Activity ID
8707Expires
October 10, 2027Format Type
EnduringCME Credit
0.5Fee
75CME Provider: Louisiana Medical Mutual Insurance Company (LAMMICO)
Description of CME Course
The second stage of labor creates the greatest physiologic challenge to both mother and fetus. Oxygen delivery is reduced while oxygen consumption increases during this phase of labor. Certain interventions may help or hinder oxygenation. Using closed-glottis (Valsalva technique), coach-assisted active pushing in non-upright positions is no longer acceptable. Using this approach has a negative impact on maternal-fetal oxygenation and increases the chance of a serious reportable event. Use of open-glottis, patient-directed active pushing in upright or lateral positions is underutilized in clinical practice by all perinatal providers. This course is part I of our Second Stage Labor series that identifies factors that increase risk exposure and barriers that may make malpractice allegations more likely. Analysis of a case study shows how mismanagement of the second stage can lead to serious reportable events that place the providers, hospital, and health system at risk for malpractice claims.
ABMS Member Board Approvals by Type
ABMS Lifelong Learning CME Activity
Family Medicine
Commercial Support?
NoNOTE: If a Member Board has not deemed this activity for MOC approval as an accredited CME activity, this activity may count toward an ABMS Member Board’s general CME requirement. Please refer directly to your Member Board’s MOC Part II Lifelong Learning and Self-Assessment Program Requirements.
Educational Objectives
a. List 3 factors/barriers that increase risk exposure and make malpractice allegations more likely during the second stage of labor.
b. Analyze a case study and identify specific areas of second stage mismanagement that led to several serious reportable events that placed the providers, hospital, and health system at risk for malpractice claims.
Keywords
Laboring down, second stage of labor, closed glottis pushing
Competencies
Interpersonal & Communication Skills, Medical Knowledge, Patient Care & Procedural Skills, Practice-based Learning & Improvement, Professionalism, Systems-based Practice
CME Credit Type
AMA PRA Category 1 Credit
Practice Setting
Academic Medicine, Inpatient, Outpatient, Rural, Urban, VA/Military
