Site Evaluator: Carlos Melendez, PA-C

As Professor Melendez is employed at Woodhull Medical Center, he was both the preceptor and site evaluator for this rotation. Being that he was on-site, we were able to have our site evaluation in person. My patient presentation involved a woman presenting to L&D triage for feeling decreased fetal movement. His comments on my focused history and physical were taken constructively and we spoke about the occurrence and management of decreased fetal movement. Because this meeting was later in my rotation, I also presented a systematic review and meta-analysis that looked at perinatal mortality when mothers were instructed to practice fetal movement counting. This practice often called kick counting, is a way a mother can help monitor the movements of her unborn baby by counting the number of kicks in a certain time period. While there are weak associations with some secondary outcomes such as preterm delivery, induction of labor, and cesarean delivery, there were no statistically significant improvements in pregnancy outcomes. As we were discussing labor and delivery, we took some extra time to understand the management of expectant mothers and the different roles that midwives, nurses, PAs, and physicians play in labor and delivery.