bluuebunny/crossref_metadata_2025 huggingface dataset:
Making midwifery-led care inclusive care
Authors: Magill-Cuerden Julia
Published: May 2014

The midwifery-led care concept is not new, but now permeates the vocabulary of midwives and stakeholders. Many organisations are seeking to change structures that embrace ideas behind this concept. Using the term ‘midwifery led’ implies care that contrasts with ‘consultant (obstetric) led’. Is this really appropriate for a midwifery profession in promoting the full role of the midwife?
Mental Capacity Bill 2005: the principles
Authors: Dimond Bridgit
Published: May 2014

This legislation, which has endured a gestation of over 10 years, will shortly be on the statute book and will be implemented at a date yet to be determined. It fills a gap which has temporarily been bridged by the common law (judge made law, case law) and provides a statutory basis to decision making on behalf of the mentally incapacitated adult. This article explains the basic provisions; an article on page 233 of this journal looks at its specific implications for midwifery care.
Being inspired by childbirth activists
Authors: Walsh Denis
Published: May 2014

Birth: Issues in Perinatal Care, the international, multi-disciplinary childbirth research journal, has taken editorial risks over the decades. In the era of evidence-based medicine, it was one of the first research journals to publish qualitative studies and a couple of years ago received some criticism for an inspirational personal account of loss penned by Robbie Davis-Floyd (2003). You could read no better example of writing to move the soul in ways that often dry research papers cannot. In December, I discovered another important paper – the first I've come across on a global perspective of country-based consumer childbirth movements (Goer, 2004).
Midwifery in Scotland 1 – the legislative background
Authors: Reid Lindsay
Published: May 2014

This article is the first in a series of four examining midwifery in Scotland from 1916 to 1983 when the Central Midwives Board for Scotland (CMB(S)) oversaw midwives' education and practice.

It gives an overview of important midwifery legislation in Scotland from the 1915 Midwives (Scotland) Act to the implementation, in 1983, of the 1979 Nurses, Midwives and Health Visitors Act.

Legislatory provision, while giving midwives a legal identity, also affected their autonomy (Fleming, 1998). During the period under examination, midwives' ability to be autonomous practitioners fluctuated within the frameworks which regulated their education and practice.
RCM conference preview – midwifery reborn
Authors: Smith Nancy
Published: May 2014

Over 800 midwives are expected to attend this year's Royal College of Midwives (RCM) conference. The annual conference, to be held in Harrogate in May, draws a broad range of speakers from across the midwifery field and provides a platform for debate and a forum for improving knowledge about midwifery practice.
Caesarean section and gut microflora
Authors: Jones Kathleen
Published: May 2014

The increasing trend towards caesarean section by maternal request has attracted much criticism and debate. This article examines the link between this mode of delivery compared to vaginal birth and the effects this choice has on the infant. The presence of microflora in the gut helps protect infants against potentially harmful pathogens. The use of prebiotics in formula feed is discussed along with the importance of educating parents about safety in formula feeding. Midwives and other health care professionals should support women whatever their chosen method of infant feeding.
Will IWL guide improve working lives?
Authors: Smith Nancy
Published: May 2014

Babies are not born between the hours of 9am and 5pm, so it goes without saying that maternity services have to operate around the clock, all year round. This means managers have to offer midwives a large degree of flexibility in order for them to do their jobs properly and balance the demands of work and home.
Midwifery in Scotland 2: developing antenatal care
Authors: Reid Lindsay
Published: May 2014

This article, the second in a series examining midwifery in Scotland from 1916-1983 explores: the development of antenatal care; the involvement of midwives in antenatal care; provision and uptake of antenatal care; and later changes and why they occurred. It employs the use of oral history testimonies where appropriate.
What midwives can learn from the slow food movement
Authors: Walsh Denis
Published: May 2014

While writing a chapter for a new book about concepts of time and childbirth, I came across a paper on the Slow Food Movement (Parkins, 2004). The movement started in Italy in the 1980s and was conceived as an antidote to ‘fast food’. It challenged the spread of fast food on a number of levels.
Working outside the box - an unlikely partnership
Authors: Sidgwick Chris
Published: May 2014

I have worked in the NHS since 1962 and after a 42 year career in nursing and midwifery, I recently left my midwifery manager's office for the last time. In my mind I dreamed of a slower pace of life but this has not materialized. I have been, almost by accident, gradually drawn into a different way of working – from home. But my resolve to improve the health of of women and babies is unchanged.
A group analytical perspective on midwifery education
Authors: Bloom Jane
Published: May 2014

This is an account of an education experience where the traditional boundaries of separation between the external social versus the internal psychological, are called into question. The students and myself, the author, became both the audience and the players when over a 6-month education period we connected with, shared, articulated and rehearsed certain psychological and social aspects of our clinical work. Using a group analytic perspective, emerging themes of separation, hope, despair, searching, loss and survival are explored in this article as they were articulated and worked on in a group.
Infant feeding and HIV in the UK: achieving woman-centred care
Authors: Sutherland Judith , Roth Carolyn
Published: May 2014

Guidelines for the management of infant feeding when a mother is HIV positive were reissued by the Department of Health last year, which reiterate advice about the avoidance of breastfeeding to protect against mother-to-child transmission of HIV. This article considers the implications of this policy for midwives in the UK and the HIV positive women in their care.
Making complaints: a guide to patient representation bodies
Authors: Dimond Bridgit
Published: May 2014

On page 513 of this journal we consider the new NHS complaints procedure. This is supported by a philosophy set out in Chapter 10 of the NHS Plan (DH, 2000) which envisaged giving patients more say in their own treatment and more influence over the way the NHS works.
Webwatch
Authors: Hassall Jenny
Published: May 2014

This month's Webwatch aims to encourage midwives to continue to explore ways to facilitate a positive birth experience for women. The sites reviewed have a common philosophy, which is one of respecting the woman's body and holding a firm belief in her ability to give birth naturally. The sites draw on midwifery expertise across the world.
How do clinicians assess and respond to raised blood pressure in pregnancy?
Authors: Bateman-Webb Trixie
Published: May 2014

The aim of this research was to determine how clinicians differentiate between a transient raise in blood pressure during pregnancy and that which is potentially pathological. The research sought to gain an understanding of the way clinicians evaluate their clients in the clinic setting. It is easy to diagnose pre-eclampsia when it is severe, but this research examined influences and responses to borderline cases in order to learn more about how clinicians manage such situations, thus impacting future practice and facilitating early diagnosis.
Birth centres: What price maternal choice and professional autonomy?
Authors: Bainbridge Jane
Published: May 2014

Jane Bainbridge, freelance writer and mother gives a consumer's view on the issues facing maternity services. This month she examines the continuing closure of birth centres.
CEMACH report on pregnancy risk in women with diabetes
Authors: Modder Jo
Published: May 2014

The Confidential Enquiry into Maternal and Child Health is the largest ever study of women with diabetes in pregnancy. The study identifies the risks and makes recommendations to reduce them.
Informed choice: The challenges for midwives in New Zealand
Authors: Stewart Sarah
Published: May 2014

An important part of midwifery practice in New Zealand (NZ) is facilitation of informed choice. However, the concept of informed choice presents challenges for midwives, not least in achieving a balance between supporting the woman, circumventing litigation and promoting normal birth.
Bullying in the workplace: What it is and how to deal with it
Authors: Keeling June , Quigley Jane , Roberts Tim
Published: May 2014

Bullying in the workplace is a common phenomenon which not only impacts on a midwife's quality of life but also her professional remit. Research has demonstrated that it is often the supervisor of midwives or line manager who is the bully. The midwife may find the situation untenable resulting in leaving the profession or changing jobs.

This article highlights bullying behaviours and describes the detrimental effect that this deviant behaviour has on victims. The organizational and professional responsibilities are addressed and details are given about where a victim can access help and support.
The ontology of childbirth
Authors: Walsh Denis
Published: May 2014

Recently I was reflecting on the experience of working as a bank midwife on a busy consultant unit. Much of the time I feel like I am an obstetric nurse, occasionally punctuated by a wonderful physiological birth when I feel like a midwife again. I trained to ‘be’ a midwife but much of the ‘doing’ of midwifery appears tangential to this initial call. The differences between being a midwife and doing stuff that a midwife does on modern delivery suites is crucial. Many influential writers like Nicky Leap, Kathleen Fahy and Holly Powell Kennedy have highlighted the difference. One emanates from a state of being and the great philosophical line of enquiry known as ontology. The question of ontology or ‘what does it mean to exist’ or ‘to be’ has been equally as important in the history of philosophical thought as the other great question of epistemology, ‘what is knowledge’ or ‘how do we know’. Knowledge is the basis of ‘the doing’ that guides practice. We are more familiar with knowledge for practice or epistemological concerns as the debates around evidence illustrate. For example, much of the ‘doing’ on busy delivery suites is based on one kind of epistemology – biomedical knowledge (observations and measurement of labour progress and biomedical parameters).
Baby boom in Kashmir: one year on from the earthquake
Authors: Bainbridge Jane
Published: May 2014

Medical services are still being restored so temporary health clinics have been set up. More women are using the maternity services now than prior to the disaster but maternal mortality remains high.
Homeopathy as a choice: the new holistic antenatal clinic
Authors: Baxter Jacqueline , Perrin Chris
Published: May 2014

Increasing numbers of pregnant women are turning to homeopathy and other complementary therapies to help with pregnancy and childbirth. In response to this, a programme was put together to provide safe education and treatment by a multidisciplinary team of professionals. Working collaboratively, a multidisciplinary group of midwives and staff from two departments within a large NHS Trust have set up this innovative new service.

This paper describes a pilot scheme to introduce homeopathy and other complementary therapies into mainstream care provision. Pregnant women can attend the new clinic for their routine follow up antenatal checks and at the same time experience a parent education session initially including homeopathy, stress management and relaxation, and also nutrition for mother and baby.
Developing and running an OSCE: a personal reflection
Authors: Zaidi Fawzia
Published: May 2014

This article is a personal reflection of an educational event that occurred last summer and as such is not informed by any feedback from other lecturers, students or clinicians. The event is outlined and evaluated. Critical reflective analysis is illuminated through the application of relevant literature.
Limitations of technology screening
Authors: Symon Andrew
Published: May 2014

This article will examine some of the circumstances surrounding legal debates about technological screening. Technological advances in recent years have opened up great possibilities, both in terms of detection and treatment of conditions. For some there may be an assumption that technology will identify a problem, which people can then resolve. However, it is important to remember that technology cannot be relied upon 100% of the time.
A new dawn for antenatal education: taking a fresh approach
Authors: Walsh Denis
Published: May 2014

Last month I had the privilege to read Mary Nolan's excellent new edited text Birth and Parenting Skills. For anyone who feels a little burnt out with teaching antenatal classes and is struggling to elicit freshness in approach, this is the book for you. Not only does it inspire a ‘make-over’ of one's classes, for the first time the book details programmes that seem to make a difference to women's experience of labour and birth, reducing interventions like epidurals and recumbent birth.
Diabetes: Monitoring maternal and fetal well-being
Authors: Blincoe Alana Juman
Published: May 2014

Pregnancies complicated by diabetes mellitus, either previously diagnosed, (pregestational) or appearing during pregnancy (gestational), present an increased maternofetal risk, so regular monitoring both of the mother and the fetus is necessary. Various studies agree optimal glucose control can reduce risks to mother and baby. Therefore diabetic care in pregnancy should ideally start at pre conception and involve a multidisciplinary approach to ensure positive outcomes. However, scientific knowledge needs to be improved in order to offer more specialised care to those patients.
Are midwives required to echo the rhetoric of equality and choice?
Authors: Thomas Tessa
Published: May 2014

The closure of a dedicated home birth team in favour of integration with a wider service claiming to offer more choice to women has not achieved its aim according to Tessa Thomas.
Tuberculosis in pregnancy: The role for midwives in diagnosis and treatment
Authors: Bothamley Judy
Published: May 2014

Tuberculosis (TB), although still uncommon in the UK, has become more prevalent over the last ten years in major cities like London. The epidemiology has changed with younger women now being more likely to be infected by TB than before. Midwives are now more likely to meet and be involved in the diagnosis and treatment of pregnant women with TB. Anti-tuberculosis drugs are effective and safe to use in pregnancy but need to be taken for at least six months. One of the main challenges is to provide support and motivation for women to take this medication regularly. After two weeks of treatment women with active pulmonary TB are no longer infectious. Separation from their newborn baby is usually not necessary. Recent changes to the BCG vaccination programme means that midwives have become involved with advising parents about TB and giving vaccinations to newborns at risk.
Antenatal screening: Choices for ethnic minority women
Authors: Permalloo Nadia
Published: May 2014

This article looks at the complex antenatal screening needs of women from ethnic minority groups which include higher rates of perinatal mortality and congenital malformations. Assumptions are often made about the choices ethnic minority women may make based on stereotypical myths which can be reflected in low uptake rates of screening. Midwives have a key role to play in ensuring the information needs of women from ethnic minority groups are met in order to enable informed decision making regarding screening and its sequelae.
Surrogacy: The legal position and the midwife's duty of care
Authors: Jones Shirley
Published: May 2014

The law is very clear as to who is the legal ‘mother’ in any case of surrogacy:
Unsolicited advice: A rite of passage through your first pregnancy
Authors: Bainbridge Jane
Published: May 2014

When it comes to handing out advice and anecdotes, welcome or not, everyone seems to have some wisdom to impart or a story to tell. Jane Bainbridge examines the phenomenon of the pregnant woman and her bump as public property and discovers that it's not all bad news.
Should fathers be in the labour room? Yes, for support not intervention
Authors: Longworth Heather
Published: May 2014

It is now common practice, in the United Kingdom, that the father is present at the birth of his child. In fact this is only a relatively recent phenomenon, which has happened over the last thirty years; the father's presence is now so normal as to be expected (Blackshaw, 2003), which must put pressure on those men who would otherwise choose not to attend (Chan and Paterson-Brown, 2002). However, the fathers’ role in the labour room has never really been defined, and while some men find it enlightening and exciting it has been mooted that others may find it distressing and distasteful.
Global partnership for maternal, newborn and child health services
Authors: Bainbridge Jane
Published: May 2014

Jane Bainbridge takes a look at the news on midwifery, reproductive and child health worldwide and offers an overview of initiatives to address current issues across the globe.
Nurturing and supporting mothers: A hidden skill in midwifery
Authors: Magill-Cuerden Julia
Published: May 2014

The concept of motherhood became very important in the middle of the last century. Women's social role was to function as child rearers in producing healthy children for society and to support domesticity in the family. Motherhood was a political ideology with a concern for mothers, as part of a state social consciousness. This was linked to the evolution of the welfare state with benefits for pregnant and childbearing women, such as free antenatal, medical and dental care, dietary supplements and financial benefits. Practical manuals were written advising women how to care for their baby and giving advice on hygiene, sanitary baby care, layette, baby feeding and management.
The National Childbirth Trust: 50 years of supporting natural birth
Authors: Bainbridge Jane
Published: May 2014

Jane Bainbridge discusses the birth of the NCT, its development over the past 50 years and the enormous contribution it has made in promoting natural birth, and offering new mothers support, information and unique and informal access to a community of mothers.
Current service provision for women in the UK who have undergone FGM
Authors: Lavendar Tina , Baker Lisa , Richens Yana , Garrett Elizabeth
Published: May 2014

Female genital mutilation (FGM) is increasingly found in the UK among migrant women and girls. This paper reports on a national survey which assessed current service provision for women who have undergone FGM. The authors conclude that, despite acknowledgment of the health consequences of FGM from professionals, disparate services continue, with seemingly little co-ordination at local or national levels.
All women in labour should have the choice of waterbirth
Authors: Benjoya Miller Jill , Magill-Cuerden Julia
Published: May 2014

If we truly wish to make birth healthier and more satisfying for mothers and babies, to enhance job satisfaction for midwives and if we are honestly committed to restoring normality in birth, then every woman without major complications should be offered the opportunity to labour and give birth in water.
To go to work or stay at home? The mother of all parenting debates
Authors: Daniel Lincia
Published: May 2014

Lincia Daniel examines the debate about roles and responsibilities in motherhood, currently being played out on the pages of various best sellers, and concludes that most mothers simply do do their best.
Midwives are ideally placed to advise parents on optimum infant nutrition
Authors: Blincoe Alana Juman
Published: May 2014

Ensuring that infant nutrition is at its very best relies on a range of factors, not just food. There are many external aspects that play a key role in determining optimum nutritional balance, for instance whether a child is breastfed or not, or whether it ends up being diagnosed with anaemia at the age of 15 months. Factors that have such impact are based on the mother and/or parental attitudes, which in turn are shaped by anything from socioeconomics, education and ethnicity, i.e. cultural influences, to religion and age. Just as breast milk as highlighted as the most important nutrition for babies for the first 6 months, so too is it important that complementary feeding covers all the bases of nutrients for infants between 6 and 24 months. This period is critical to a child's growth, as there is little chance later on to change any retardation that may occur during this period if the child is malnourished.
A comprehensive reference for the breastfeeding enthusiast
Authors: Shepherd Jancis
Published: May 2014

It is a privilege to be asked to review a book by such an eminent author as Marsha Walker. This is a comprehensive breastfeeding tome that will appeal to health professionals and lay supporters who are passionate about breastfeeding. It is a fabulous reference book to dip into to seek answers to specific breastfeeding challenges.
Vaginal Birth After Caesarean: does more time influence the decision?
Authors: Warriner Sian , Haines Anne
Published: May 2014

Does providing women who have had a previous caesarean section with additional time for discussion and information-giving influence their decision regarding mode of birth in a subsequent pregnancy? This article looks at the background to the introduction of a Vaginal Birth After Caesarean (VBAC) clinic in a District General Hospital and the impact it had on VBAC rates.
Hypertension in pregnancy: the importance of monitoring
Authors: Blincoe Alana Juman
Published: May 2014

The prevalence of gestational hypertension is quite common, however, some forms of this condition can range from a mild occurrence of high blood pressure to posing life-threatening complications for both the mother and the fetus. There are three types of hypertension—chronic, pre-eclampsia and transient. There are a number of indicators that have been identified as predisposing some women to developing either of the above forms of hypertension. The main contributors are age, obesity, diabetes, underlying hypertension and kidney disorders. The only known ‘cure’ for any hypertensive problem is delivery of the baby, but a number of ways to control this condition have been developed. The most established and reliable way to ensure a favourable outcome is to closely monitor the woman and provide a well-formulated management plan.
Amniotomy in spontaneous, uncomplicated labour at term
Authors: Andres Marjorie , Rankin Jean
Published: May 2014

With the emphasis on minimal or non-intervention in midwifery-led care many midwives are now reviewing their practice towards interventions such as amniotomy. Statistics are presented for over 11000 women admitted to a midwifery-led unit (MLU) alongside a consultant-led unit resulting in a delivery rate of 89% for normal births, 6% for forcep/vacuum extractions and 5% for emergency LUSCs. The trend in the use of amniotomy and the changing beliefs of midwives has led to the amniotomy rate reducing from 34% to 14% without affecting the normal delivery rate in the MLU. Birth statistics are presented for 4676 women admitted to the MLU subdivided by parity and related to amniotomy. Fifty per cent of primiparous women delivered in the MLU with an amniotomy rate of 13% resulting in a normal delivery rate of 72% for all primiparous admitted. ninety-one per cent of multiparous women delivered in the MLU with an amniotomy rate of 12% resulting in a normal delivery rate of 97% for all parous women admitted.
Supervisors of midwives: the leadership role
Authors: Warwick Catherine
Published: May 2014

Astrid Osbourne's article ‘Supervision: the changing world of midwifery’ (2007) gave me food for thought. In the article Astrid traces the history of Supervision of Midwives and notes its evolution from a role seen as ‘semi-managerial, punitive and authoritative’ to a situation where: ‘for many supervisors their work places them firmly at the forefront as the providers of support and wisdom to a developing workforce’. Through two case studies Astrid clearly demonstrates the value of the supervisor playing exactly such a supportive role.
Doppler sonography: improving outcome in high risk pregnancy
Authors: Blincoe Alana Juman
Published: May 2014

Doppler sonography has become a principal diagnostic tool in antenatal care, and as a consequence the perinatal outcome of high risk pregnancies has significantly improved. As an ultrasound scan is able to show the severity of any fetal malformations in a high risk pregnancy, health care professionals are able to be alerted relatively quickly that a condition may need treatment and/or alter the management of a pregnancy. The timing of scans can also be of great consequence. Ultrasounds are able to pick up defects in very early periods of gestation and when acted upon can ensure that the mother is in a position to have a number of options open to her.
Childbirth according to Hollywood
Authors: Walsh Denis
Published: May 2014

A couple of weeks ago, I went to the cinema to see ‘Knocked Up’. I went with some trepidation, not anticipating how pregnancy and birth might be portrayed but concerned that this so-called fresh comedy from a new writer, Jud Apatow, would trot out the usual misogynist ‘take’ on boys becoming men with accompanying toilet humour in excess. There was plenty of that with some taboos broken like sexual positions for pregnancy, previously not the butt of jokes in the movies. Beyond the implausible story of an attractive young career woman (Alison) having a ‘one-night stand’ with an unemployed, unattractive, unappealing young lad and getting pregnant, the portrayal of their encounter with the maternity services was full of all the stereotypes midwives would hope had been consigned to the cutting room floor.
Counselling skills within midwifery practice
Authors: Gould Georgina
Published: May 2014

I am currently a third year midwifery student and it was not until recently that I experienced the grief and torment women and their families go through during the horrific time of mourning a baby. My midwifery training has not been the easiest time of my life to say the least but it was only until the latter half of my third year that I really understood what a bad experience was in midwifery. The following account had an enormous impact on me as a student midwife and as a person.
Current issues in midwifery
Authors: Clift-Matthews Victoria
Published: May 2014

The British Journal of Midwifery fifth national conference on current issues in midwifery took place last month at Birmingham Children's hospital. Organized by our joint Editor-in-Chiefs, Professor Tina lavender and Yana Richens and aimed at clinical midwives, student midwives, professors of midwifery, consultant midwives and supervisors, to name just a few, it proved to be a very successful two days. The delegates were treated to an enlightening programme covering good practices around normal birth, pregnancy and public health, and the factors that create a good environment for midwives, students and women. It aimed to alert delegates to the current national midwifery issues and give them an appreciation of the research underpinning midwifery practice.
Epilepsy in pregnancy
Authors: Clarke Sonji D
Published: May 2014

Epilepsy affects 1 in 200 women of childbearing age and is a cause of maternal death. For the fetus and neonate, epilepsy is associated with a significant risk of major and minor congenital anomalies, related to the use of anti-convulsant medication. Recent guidance published by the National Institute for Clinical Excellence and recommendations from the CEMACH reports into maternal deaths and perinatal mortality, have clearly recommended the need for multi-disciplinary team management of these women during pregnancy and the need for pre-conceptual care and advice. There is a clear opportunity to reduce the risks to both mother and fetus if we embed these in our practice. The teratogenic potential of anti-convulsants is discussed, and the most recent recommendations for contraception for women with epilepsy, which apply to women pre-pregnancy and post delivery.
Further abortion reform sparks fierce dabate
Authors: Daniel Lincia
Published: May 2014

A new government report that advocates allowing just one doctor to sign abortion consent forms, as well as allowing women to have abortions at home by taking the second of two pills required, has incited rage.
Lonely labours and routine enemas: a view of Polish maternity services
Authors: Bayley Patrycja
Published: May 2014

During the recent summer holidays I had the opportunity to spend a two-week elective observational visit in Poland. As part of our second year of midwifery training (direct entry) we were encouraged to choose a placement that was different, appealing to us and one with the potential to enhance our understanding of diversity within the world of midwifery.
Sudden unexplained infant death and unexplained stillbirth in Wirral
Authors: Manning D , James C , Birch L , Bundred P
Published: May 2014

Clinical and demographic variables in sudden unexplained infant death (SIDS) and sudden unexplained intrauterine death (SIUD) in Wirral between 1995 and 2001 were compared. In comparison with SIUD mothers of SIDS cases were younger and the families were more deprived. There were non-significant trends towards greater maternal body mass index and lower birth weight standard deviation score among the SIUD cases. Antenatal glycosuria occurred in 16% of the SIUD cases and none of the SIDS cases. Families experiencing SIDS and SIUD show significant clinical and demographic differences suggesting that pre-natal and postnatal factors exert differing degrees of influence in each condition.
Hospital is the best placefor all women to give birth
Authors: Downe Soo , Gyte Gill
Published: May 2014

The first question to ask is, who are hospitals best for? The obvious answer is that women and babies who are at high risk of adverse events that can be ameliorated by hospital based treatment would probably do better (clinically, at least) in an institutional setting. However, more controversially, we should also recognize that women who are in a place of birth where they feel safe will probably do better there. Given that most low risk women currently choose hospital care, this suggests that large numbers of women may do well in this setting, even if they don't need it for clinical reasons. It is of interest that in Holland only 30% choose home birth, despite a policy for all low risk women to be offered out of hospital midwife led care.
Planning and implementing mental health training
Authors: Ross-Davie Mary , Elliott Sandra , Green Lucinda
Published: May 2014

This article describes the development of a training day for maternity professionals on perinatal mental health. The need for such ongoing training has been highlighted by the Confidential Enquiries into Maternal Deaths. Death from psychiatric causes has been the leading cause of maternal death for the last two Triennia. The aims of the training programme are to improve the detection of women with current mental health problems and those at high risk of a serious mental illness following delivery in order to improve the care and support offered to them throughout their contact with maternity services. The training day aims to facilitate improvements in knowledge, attitudes and skills of midwives and obstetricians in relation to mental health.

The article sets out the programme for the day and the lessons learned by the team providing the training to assist others who are hoping to develop perinatal mental health training programmes in their area.
How would you feel about surrogacy?
Authors: Roughley Gwen
Published: May 2014

As a student midwife part of my training includes reflection on events that have occurred in clinical practice for my professional portfolio. These reflections are sometimes comprised of very personal thoughts and on occasion are concerned with emotive subjects. My intention here is not to offend or upset but to give insight into an area rarely explored unless you have been exposed to it in some way, be it on a professional basis or at a more personal level. Names have been changed to protect anonymity.
Are maternity assistants helping to ease midwives' workloads or are they lining up to replace them? Where are the jobs for newly qualified midwives?
Authors: Rouse Helen
Published: May 2014

As a third year student midwife it would be nice to know that the trust where you are training could offer you a job at the end of the year. The harsh reality is that although there is a shortage of midwives no funding is available for the staff that are desperately needed and trained to do the job.
Advances in protein composition of infant formula
Authors: Cowbrough Kathy
Published: May 2014

Breast milk provides the optimal source of nutrients for infants. For infants who are not breastfed, infant formulas are available to ensure normal growth and development. A key macronutrient for infants is protein, due to its role in linear growth and the maintenance of cell development and function. Over the past 90 years, there have been many developments in infant formula. The latest technology now allows for the manufacture of an alpha-lactalbumin (alpha-protein) enriched infant formula. This formula contains higher levels of alpha-lactalbumin, which is the dominant whey protein in human milk. The new alpha-protein enriched formula has a whey protein profile that is closer to that of human milk, an improved essential amino acid profile, and is better tolerated by bottle fed infants.
Betraying the NHS--Health Abandoned
Authors: Davies Louise
Published: May 2014

This book is an analysis of the decision making made by National Health Service (NHS) management at all levels, including Trusts and Councils during 2005 and 2006. This decision making was seemingly fuelled by the necessity of Strategic Health Authorities (SHAs) and Primary Care Trusts (PCTs) to balance their books and reduce their financial deficits.
Innovative changes in a UK midwifery education programme
Authors: Porter Jan , Meddings Fiona
Published: May 2014

At the University of Bradford, the midwifery team have developed an innovative approach to the delivery of their midwifery programme. This includes the use of a spiral curriculum that is underpinned by problem based learning. A spiral curriculum is one that facilitates an iterative revisiting of topics, subjects or themes throughout the programme. The approach is not simply one of repetition but one that enables the student to achieve deeper knowledge with each turn of the spiral.
Society rules: one individual per body
Authors: Winter George
Published: May 2014

There is a near automatic assumption that conjoined twins must be separated, no matter what the risk to the twins themselves, but it seems it is only society that views the conjoined state as intolerable…
Bad practice compromises public safety in Canada
Authors: Daniel Lincia
Published: May 2014

Outbreaks of MRSA draw attention to the importance of good hygiene in hospitals but a report reveals shocking examples of bad practice sterilizing equipment at facilities in Canada's East Central region.
Antenatal assessment for risk of venous thromboembolism
Authors: Whapshott Helen C
Published: May 2014

Thromboembolic complications during pregnancy are the highest cause of maternal death but there is a lack of risk assessment tools designed to estimate the degree of risk for individual women. The aim of this study was to create a risk assessment tool using the available evidence from the literature which could be used by community midwives at the antenatal booking interview to assess a woman's degree of risk for venous thromboembolism in pregnancy.

A comprehensive literature review was carried out to evaluate the literature and calculate degrees of risk.

Further development of the risk assessment tool will enable midwives to assess women for their degree of risk for developing venous thromboembolism after delivery or if they are admitted to hospital during the course of their pregnancy.
Maternity services to tackle obesity
Authors: Bainbridge Jane
Published: May 2014

In the recent CEMACH report more than half the women who died from direct or indirect causes were obese, highlighting an urgent need for specific care plans for overweight mothers to be introduced.
Money for maternity matters but not as we know it
Authors: Gould Debby
Published: May 2014

The implementation of Maternity Matters rests firmly on the need for an appropriately funded midwifery establishment. ‘Every woman needs a midwife and some need a doctor too’ (Shribman, 2007). There is a direct relationship between funded midwifery establishment and the low achieving trusts in the HCC report into maternity services (HCC, 2008).
Work related road safety
Authors: Griffith Richard
Published: May 2014

The community midwife's role requires travel from woman to woman to fulfil her duties. Concerns over the high rate of accidents involving people using their vehicles for work has resulted in a concerted effort by the police and health and safety executive to improve work related road safety (The Work-related Road Safety Task Group, 2001).
Place of birth: can ‘Maternity Matters’ really deliver choice?
Authors: Edwards Alison
Published: May 2014

This article provides an overview of the literature regarding choice and how this impacts on the potential success of ‘Maternity Matters’, with particular focus on place of birth. The findings neither favour nor discourage the introduction of the latest government paper, but indicate the complexity of implementing choice. Choice is not straightforward and women are placed within a whirlpool of influences from professionals, the institution and from those around them. There are a number of success stories and these should be used as examples of good practice but many trusts and individuals will need to think quickly and carefully about how they will implement Maternity Matters, not least because of the tight deadline set.
Infant nutrition part 2: the midwife's role in allergy prevention
Authors: Venter Carina , Clayton Bernie , Dean Tara
Published: May 2014

Dietary intake during pregnancy, breastfeeding and an infant's first year of life plays a crucial role in the development of the immune system and development/prevention of allergic disease. Maternal dietary avoidance of the major allergenic foods is not recommended, apart from peanuts, which mothers from high risk families may wish to avoid. Exclusive breastfeeding is recommended for six months, but at least four months. Should a mother wish not to breastfeed or have problems with breastmilk supply, advice should be provided regarding the use of a hydrolysed formula in high risk families.
Uptake of optional newborn screening and social distribution in Wales
Authors: Joomun Lorraine , Parsons Evelyn , Bradley Don
Published: May 2014

This paper presents the findings from a research study to investigate if there was an association between uptake of newborn screening for Duchenne muscular dystrophy (DMD) and social distribution. Postcode data was obtained over a three month period for all new births in Wales. Sample of 1636 new births that were offered screening, of these 567 refused and 1069 accepted screening. Postcodes were linked to social distribution using the Welsh Index of Multiple Deprivation. Statistical analysis was carried out using SPSS. There was evidence of a weak association between uptake and social distribution but further investigation is required.
Eco Baby, A Guide to Green Parenting
Authors: Jones Shirley
Published: May 2014

This little book, true to its eco-friendly intention, is printed on good quality, recycled paper. It has142 pages and it is packed with very useful information. Although the title is aimed at families during the pregnancy and young baby stage of their lives, most of the contents of the book are suitable for any householder, with or without babies.
Breathing problems for babies after elective caesarean delivery
Authors: Bainbridge Jane
Published: May 2014

Research in Denmark has shown that babies delivered by elective caesarean are up to four times more likely to suffer from breathing problems than those delivered by other methods.
Breastfeeding in the delivery room
Authors: Warren Raquel
Published: May 2014

It is unequivocal that no substitute can match the nutritional, immunological or other properties of living breast milk. For some time now evidence has demonstrated that breast milk protects babies against gastrointestinal, urinary, respiratory and middle ear infection (Howie et al, 1990) and atopic disease (Oddy et al, 1999). Maternal benefits include reduced risk of pre-menopausal breast cancer, some forms of ovarian cancer (DH, 1994a) and protection against osteoporosis in later years (DH, 1994b).
Teenage fathers: risky business for unborn babies
Authors: Bainbridge Jane
Published: May 2014

So much attention is placed on mothers when it comes to risk factors for adverse pregnancy outcomes that the possibility of risk from fathers is largely forgotten, yet they can have significant influence too.
Professional dominance and subversion in maternity services
Authors: Gould Debby
Published: May 2014

Recently Safe Birth: Everybody's Business (Kings Fund, 2008) recommended the need for greater teamwork to improve safety in maternity services. The report states that there is little understanding of the differing philosophies between midwifery and obstetrics. These professional tensions often arise at the interface of clinical care, where each finds themselves struggling to understand each other, and sometimes jousting for position. Such dysfunctional behaviour compromises safety. This was tragically illustrated by the high profile midwifery case before the Nursing and Midwifery Council (NMC). The main charge was that the midwives failed to monitor Mrs A (a woman having a vaginal birth after caesarean section (VBAC)) correctly during labour, disregarding the consultant obstetrician's instructions for continuous electronic fetal monitoring. Mrs A's baby sadly died. The NMC (NMC, 2008) has dealt with the facts concerning the midwives’ behaviour during the care of Mrs A. However the underlying organizational cultural origins, contributing to dysfunctional behaviour between doctors and midwives, are complex, widespread, and still need to be addressed (Kings Fund, 2008).
Obesity expert calls for pregnancy guidelines to be revised
Authors: Bainbridge Jane
Published: May 2014

Obese and overweight women need to take regular exercise during pregnancy to reduce their risk of developing gestational diabetes and guard against the tendency to retain extra weight postpartum.
`Drop the bags and catch the baby': the night I realized I'm a midwife
Authors: Ford Helen
Published: May 2014

I was on-call on a frosty December night, insignificant to the sleeping majority, but this night would prove to be one of the most profound of my life; I would mark it as the point where I fully realized my transformation to becoming a midwife.
Nutrition under six months:components of infant milk
Authors: Lowdon Jacqueline
Published: May 2014

The main functions of breast milk and infant formulae are to provide nourishment, protection and to aid normal development. It is well accepted that breastfeeding is the best way to meet an infant's nutritional requirements and is considered nutritionally adequate up until six months of age for healthy, term babies. Infant formulae are intended for infants who cannot be fed at the breast, or who should not receive breast milk, or for whom breast milk is not available. This article outlines the components of infant milk with an explanation of the benefits.
Taught to be kind
Authors: Gould Debby
Published: May 2014

Given the recent media attention to maternity services in the UK you could be forgiven for thinking that compassionate maternity care could be an oxymoron. For it seems that ‘care’ and ‘compassion’ no longer seem to sit side by side in health care. We value excellent technical skills so much that we are prepared to disregard poor attitudes and behaviours in some individuals. Yet it seems extraordinary that we have managed to separate care and compassion, rather like splitting the atom. And just like splitting the atom the negative ramifications from a seemingly insignificant split is contaminating our profession worldwide and may persist for generations. Maternity services need to be high quality, compassionate and above all safe in its widest sense, including emotional, physical and psychological safety. The recent Kings Fund Report (2008) highlights the need for interprofessional respect with regards to safety. However, of equal importance is the link between the delivery of respectful sensitive care and physical and psychological safety.
Interprofessional education: reviewing the evidence
Authors: Ireland Jillian , Gibb Susan , West Bernice
Published: May 2014

The objective of this review of recent literature was to assess the evidence on the efficacy of skills based interprofessional education (IPE) for post-qualifying health care professionals involved in maternity care in the UK. A systematic literature review of relevant UK based papers was conducted using an a-priori search strategy. Agreement on final inclusion was reached by consensus across the team. The findings were scored and described narratively and thematically. Of 225 studies identified, seventeen fitted the inclusion criteria. The papers included in this review varied in design, quality and focus. This is reflected in the scoring and coding system adopted. After scoring, four papers were considered to be of a higher order, and are described in more detail. It is evident from the review of the literature that evaluations of IPE programmes are often positive but it is not clear to what extent the interprofessional nature of the programme affects the outcomes.
Interprofessional learning in health care programmes
Authors: Wright Lee
Published: May 2014

The objective of this study was to investigate the views of students who had undertaken Interprofessional learning (IPL) in the first three months of health care courses. A generic qualitative approach was adopted and three focus groups were used in 2006 to capture the data. A purposive sample of students was selected at one university in the UK. Thematic analysis led to the identification of four main themes: students' understanding of interprofessional learning; educational issues; feelings of isolation; and influence on future practice. Students thought that IPL should involve interaction between students and enable them to find out more about other professions. Common core lectures were not thought to constitute interprofessional learning The findings confirm what other authors have found, but also provide valuable insight into the students' experiences. They can be used to inform quality management processes and curriculum development.