Midwife - Nurse Midwifery MSH - Mount Sinai Hospital - Full Time Days

This role is responsible for:

Primary care and management of womens health, including obstetric and gynecological care. Both low risk and high-risk pregnancies are managed as outlined within practice guidelines.

Developing and supporting excellence in the clinical practice and patient care.

Maintaining the Maternal Child Health Services mission, philosophy, and policies as well as the standards and practices of the Mount Sinai Health System.

The midwife performs functions as an integrated member of the Department of OB/GYN and Nursing. The midwife will:

1. Coordinate prenatal care to the caseload of patients in the ambulatory care setting.

2. Take pertinent history.

3. Perform physical and pelvic examination.

4. Obtain laboratory and diagnostic tests.

5. Provide counseling and teaching as needed.

6. Identify risk factors and develop appropriate plan of management.

7. Manage the care of selected patients admitted to the inpatient unit-based on unit protocols and with the collaboration of the attending physician.

8. Obtain physician consultation for plan of management for any medical or obstetrical complications not addressed in departmental protocols.

9. Review prenatal chart with attending and/or clinical director of midwifery at first visit and at approximately 28 weeks.

10. Have the ability to schedule appointments for own gynecological patients.

11. Performs functions as identified in the Midwife Scope of Practice.

Provide Intrapartum Care as follows:

1. Evaluate the status of labor and admits patient to the labor floor.

2. Perform admission physical examination.

3. Perform venipuncture and starts intravenous infusions if nursing staff is unavailable.

4. Obtain laboratory and diagnostic tests and evaluates results.

5. Evaluate the progress of labor by vaginal examination.

6. Make decisions regarding ambulation of the patient during labor.

7. Request conduction anesthesia.

8. Perform amniotomy as indicated.

9. Apply external fetal monitor & tocodynamometer.

10. Apply internal fetal scalp electrode and pressure catheter.

11. Evaluate fetal monitor tracing & consults with physician if abnormalities are present.

12. Make decisions regarding the position(s) of the patient during second stage of labor.

13. Make decisions regarding performance of delivery in the birthing room or transfer to the delivery room.

14. Utilize local infiltration or pudendal block.

15. Perform and repairs episiotomies.

16. Conduct spontaneous deliveries of cephalic presentations.

17. Obtain specimen of cord blood for cord gases when appropriate.

18. Manage the third stage of labor.

19. Perform cervical and vaginal inspection.

20. Repair first- and second-degree vaginal, perineal, and labial lacerations.

21. Take responsibility for the management of the uncomplicated patient in recovery room.

22. Decide when the normal infant should be transferred to the nursery.

23. Request attendance of pediatrician at delivery when neonatal problems are anticipated.

24. Order intermittent fetal monitoring based on patients risk status.

25. Perform immediate appraisal of the newborn.

26. Perform newborn physical examination.

27. Sign birth certificate of delivery (operative delivery requires physician signature).

28. Coordinate patient care in triage room on L&D.

29. Attend and participate in L&D board rounds.

Participate in the care of women during labor & delivery in consultation with attending physician:

1. Perform prostaglandin and misoprostol (Cytotec) insertions for cervical ripening or insert a Foley catheter bulb for induction of labor.

2. Manage OCT after evaluation of the patient by the physician.

3. Insert intrauterine pressure catheters and internal scalp electrodes.

4. Perform & monitor amnioinfusion.

5. Initiate and monitor oxytocin infusion for induction or stimulation of labor in collaboration with the attending physician.

6. Conduct spontaneous deliveries of these patients.

7. Manage the labor & conduct the deliveries of women who have been approved by the physician for vaginal birth after cesarean section (VBAC).

8. Repair cervical or extended vaginal lacerations in collaboration with the attending.

9. Repair third- and fourth-degree extensions under the direct supervision of the attending.

10. Participate as first assist on C-Sections and/or BTL.

11. Order appropriate drugs to treat hemorrhage during third stage of labor per department policy for Post-Partum Hemorrhage.

12. Manually remove placenta.

13. Perform exploration of uterus.

14. Perform selected patient high risk delivery in collaborat