions, midwives' exemptions or prescriptions. Check identity, allergy status, indication, dose, route, time and documentation, and record the time given. Controlled drugs require a second checker and correct register entries.
Traps
- Reassurance from a single normal CTG or a single normal blood pressure.
- Interrupting a course of antibiotics because the woman feels better, or omitting a dose because the drug chart was elsewhere.
- Confusing liquor draining with urinary incontinence, or discharging a woman without checking bladder emptying after epidural or operative birth.
- Failing to document a drug's administration time or a declined dose.
Worked example
Before giving intramuscular vitamin K to a newborn: confirm identity against the wristbands, check maternal consent is documented, confirm the dose for birth weight, check no allergy, use an appropriately sized needle, give within the recommended time, document in the neonatal record, and observe the baby afterwards.
Rule of thumb
Right woman, right baby, right drug, right dose, right route, right time, right documentation - and if in doubt, stop and check.