Obstetric Call: Minimum Expectations

You should be available whenever a patient comes to the delivery floor.

On arrival of the patient at the delivery floor, you should be able to:

  1. Evaluate vital signs and condition (fever, BP, bleeding).
  2. Define labor, false labor, premature labor, and to distinguish which of these (if any) the patient has on the basis of your history and examination.
  3. Evaluate the patient's antepartum care by careful review of her chart and identify problems, complications and risk factors.
  4. Decide whether or not the patient should be admitted.

During first stage, you should be able to:

  1. Follow the patient with hand on abdomen and be able to tell her when a uterine contraction is developing.
  2. Define lie, presentation, position, and delineate by examination.
  3. Describe labor patterns: normal, subnormal, abnormal.
  4. Recognize the normal duration of first stage for multipara and primipara.
  5. Describe cervical dilation by examination and draw a labor curve (Friedman curve).
  6. Define and determine station, position and effacement.
  7. Recognize dangers of first stage, e.g., hypertension, failure to progress, bleeding, prolapsed cord and fetal distress).
  8. Assess fetal status by monitoring fetal heart rate.
  9. Evaluate need for and type of anesthesia

During second and third stages, you should be able to be present at deliveries and to:

  1. Evaluate the duration and normalcy of second and third stages.
  2. Assess fetal status by monitoring fetal heart rate.
  3. Evaluate need for and type of analgesia and anesthesia.
  4. Define bulging, crowning, NSVD, and elective vs indicated operative delivery (e.g. vacuum forceps).
  5. Evaluate the change in uterine contour and consistency from before delivery to after delivery.
  6. Evaluate maternal status during the first hour postpartum (e.g.vital signs, preclampsia, bleeding).
  7. Recognize dangers of second and third stages.
  8. Evaluate signs of placental separation.
  9. Describe steps of performing a delivery

Evaluate infantā€”Apgar, cord vessels, weight, congenital anomalies.

Evaluate the condition of mother and infant the following morning in terms of vital signs, bleeding, lab work, etc. and of the subjective feelings of the mother.