Labour and the postpartum period
Normal and abnormal labour, induction, fetal monitoring, perineal care, breastfeeding and postnatal mental health.
High-yield points
Stages of labour: first (to full dilatation), second (to birth of the baby), third (to delivery of the placenta); active management of the third stage uses oxytocin.
Bishop score assesses cervical favourability before induction.
CTG interpretation follows the RANZCOG intrapartum fetal surveillance guideline (baseline, variability, accelerations, decelerations).
Third and fourth degree perineal tears (involving the anal sphincter) need repair in theatre and follow-up.
Postnatal depression: screen with the Edinburgh Postnatal Depression Scale (EPDS); any positive answer to the self-harm item needs same-day assessment.
Postpartum psychosis usually starts in the first 2 weeks and is a psychiatric emergency.
Exclusive breastfeeding is recommended to around 6 months; most drugs are compatible, check before stopping breastfeeding.
Postpartum contraception: progestogen-only methods are safe while breastfeeding; avoid combined pill in the first 6 weeks.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| Place and model of birth | Hospital birth promoted; high caesarean rates in private hospitals. | Hospital, birth centre or (uncommonly) home birth; midwife-led continuity models are common. |
| Group B strep | Not routinely screened. | Screening at 35-37 weeks or a risk-based approach, depending on the hospital; intrapartum antibiotics if indicated. |
| Birth after caesarean | Repeat caesarean is often the default. | Planned VBAC is discussed and offered where suitable, as a shared decision. |
| Postnatal follow-up | Family support during confinement; ASHA home visits. | Maternal and child health nurse visits, GP check at 6 weeks, and depression screening with the EPDS. |
Place and model of birth
India (MBBS)
Hospital birth promoted; high caesarean rates in private hospitals.
Australia (AMC): what the exam expects
Hospital, birth centre or (uncommonly) home birth; midwife-led continuity models are common.
Group B strep
India (MBBS)
Not routinely screened.
Australia (AMC): what the exam expects
Screening at 35-37 weeks or a risk-based approach, depending on the hospital; intrapartum antibiotics if indicated.
Birth after caesarean
India (MBBS)
Repeat caesarean is often the default.
Australia (AMC): what the exam expects
Planned VBAC is discussed and offered where suitable, as a shared decision.
Postnatal follow-up
India (MBBS)
Family support during confinement; ASHA home visits.
Australia (AMC): what the exam expects
Maternal and child health nurse visits, GP check at 6 weeks, and depression screening with the EPDS.