Birth plan counselling in early labour — communication station

Simulated-patient communication station: negotiating an intervention-minimising birth plan in the latent phase. Tests the RANZCOG C-Obs 31 definitions delivered in plain language, honest quantified counselling on monitoring, augmentation and the third stage, shared decision-making, and documentation. Includes assessor timeline, marking domains, assessor key and fail criteria.

Prompt

A 29-year-old G1P0 at 39+2 weeks attends birth suite in the latent phase, 3 cm dilated, contracting irregularly, mother and baby well. She hands you a written birth plan requesting no vaginal examinations, no continuous monitoring, no oxytocin, and a physiological third stage with the cord left unclamped until the placenta is delivered. She is articulate, anxious about being 'pushed into things', and asks you to sign the plan. You are the registrar; a midwife is present.

Station brief

Format. Simulated-patient communication station, approximately 12 minutes, with a midwife in the room. The assessor will not interrupt; the simulated patient is briefed to push back if you are paternalistic and to soften if you are collaborative. ^[1]

Candidate instruction. Discuss the birth plan with her. Establish what matters to her, give her honest information about each request including where you agree and where you have concerns, and reach a documented shared plan. You are not required to sign anything. ^[1]

References7Show

[1]Oladapo OT, Tunçalp Ö, Bonet M, et al. WHO model of intrapartum care for a positive childbirth experience: transforming care of women and babies for improved health and wellbeing BJOG, 2018.PMID 29637727
[2]Bohren MA, Hofmeyr GJ, Sakala C, et al. Continuous support for women during childbirth Cochrane Database Syst Rev, 2017.PMID 28681500
[3]Alfirevic Z, Devane D, Gyte GM, et al. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour Cochrane Database Syst Rev, 2017.PMID 28157275
[4]Begley CM, Gyte GM, Devane D, et al. Active versus expectant management for women in the third stage of labour Cochrane Database Syst Rev, 2019.PMID 30754073
[5]McDonald SJ, Middleton P, Dowswell T, et al. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes Cochrane Database Syst Rev, 2013.PMID 23843134
[6]Lawrence A, Lewis L, Hofmeyr GJ, et al. Maternal positions and mobility during first stage labour Cochrane Database Syst Rev, 2013.PMID 24105444
[7]Gallos ID, Yunas I, Devall AJ, et al. Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis Cochrane Database Syst Rev, 2025.PMID 40237648

Birth plan counselling in early labour — communication station

Station brief

References7Show

[1]Oladapo OT, Tunçalp Ö, Bonet M, et al. WHO model of intrapartum care for a positive childbirth experience: transforming care of women and babies for improved health and wellbeing BJOG, 2018.PMID 29637727
[2]Bohren MA, Hofmeyr GJ, Sakala C, et al. Continuous support for women during childbirth Cochrane Database Syst Rev, 2017.PMID 28681500
[3]Alfirevic Z, Devane D, Gyte GM, et al. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour Cochrane Database Syst Rev, 2017.PMID 28157275
[4]Begley CM, Gyte GM, Devane D, et al. Active versus expectant management for women in the third stage of labour Cochrane Database Syst Rev, 2019.PMID 30754073
[5]McDonald SJ, Middleton P, Dowswell T, et al. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes Cochrane Database Syst Rev, 2013.PMID 23843134
[6]Lawrence A, Lewis L, Hofmeyr GJ, et al. Maternal positions and mobility during first stage labour Cochrane Database Syst Rev, 2013.PMID 24105444
[7]Gallos ID, Yunas I, Devall AJ, et al. Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis Cochrane Database Syst Rev, 2025.PMID 40237648