In the journey of a birth attendant, Midwifery III is the stage where the stakes are highest. While earlier units focus on the beauty of normal physiological birth, Midwifery III pulls back the curtain on the “abnormal”—the complications, the emergencies, and the life-saving interventions. It is the unit that transforms a student into a vigilant practitioner capable of managing obstetric crises.
Below is the exam paper download link
Past Paper On Midwifery III For Revision
Above is the exam paper download link
Whether you are studying at a national polytechnic or a medical college in Kenya, the final exam for this unit is notoriously rigorous. To help you navigate the complexities of high-risk obstetrics, we have put together a deep-dive revision session in a question-and-answer format. Once you’ve sharpened your clinical judgment here, use the link at the bottom of the page to download the complete past paper for your revision.
Section 1: Abnormal Labor and Malpresentations
Question 1: What are the “Four Ps” that contribute to prolonged or obstructed labor? In midwifery, we look at the Powers (inefficient uterine contractions), the Passage (a contracted or abnormally shaped pelvis), the Passenger (a large baby or malpresentation), and the Psyche (the mother’s anxiety or exhaustion). In an exam, if you are asked to manage slow progress, you must systematically assess each “P” to decide whether to augment labor or prepare for a Cesarean section.
Question 2: How does a midwife manage a “Breech Presentation” during the second stage of labor? The golden rule here is “hands off the breech” until the umbilicus is born. Premature pulling can cause the baby’s head to extend, leading to entrapment. You must be prepared to perform maneuvers like the Løvset maneuver for extended arms or the Mauriceau-Smellie-Veit maneuver to deliver the after-coming head.
Question 3: What is the clinical significance of “Deep Transverse Arrest”? This occurs when the fetal head is arrested in the transverse diameter of the pelvic outlet. It is a common cause of obstructed labor. As a midwife, you must recognize that this usually requires an instrumental delivery (forceps or vacuum) or a surgical intervention, as the baby cannot rotate further on its own.
Section 2: Obstetric Emergencies
Question 4: What is the “Rule of Threes” in managing Cord Prolapse? When the umbilical cord falls below the presenting part, every second counts. The goal is to relieve pressure on the cord: 1. Call for help immediately. 2. Change position (put the mother in a knee-chest or Trendelenburg position). 3. C-section (prepare for the fastest possible delivery). Never attempt to push the cord back inside.
Question 5: How do we identify the early signs of Uterine Rupture during labor? Watch for a sudden, sharp abdominal pain that persists between contractions, the cessation of previously strong contractions, and a “recession” of the presenting part (the baby’s head moving back up the birth canal). You may also see a “Bandl’s Ring,” which is a visible retraction groove across the abdomen—a major red flag for impending rupture.
Section 3: Complications of the Third Stage and Neonatal Care
Question 6: Why is “Active Management of the Third Stage of Labour (AMTSL)” the standard of care? AMTSL is designed to prevent Postpartum Hemorrhage (PPH). It involves three steps: administration of a uterotonic (usually oxytocin), controlled cord traction (CCT), and uterine massage after the placenta is delivered. In your revision, ensure you can justify why this is superior to “expectant” management in reducing blood loss.
Question 7: How do we assess a “Flat” newborn using the Neonatal Resuscitation Algorithm? If a baby is born floppy or not breathing, you don’t wait for the 1-minute APGAR. You immediately follow the “TABC” of resuscitation: Thermoregulation (dry and warm), Airway (position and suction if needed), Breathing (provide positive pressure ventilation), and Circulation (chest compressions if the heart rate remains below 60).
Take Your Revision Further
Midwifery III is a subject where theory meets high-pressure reality. While these questions cover the “must-know” topics, the actual exam will test your ability to prioritize care under stress. Testing yourself with real past papers is the most effective way to build the mental stamina required for your final board or college exams.
For all midwifery students across the country, this resource is a vital stepping stone toward your professional certification.
Stay focused, keep your clinical instincts sharp, and remember that your skill is the difference between a crisis and a safe delivery. Good luck!
Last updated on: March 17, 2026