1. Worth the labor pain: Toolkit for re-entry into maternity care Rita M. Girard, MD Adjunct Assistant Professor Dept. of Family & Community Medicine, University of Cincinnati The Christ Hospital/UC Family Medicine Residency Program 2123 Auburn Ave., Suite 340 Cincinnati, OH 45219 Office: 513-721-2221 GIRARDRM@ucmail.uc.edu

2. Disclosures none

3. Useful Resources to Get Started Provider Course Instructor Course Teach! Family Centered Maternity Care Conference

4. Curriculum RECOMMENDED CORE EDUCATIONAL GUIDELINES FOR FAMILY PRACTICE RESIDENTS Am Fam Physician. 1998 Jul 1;58(1):275-277 (amended) http://www.aafp.org/afp/1998/0701/p275.html

5. Curriculum Pre-pregnancy evaluation Initial pregnancy visit Risk assessment History, physical examination, laboratory monitoring, and counseling throughout pregnancy Noninvasive evaluation of fetal gestational age and fetoplacental adequacy, including limited obstetric ultrasound examination Labor and delivery triage (rupture of membranes, assessment of labor, hyperemesis, common discomforts of pregnancy) Management of labor

6. Curriculum (continued) Pudendal and local block anesthesia Fetal assessment, antepartum and intrapartum, including limited obstetric ultrasound examination Induction of labor Internal fetal monitoring Normal cephalic delivery including use of vacuum extraction / outlet forceps Episiotomy and repair, including third-degree lacerations Management of common intrapartum problems (e.g., hypertension, mild pre-eclampsia, fever, infection, nonreassuring fetal status, unanticipated shoulder dystocia, manual removal of placenta)

7. Curriculum (continued) Exploration of vagina, cervix, uterus Emergency breech delivery Neonatal resuscitation Management of common postpartum problems (e.g., hemorrhage, endometritis); routine postpartum care and patient education First-assist at cesarean delivery Vaginal delivery after previous cesarean delivery Care of the normal newborn Common neonatal problems Newborn Circumcision with anesthesia Breastfeeding support Management of IUFD

8. Two-Part Experience University of Cincinnati The Christ Hospital Family Practice Residency 9 month Longitudinal Experience Lakewood, Missouri Experience 6 week visiting Faculty Experience

9. Costs- TIME and $$ ExpenseApprox cost MO Bureau of Narcotics and Dangerous Drugs$31 Missouri License Application$300 Medical School Transcript Requestvaries NBME Score Request$65 Ohio License Verification Fee$50 Data Bank Request$8 Truman Credentialing$200 Change Practice location for DEAvaries Liability Insurancevaries Housing$2500 Travel$800 TotalAppr.$4000

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