Family-Centered Perinatal Care

Family-Centered Perinatal Care Curriculum for all Family Medicine Residents

Our program includes a solid clinical experience in perinatal care for all residents that is designed to provide a foundation for the care of the pregnant patient and family during their voyage in entering parenthood. This includes readings on perinatal topics, specific rotation schedules, and collaborative arrangements for faculty trainees to participate in an adequate number of labor and delivery sessions. The curriculum for perinatal care re-training is modeled on the curriculum components mapped out by the Society of Teachers of Family Medicine Working Group on Family-Centered Perinatal Care. Pre-conception care curricular components include evaluation and advice regarding the patient’s health and habits as they relate to a healthy pregnancy, e.g., weight; nutrition; exposures; family stressors; psychosocial issues; lifestyle issues, including prevention of drug abuse and counseling in smoking cessation; genetic risks assessment; review of medical conditions; and immunizations. Prenatal care curriculum components include counseling to reinforce healthy behaviors, childbirth and postpartum preparation, prenatal routine and elective screening tests, risk assessment, referrals for high-risk patients, and fetal assessment. The midwife provides initial counseling, and the resident, the faculty member, and the midwife are available for subsequent counseling. Normal labor and delivery components include fetal heart rate monitoring, contraction monitoring and augmentation, infant position during delivery, infant assessment, placental delivery, and intrapartum analgesia and pain management. The curriculum incorporates education in the management of acute complications in pregnancy, including abruption of the placenta and bleeding in pregnancy, spontaneous rupture of membranes and assessment of reduced fetal movements, and labor ward triage. The residents also provide postnatal care and follow-up for the mother and baby in the clinic and through home visits provide continuity of care (prenatal, intrapartum and postnatal care) for Family Medicine patients. The OB faculty and residents use the tool “MOMCARE,” provided by the American Academy of Family Physicians (AAFP), to document patient care. This package is a system of practice guidelines, documentation forms, and patient and physician education materials developed and pre-tested by AAFP members. The initial package includes prenatal documentation forms; visit flow sheets, a prenatal program guide, and a resource list of patient education materials. Additionally, educational programs are provided to community-based agencies, such as “Healthy Start” and “Healthy Families,” to help coordinate care for members of our community.