Core Curriculum: CiP 10

Manages pain and bleeding in the obstetric person

• Performs focused history, appropriate examination and orders appropriate investigations.
• Establishes fetal wellbeing.
• Formulates a differential diagnosis.
• Discusses diagnosis in a sensitive manner.
• Formulates an appropriate and individualised management plan taking into account patient preferences and the urgency required.

Manages concerns about fetal wellbeing prior to labour

• Appropriately assesses concerns regarding fetal movements.
• Can use appropriate investigations to confirm the loss or death of a baby.
• Discusses the diagnosis in a sensitive manner and recognises in cases where a baby has died the psychological impact on an individual and their family.
• Is able to sensitively discuss management options where the death of a baby has occurred.
• Can provide a supportive environment and signpost to relevant support services for an individual and her partner who have suffered the loss of a baby.

Manages suspected pre-term labour/ruptured membranes

• Performs focused history, appropriate examination and orders appropriate investigations.
• Establishes fetal wellbeing.
• Discusses findings in a sensitive manner.
• Formulates an appropriate and individualised management plan taking into account patient preferences and the urgency required.
• Aware of additional issues at extremes of viability including ethical concerns and additional therapies which may be of benefit.

Manages labour

• Demonstrates understanding of the physiology of labour.
• Is aware of situations where labour may be more complex such as multiple pregnancy.
• Uses history and clinical signs to anticipate possible problems.
• Can formulate safe management plans taking into account the woman’s preferences.
• Can succinctly explain management plans to women and birthing partners.

Manages intrapartum fetal surveillance

• Can use intrapartum fetal surveillance strategies to help assess risk.
• Can recognise abnormal fetal heart rate patterns, perform and interpret related tests.
• Communicates concerns effectively and sensitively with colleagues, women and birthing partners.

Manages induction and augmentation of labour

• Can formulate safe management plans for induction and augmentation taking into account the woman’s preferences.

Manages emergency birth and immediate postpartum problems

• Can recognise when birth may need to be expedited.
• Communicates concerns and recommendations effectively and sensitively with colleagues, women and birthing partners.
• Formulates an appropriate and individualised management plan taking into account patient preferences and the urgency required.
• Demonstrates the skills needed to facilitate safe operative birth.
• Demonstrates skills in managing problems arising immediately postpartum.

Manages maternal collapse and people who are acutely unwell in pregnancy

• Demonstrates prompt assessment of acutely deteriorating patient.
• Performs procedures necessary in emergency situations.
• Escalates to senior colleagues and other specialities.

Manages labour ward

• Demonstrates leadership skills within the multidisciplinary team, anticipating problems, prioritising and managing obstetric care.
• Recognises limitations and escalates care to senior colleagues and other specialities when appropriate.
• Ensures continuity of care, effective handover and appropriate discharge plan.
• Manages complex problems, including liaison with, and referral to, other specialties where appropriate. 
• Demonstrates the skills to sensitively explain unexpected events of labour and birth and anticipates where later debrief may be necessary.