MAJOR DUTIES Serves as Nurse Midwife for an Army Medical Hospital, providing management and care of mothers and babies throughout the maternity cycle within the framework of a medically directed health service. Provides leadership in Obstetric/Gynecology nursing skills, knowledge, and judgments that foster the delivery of safe and quality care in the areas of antepartum, intrapartum, postpartum, neonatal, family planning, and gynecological care. 1. Provides independent preventive, therapeutic, and comprehensive obstetric and gynecologic care. Collaborates with Obstetricians and Gynecologists when caring for women with obstetric, gynecologic, and general medical complications in both the ambulatory and inpatient settings. Makes decisions regarding medical and nursing care of patients and directs care, co-manages, or refers as appropriate. Plans and coordinates care given with other professional providers and agencies involved in patient and family care. Performs accurate history and physical examination on obstetric, gynecologic, and neonatal patients, making critical evaluation of patient's status, establishing diagnoses, recording examination findings and evaluation, and planning and/or providing follow-up care. 2. Performs and/or requests laboratory, radiologic and other diagnostic and screening tests, interprets results, assesses specific problems/complications as appropriate, and provides follow-up as needed. Discriminates between normal and abnormal assessments; manages, co-manages, and/or refers appropriately; informs patient/family; and initiates appropriate nursing intervention/medical consultation. Manages labor to include initial evaluation/hospital admission, ongoing assessment of maternal and fetal status, labor progress, need for intervention/consultations, and patient/family education and support. 3. Provides inpatient obstetrical care including labor management and vaginal delivery. Starts intravenous infusions; selects and administers appropriate analgesia and anesthesia according to protocols; applies external and internal fetal monitoring equipment; performs local and pudendal anesthesia; performs cervical inspections; performs and repairs episiotomies; repairs lacerations associated with childbirth to include fourth degree perennial lacerations; records the labor and delivery, and signs and completes birth certificates. Evaluates and manages immediate obstetric complications. Initiates and conducts emergency life saving procedures until patient management can be transferred to the consulting physician. Acts as the first assistant to the obstetrician during emergency caesarean sections, obstetric and gynecologic surgery. Provides postpartum care using a family centered approach. Evaluates and manages the normal postpartum period to include determining hospital disposition, providing discharge counseling, completing necessary records, and conducting clinic follow-up. 4. Provides well woman care to include family planning, counseling and the prescription of contraceptives. Manages the care of the normal antepartum woman through routine assessment of maternal and fetal status, maternal and family counseling and support, and teaching prenatal classes to include orientation, labor preparation and breast-feeding. Provides immediate newborn care, initial physical assessment of the newborn upon delivery, evaluation, and resuscitation as needed. Manages care of normal newborn including nutrition, elimination and activity. 5. Monitors and preceptors midwife students who are participating in a medical training program at an Army Hospital/Medical Center. Serves in a teaching capacity in the development of other health care workers. Operates computer terminal to input statistical data to include number and type of patient encounters, additional duties, actual hours worked, etc. Performs other duties as assigned.