Definition of "Initial Physical" for prenatals??

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Definition of "Initial Physical" for prenatals??

Postby skhchamberlain » Wed Dec 08, 2010 4:09 pm

Hi folks/NARM folks,

I'm trying to nail down something: for "initial prenatal appointments", if one is working as a primary midwife under supervision, the NARM paperwork stipulates that an initial prenatal should include a basic physical exam. My trouble is that in one spot (and I may be flipping these in my mind, but you get the idea), perhaps the CIB, the list of what is part of a physical assesment includes a full pelvic exam, perhaps with PAP. In another place, the PSG for example, the physical is more streamlined, and includes all the basics plus a breast exam. Can anyone tell me how they have been doing these, or what NARM specifically expects us to use as the standard? My preceptor hardly ever does pelvic exams in early pregnancy, and it would be stepping way outside of what most of her clients expect for me to do such a comprehensive physical at an early appointment before we even know each other well.

Thanks!
Sonya
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Re: Definition of "Initial Physical" for prenatals??

Postby clearroadbirth » Sun Dec 26, 2010 10:21 pm

I know that the Student Page for National College of Midwifery specifically mentions performing a PAP as a skill to be attained under their Antenatal Assessment module. They do, however, differentiate between Initial Physical Assessment and Antepartum Assessment. This leads me to believe that the PAP and gynecological cultures fall outside of the initial skill set.
Does that make sense?
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Re: Definition of "Initial Physical" for prenatals??

Postby NARMinfo » Tue Jan 04, 2011 6:11 pm

Paps and cultures are separate skills that can be combined with the initial exam but are not required to be a part of it.
NARM - North American Registry of Midwives
An international certification agency for the credential "Certified Professional Midwife" (CPM).
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