initial physicals

[Sora Colvin]

The NARM CIB says "NARM’s definition of the Initial Prenatal Exam includes covering an intake interview, history (medical, gynecological, family) and a complete physical examination. These exams do not have to occur all on the first visit to the midwife, but the apprentice should perform at least 20 of these examinations on one or more early prenatal visits."

I'm wondering what a "complete physical examination" needs to include in order to count.

I've looked at the "basic physical exam" in Practical Skills Guide, the "general physical examination" in the NARM Candidate Information Bulletin skills assessment specifications (which does NOT include a pelvic exam), and the "Maternal Health assessment: Performs an initial history and physical examination, including..." on pages 68-70 of NARM form 201 -- and they are all slightly different in what they do and don't include.

[babiesforRuby]

I think the consensus is that you learn from your preceptor what she does. If you have a CPM, then they are considered the standard. Being ABLE to do each step is a necessary piece, so that IF one of them is useful or necessary, you will even recognize it. But that doesn't mean that you would necessarily do those routinely in your practice.

Hope that helps!! A CNM can be very helpful with teaching phys exam skills. I have found that having multiple preceptors is a wonderful addition to my training.