bluuebunny/crossref_metadata_2025 huggingface dataset:
Positive response to HIV therapy for women in India
Authors: Daniel Lincia
Published: May 2014

Freelance health writer Lincia Daniel looks at midwifery news and and events from around the world
The Birth Place Choices Project: phase two initiative
Authors: Barber Toni , Rogers Jane , Marsh Sarah
Published: May 2014

The Birth Place Choices (BPC) Project was carried out between May 2003 and May 2005 as a collaboration between Southampton University Hospitals NHS Trust and Portsmouth Hospitals NHS Trust. The BPC Project had three aims:

1. To identify factors that influence women's decisions about where to give birth.

2. To determine whether the introduction of specially designed information and educational initiatives increase women's knowledge of choices for place of birth.

3. To determine whether implementation of these initiatives was associated with an increase in the number of women choosing to give birth outside main consultant-led maternity units.

This article describes the educational, marketing and change management initiatives that were carried out as part of phase two of the BPC Project. These included a marketing campaign for local Midwifery-Led Units, the provision of a maternity service user leaflet on local birthplace choices, and the development of a multi-professional guideline on place of birth. Midwife practice educators were employed to help disseminate the leaflet and guideline as well as implement educational initiatives for local midwives on and around informed choice and place of birth.
Advances in newborn bloodspot screening
Authors: Israel Janet , Parsons Evelyn P , Bradley Don M
Published: May 2014

This paper looks at the utilisation of tandem mass spectrometry (MS/MS) in newborn bloodspot screening. MS/MS has the ability to analyse a single blood sample for a relatively large number of neonatal disorders, including inborn errors of metabolism. It has therefore the capability to transform the face of newborn screening. In the UK medium chain acyl-coenzyme A dehydrogenase deficiency (MCADD) has been highlighted as a suitable candidate for screening using MS/MS but debates are still taking place about the disease process and the psychosocial implications of screening.

Midwives are central to newborn screening and therefore any expansion of bloodspot screening would have implications for their practice in terms of information giving, parental consent and education. To ensure the continued success of newborn bloodspot screening it is important that midwives practice in accordance with professional standards, are aware of current developments and engage in debates prior to new service delivery implementation. The Department of Health and the National Screening Committee have undertaken a two year pilot study (2004–2006) looking at newborn screening for MCADD and their report, due out 2006/2007, has the potential to contribute constructively to current debates.
National training resources for newborn bloodspot screening
Authors: Stewart Ruth , Oliver Sandy , Hargreaves Katrina
Published: May 2014

Policy decisions to expand newborn screening and support informed choice prompted a review of information for parents and resources to support health professionals.

The UK Newborn Screening Programme Centre conducted a needs assessment to identify training needs. We took into account existing reports of training needs as well as conducting our own survey of Midwifery Schools and screening laboratories.

Prior evaluations, and our own survey, suggested the need for national resources on newborn bloodspot screening, rather than an additional national training programme.

Based on these findings we developed resources that could be used within current training initiatives. These resources are now available to midwifery trainers for use alongside or in place of existing resources, as well as to individual midwives as part of a ‘self-learn’ package.
Motherhoods yet to come&
Authors: Daniel Lincia
Published: May 2014

Genetic abnormalities in the eggs of older mothers could affect the fertility of their daughters, with alarming consequences for the future should the number of women delaying motherhood continue to rise.
Using complementary therapies in pregnancy: the debate continues
Authors: Daniels Lincia
Published: May 2014

Pregnant women and midwives are making use of complementary therapies and herbal remedies. Freelance writer Lincia Daniels looks at the questions raised and the information available.
National campaign to end obstetric fistula launched in Pakistan
Authors: Daniel Lincia
Published: May 2014

Freelance health writer Lincia Daniel takes a look at news on midwifery worldwide and gives an overview of initiatives to promote maternal, infant and reproductive health across the globe.
RCM conference preview: Where now for midwives?
Authors: McGuinness Fiona
Published: May 2014

This year's RCM conference promises, as ever, to be the premier event on the midwifery calendar. The theme of the 124th Annual Conference is ‘Where now for midwives?’
Young Vietnamese need more access to reproductive health education
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.
Developing a multidisciplinary scan clinic for teenage parents
Authors: Hansom Justina
Published: May 2014

This article discusses a service that was set up to address the needs of young pregnant women. The multidisciplinary scan clinic has been developed in response to the publication of the Social Exclusion Unit's report on teenage pregnancy in 1999. This report highlighted the prerequisite for improved antenatal care and more responsive services. Teenage Parents: who cares? (Department of Health, 2004a) is another document jointly published by the Department of Health, Royal College of Midwives and Teenage Pregnancy Unit, and is a guide to commissioning and delivering maternity services for young parents. It demonstrates that dedicated staff and services that are designed with the needs of young people at the centre, can alleviate issues such as late booking and poor attendance at antenatal appointments. A number of examples of ‘best practice’ are described in the document including the Multi-agency Young Parents Scan Session that was developed at the Royal Victoria Infirmary in Newcastle.
Fetal consciousness and the midwife
Authors: Kightley Robb
Published: May 2014

The impact of life in-utero and birth upon the infant and subsequent adult has been explored by psychoanalysts and psychotherapists who have generated maps of this affect. Biomedical research is explaining the pathways to this affect and underlining the impact of antenatal depression on the postnatal experience of mothers and infants. Identifying those who are prone to, or suffering from affective disorders, and supporting/referring as appropriate will have a significant effect upon the health and wellbeing of the woman and the infant throughout its life. An appreciation of the social and emotional factors that can lead to antenatal depression will assist us as midwives to make a positive contribution to the outcomes of vulnerable families.
Sexual function and wellbeing after obstetric anal sphincter injury
Authors: Boij Carin , Matthiesen Leif , Krantz Margareta , Boij Roland
Published: May 2014

This study investigated women's problems and pains five years after an anal sphincter injury was received during birth, and the impact this might have on women's sexual life and wellbeing. The study was conducted in 2000 at the Department of Gynaecology and Obstetrics at the Ryhov County Hospital in Jonkoping, Sweden. Five years after giving birth, 51 women who had experienced a third-degree tear and 50 women without such perineal tear were given a questionnaire. The response rate was 38 out of the 51 women with third-degree tear (75%) and 34 out of the 50 women without a perineal tear (68%). Women with third-degree tear have significantly more difficulties when doing physical exercise and in their sexual life, which is also resumed later. They more often refrain from or are hesitant about further pregnancies. Anal incontinence is present in 40% of these women and perineal complaints persisted for an extended period. Lack of information concerning the sphincter injury was reported by 40% of the women.
Choosing private hospital care
Authors: Bannon Monique Daragjati
Published: May 2014

When I look at my pictures of my newborn boys my heart instantly fills with the happiest of memories. That cold night in February and that hot August morning are the greatest days of my life. I truly look forward to adding another amazing day, maybe two, to all our lives, but for now I'll enjoy my 19-month-old and 7- week-old. After all, having a baby is not an easy task. The nine months leading up to that moment are fraught with worry, attempts at the healthiest of diets, and, like the rest of motherhood, total selflessness. We were married in October and by May we were hoping to start trying for a family.
Legal requirements for conducting intimate examinations and treatments
Authors: Griffith Richard
Published: May 2014

Midwives are frequently required to touch patients in intimate or sensitive areas as part of their examination or treatment. Such examinations are often a source of distress and embarrassment to patients (Caldicott et al, 2003) and of unease to midwives who wish to ensure that they are above reproach where such sensitive touching is necessary (National Patient Safety Agency, 2004). This article considers the legal obligations on midwives when conducting intimate examinations and treatment.
Skewing the ratio of girls to boys in India
Authors: Bainbridge Jane
Published: May 2014

In certain regions of India the numbers of girls and boys has become worryingly imbalanced leading to a trade in women of marriageable age, who are often forced into marriage against their will.
National campaign in Pakistan to end fistula
Authors: Bainbridge Jane
Published: May 2014

Almost two million women suffer from fistula following complications during childbirth leading to incontinence and consequent psychological trauma and social ostracism.
Maternity services policy: does the rhetoric match the reality?
Authors: Beake Sarah , Bick Debra
Published: May 2014

The maternity services in England probably have one of the most comprehensive policy agendas of any maternity service in the world. The aim of this survey of service provision was to assess the extent to which policy reforms, national guidance for NHS care and recommendations of the Confidential Enquiries had been implemented in nine maternity units in the south of England. All the Trusts provided consultant-led care however only three Trusts provided a midwifery-led unit and, although all Trusts offered home birth as an option, in three Trusts this depended on midwifery staffing levels. All nine Trusts reported having a diabetic clinic but only two Trusts offered a specific psychiatric maternity clinic. Apart from specific ‘skills drills’ sessions there was ad hoc provision of ongoing staff development.
Oldest mum in the world is Spanish
Authors: Daniel Lincia
Published: May 2014

A 67-year-old woman has officially entered the Guinness Book of Records as the world's oldest mum. Carmela Bousada from Cadiz, Spain, gave birth to twin sons, Pau (3lb 7oz) and Christian (3lb 5oz), in Barcelona on 29 December—seven days before her 67th birthday. The babies were delivered by caesarean.
Choosing mode of delivery after previous caesarean birth
Authors: Farnworth Allison , Pearson Pauline H
Published: May 2014

Women who have had a caesarean birth face a decision about how to deliver their baby in a subsequent pregnancy. This paper describes a qualitative study exploring the decision making experience of such women. Eleven pregnant women who had had a caesarean section in their previous pregnancy took part in semi-structured interviews one to three days after they had made a choice about mode of delivery. A thematic analysis of the transcripts revealed that most women felt they had made a choice about delivery method, though the extent of involvement in the decision differed. Making choices about delivery after a previous caesarean birth was influenced by a number of people and other factors and it involved assessment of information from previous experiences and trusted others. Medical information about risk/benefit was considered alongside beliefs about birth and moral concerns about the ‘correct’ choices to make.
Smoking exposure in pregnancy: use of salivary cotinine in monitoring
Authors: Delpisheh Ali , Topping Joanne , Reyad Manal , Tang Ai-Wei , Brabin Bernard J
Published: May 2014

The role of salivary cotinine for monitoring maternal pregnancy smoking as an alternative to self-reported smoking exposure is not well established. This was a case-control study to assess the correlation between maternal self-reported pregnancy smoking exposure and postnatal salivary cotinine levels in 90 mothers with a baby with fetal growth restriction (cases) and 180 mothers with a normal birthweight for gestational age infant (controls) attending the Liverpool Women's Hospital for delivery between 2004 and 2005. Cases had increased exposure to cigarette smoke during pregnancy compared to controls. Using the salivary cotinine assay as the reference two-thirds of women, both cases and controls, correctly reported their smoking status during pregnancy. There are limitations with the accuracy of self-reported pregnancy smoking as an exposure indicator, especially in mothers delivering babies with Intrauterine fetal growth restriction (IUGR) who are also those most likely to smoke. In view of this there is a need to consider using salivary cotinine measurements in antenatal settings in order to facilitate monitoring of smoking exposure in pregnancy and for evaluation of deterrent interventions.
A remarkable realization
Authors: Gould Debby
Published: May 2014

Purple cow is not an insult! It is a term used to describe something remarkable adopted by the famous marketing guru Seth Godin (2003). He argues that to be successful you can no longer rely on appealing to the masses, you have to find what makes you ‘remarkable’, what makes you stand out, and promote it. Being remarkable is hazardazous. Inevitably as you start to stand out people begin to criticize. Being remarkable paradoxically acts as a magnet for criticism and respect, potential failure and ultimate success. Most people have been conditioned to perceive criticism as synonymous with failure and avoid it at all costs, not realising that success sleeps alongside potential failure—you have to take risks to be successful. Fear of failure stifles success.
RCM conference preview: midwives delivering choice
Authors: Clift-Matthews Victoria
Published: May 2014

The Royal College of Midwives provides excellence in professional leadership, education, influence and representation for and on behalf of midwives. It represents 95% of practising midwives and is the voice of midwifery. Each year the RCM holds a national conference and exhibition that is the premier event in the midwifery calendar. The conference offers delegates the opportunity to attend cutting-edge lectures, take part in lively debate and fascinating knowledge sharing forums, browse the extensive exhibition and take part in the lively social and networking programme. Over 800 delegates are expected to attend this year's conference, which is held in Brighton and promises to be better than ever.
Choices in contraception
Authors: Hale Rachel
Published: May 2014

Provision of good information on contraceptive choices for new mothers is important. Many new mothers risk an unplanned second pregnancy because they are confused about what forms of contraception they can use safely after giving birth. Postpartum ovulation can occur as early as 28 days following delivery however women who are fully breastfeeding their baby are likely to suppress ovulation for a longer time (Too, 2003). The onset of the first menstrual period following delivery is a sign of impending fertility so it is therefore advisable for breastfeeding women to use some sort of contraceptive protection if they do not wish to become pregnant, regardless of their breastfeeding and/or amenorrhoea status. The chosen contraception should not interfere with the quantity or quality of the milk supply. Women should be offered accurate, evidence based information during contraceptive counselling, which must include the failure rates and the health risks/benefits so that they can make an informed decision about their preferred method. Midwives are ideally placed to give contraceptive advice and this article aims to discuss the contraceptive choices that are available for new mothers in particular those who breastfeed.
Narratives from the Blackburn West caseholding team: success stories
Authors: Fleming Anita , Birch Jo , Booth Chris , Cooper Jill , Darwin Joanne , Grady Angela , Downe Soo
Published: May 2014

The first two papers in this series described the early development, and ongoing evolution of a caseholding team in the north-west of England (Byrom and Downe, 2007; Fleming and Downe, 2007). We described the outcomes of the scheme and suggested that nine key factors may underpin the success of the project, namely: continuity of carer; visibility in the community; multi-agency involvement; inter-disciplinary collaboration; leadership; strategic partnership; ability to be innovative and flexible; involvement of local community and individuals; and shared group philosophy. Based on principles of service user involvement it was agreed that the ongoing monitoring of the project would include an invitation to all those using the service to write their birth story to summarize their experiences with the scheme. This paper presents a selection of these stories as a reflection on the processes and outcomes of the scheme. The stories indicate that the benefits of the scheme are evident for both the women using the service, and the midwives providing it. They also illustrate many of the nine core factors for success identified in our previous paper. Specifically, the scheme offers the opportunity for women at high clinical and socio-demographic risk to experience positive childbirth experiences. It also offers the opportunity for midwives to exercise their skills in normalizing birth in complex situations.
No registered midwives since 1965
Authors: Bainbridge Jane
Published: May 2014

It's been over forty years since midwives were officially allowed to practice in Illinois but there is now hope for the traditional midwife in the form of a new bill outlining criteria for their registration.
Teaching and learning: flexible modes and technology applications
Authors: Morrow Jane , Phillips Diane J , Bethune Elizabeth
Published: May 2014

Australian universities face many challenges in providing postgraduate midwifery education opportunities for registered nurses, particularly for those residing in rural areas. This paper will describe the measures implemented by a team of midwifery academics of Deakin university, Melbourne campus, specifically for units of study within the Graduate Diploma of Midwifery. As a consequence of these measures, student travel to a campus of the university and separation from their families and communities have been reduced. These innovative measures include a blended teaching approach incorporating face-to-face and online teaching consisting of Deakin Studies Online based in Web CT Vista, and Elluminate Live, an interactive online synchronous communication tool. Over the past 20 years in Australia, Deakin university has led the way in computer mediated learning methods and the challenge was to provide appropriate teaching strategies for course content to meet the requirements of the regulatory authority, the Nurses Board of Victoria (NBV), while promoting pedagogical methods of teaching and learning.
Should HIV positive mothers breastfeed?
Authors: Junaid Ola
Published: May 2014

It is one of the requirements of the Nursing and Midwifery Council (NMC) that reflection of practice is carried out. Though I have not personally looked after a breastfeeding HIV woman since starting midwifery training, it is a topic that has fascinated me for a long time. Having moved from London where there is a high prevalence of HIV positive patients to the North-West of England where HIV prevalence is low, I am interested to find out what advice midwives should be giving to HIV positive mothers who wish to breastfeed.
Improving care for women with epilepsy
Authors: Morley Kim
Published: May 2014

All women with epilepsy require multi-professional shared care in pregnancy to reduce the risk of maternal death and fetal compromise. This is achievable by the development of shared care pathways between the woman and her neurological and obstetric team. To facilitate this, as part of Epilepsy Action's Mother's in Mind healthy births campaign, a resource pack for obstetricians, midwives, health visitors and community practitioners has been produced by Epilepsy Action in conjunction with a working party of Specialist Epilepsy Nurses and Midwives referencing recommendations from NICE (2004) and CEMACH (2007).

This article focuses on women with epilepsy and not those taking antiepileptic drugs for migraine, neuropathic pain and mental illness; the effects of exposure to the foetus and on hormonal methods of contraception are the same therefore, these women of childbearing potential should be counselled accordingly.
There's no place like home
Authors: Daniel Lincia
Published: May 2014

If a woman can give birth in a tree while flood waters rise beneath her, surely low risk women can give birth safely in the comfort of their own homes and even enjoy it, but how do we persuade them?
Critical Care in Childbearing for Midwives
Authors: Davies Louise
Published: May 2014

This is an extremely well written, comprehensive text surrounding the care and management of the high risk pregnant or newly delivered woman. It is specifically written for midwives, which makes a refreshing change from those texts referring to the obstetric and medical view point.
Experiences of first trimester antenatal screening in a one-stop clinic
Authors: Lewando Hundt Gillian , Sandall J , Spencer K , Heyman B , Williams C , Grellier R , Pitson L , Tsouroufli M
Published: May 2014

Antenatal screening in the first trimester of pregnancy in a one-stop clinic through the use of ultrasound to measure nuchal translucency and the analysis of maternal blood serum for biochemical markers alters the experience for women and their partners. The conflation of the dating scan with the measurement of nuchal translucency means that there is early visualization of the fetus and reassurance that the risk of Down's syndrome has been assessed. The period of uncertainty between having the screening and getting the results is shortened from seven to ten days to one hour but the uncertainty concerning the possibility of Down's syndrome is raised earlier in the pregnancy with health professionals. Contrary to professional expectations, many women surveyed after visiting the clinic understand the dual purpose of the ultrasound. These technologies delivered in a one-stop setting have altered not only the organization of the clinic but also women's experiences of early pregnancy.
Ethics and qualitative research: issues for midwifery researchers
Authors: Rogers Kay
Published: May 2014

Within health care the perceptions of those involved with, and accessing care, are now incorporated within the concept of quality care and are integral to maternity services where choice and empowerment are central components to care provision. Qualitative research, with its ability to explore values, beliefs and perceptions, has therefore gained increasing acceptance as a valid means to inform midwifery practice. However such research brings a myriad of ethical considerations and this paper examines the issues that researchers may face as they undertake a qualitative research study.
‘Difficult’ babies are more intelligent
Authors: Daniel Lincia
Published: May 2014

If you've ever envied your friends or siblings for having an ‘easy’ baby then take heart because your ‘difficult’ baby is more likely to achieve academically and have better social skills in later life.
Midwives: all things to all women?
Authors: Blake Diane
Published: May 2014

Teenage pregnancies, ethnic minorities, asylum seekers have all been recognized as requiring intense support during pregnancy. The need for such support is extremely likely because of the poor economical and psychosocial status of these categories, which can lead to potentially severe medical conditions affecting maternal and fetal outcomes. Midwives are expected to tailor their support and care for these women, ensuring they are able to make appropriate choices about the services they require. this article discusses the challenges midwives face in meeting the needs of vulnerable women and delivering holistic, women-centred care.
Modern man battles to be included
Authors: Bainbridge Jan
Published: May 2014

The shifting roles of both sexes has led to the modern man being more involved in birth and parenting, benefiting all concerned, but does the NHS make adequate provision to encourage fathers' participation?
Marriage and sexual intercourse: autonomy and capacity to consent
Authors: Symon Andrew
Published: May 2014

When might a court step in and say that sexual intercourse between an ostensibly married couple would be a criminal offence? Clearly the issue is to do with consent: either consent has been withheld by a mentally competent adult, or there is a lack of capacity to consent. In what circumstances could this arise with a married couple?
Pinards: out of use and out of date?
Authors: Blake Diane
Published: May 2014

Intermittent fetal heart auscultation is an important and essential assessment that is performed for all women during pregnancy and specifically for low risk women during childbirth. Certainly women with complicated pregnancies would benefit from continuous fetal monitoring via a Cardiotocograph (CTG) monitor (National Institute of Clinical Excellence, (NICE) 2003). However the main focus of this article is to examine the methods used for intermittent auscultation of the fetal heart for low risk women and to challenge the use of the Pinard in modern midwifery practice.
Compensation for nervous shock
Authors: Griffith Richard
Published: May 2014

The law of negligence has long recognized that individuals who breach their duty of care by carelessly harming another must pay compensation for the harm caused.
Research evidence and clinical expertise
Authors: Walsh Denis
Published: May 2014

I came across a very interesting paper recently challenging the notion that clinical expertise is as good as research-based evidence for guiding decisions in practice (Paley, 2006). Sackett (1996) has famously defined evidence-based decision making as a combination of research, clinical expertise and patient preference. In the intervening years since, debate has raged over evidence-based decision making and to what extent it should be based on research only. In particular, some have argued that the only legitimate evidence is from quantitative research methods with the randomized controlled trial as the pinnacle of good evidence. In midwifery circles, I have suggested a broader ‘take’ on evidence, drawing on qualitative research, intuition and ancient wisdom (Walsh, 2007).
Making sense: women's abortion experiences
Authors: Trybulski JoAnn
Published: May 2014

This study investigated the meaning of women's elective abortion experiences. American women who had ended or were nearing the end of their intended childbearing and had terminated a pregnancy for non-genetic reasons participated in a phenomenological exploration.

Sixteen women participated in this interpretive phenomenological study which resulted in nine overall themes. The theme of making sense is detailed in this article. Women make sense of their abortion in varied ways and helping women make sense of their abortions is critical for their wellbeing.
Assessing progress in Maternity Matters
Authors: Clift-Matthews Victoria
Published: May 2014

This month's theme is on caring for the individual which, according to Maternity Matters, is what the maternity services are supposed to be all about in 2009. By the end of this year women should be able to make a number of choices when they find they are pregnant. First they should have the option to refer themselves directly to a midwife or make use of their GP, whichever they prefer. They should have the freedom to choose whether they are cared for only by a midwife or by a team including midwives and obstetricians (depending on their circumstances). When choosing where to birth a whole range of options, from being supported by a midwife at home, in a midwifery facility such as a birth centre or being supported by a maternity team in hospital, should be available. Postnatal care should be provided either at home or in a community setting, depending on the woman's choice. (Department of Health (DH), 2007).
‘A labour of love?’: mothers and emotion work
Authors: John Veronica
Published: May 2014

The aim of the study was to explore the emotion work involved between mothers and their midwives during birth. Ethnographic observation and in-depth interviews explored the experience from the perspective of mothers and their midwives. This article analyses emotion work during birth from the mothers' perspectives.

A key finding of the study was that mothers valued the feelings of calm provided by the midwives' during birth but did not recognize this as a component of midwifery work (John and Parsons, 2006). This was because of the profound range of emotions that mothers' themselves experienced throughout labour. One important finding was that the mothers identified that it was important for midwives to be intuitive and sensitive to their changing needs. The mothers realized that their needs altered during labour as they experienced feelings of fear, relief and changes in consciousness. Thus, mothers used emotional management techniques to stay calm and gave subtle clues to indicate the level of input they needed from their midwives. They also noted the need for different types of emotional care in different situations.
Supervision issues in practice: supporting and advising midwives
Authors: Gnash Lynn
Published: May 2014

A case study involving a planned home birth in an unusual location is examined using Gibbs reflective cycle to highlight the issues for supervisors of midwives. A number of points are raised that relate to the supervisor's role, such as support, advocacy and risk management.
Child Protection and the Law: urgent intervention
Authors: Griffith Richard
Published: May 2014

The need for timely intervention is crucial to the proper protection of children at risk of significant harm. The state and its agencies, such as the health and social services, have an obligation under the Human Rights Act 1998 that where they know or ought reasonably to know that a child is at risk then they have a duty to act.
Providing a quality service
Authors: Stephens Liz
Published: May 2014

It is looking increasingly likely that the Clinical Negligence Scheme for Trusts (CNST) is going to set the standard for midwifery staffing at a ratio of 1 midwife to 28 births. Overall I think this is a good thing; we only have to look at the example of our obstetric colleagues to see that CNST can drive changes in the workforce. Further to this the Healthcare Commission Report Towards Better Births (2007) quite clearly showed that the better performing trusts were those with better midwifery staffing.
Developing decision making for students using interactive practice
Authors: Kitson-Reynolds Ellen
Published: May 2014

Decision making is one of the most important skills that midwifery students should acquire through their education. Various methods of teaching the theoretical perspective can be easily adopted in the classroom. However, the speed that decisions sometimes have to be made in the clinical situation may not always allow time for the student to practise these skills for real or give the opportunity to realize the consequence of them. This article identifies how a filmed scenario-based activity can provide a ‘real time’ skills rehearsal for third year student midwives within the confines of a safe environment. Interactive decision making increases the development of procedural knowledge within the student and may also reduce the period of time required to acquire skills of effective clinical decision making. It is anticipated that this format for providing education can be used effectively for bridging the transition period from student to newly qualified midwife.
Midwives in the public eye
Authors: Pearson Susan
Published: May 2014

As midwives we are constantly in the public eye. Actions and comments, if not our faces, will be remembered and retold to generations as part of the birth experience in which we play a role (Moore, 2003; Romero, 2005). Our society is fascinated by celebrities but are their exploits going to be recalled in precise detail for decades to come?
Research: making the profession stronger
Authors: Clift-Matthews Victoria
Published: May 2014

Research methods may well seem like a daunting topic for a midwife unused to an academic environment but I would hope that readers of the British Journal of Midwifery are only too aware of their importance and know that they are critical to clinical practice. Research is not merely information gathering. It attempts to answer a question, resolve a problem or explore a phenomenon through a systematic process, using data that is interpreted to either answer the question, resolve the problem or allow a greater understanding of a phenomenon. This is one definition but I'm sure researchers reading this could improve it.
Breastfed babies less likely to become overweight children
Authors: Bainbridge Jane
Published: May 2014

According to a new study breastfed babies experience slower growth than formula-fed babies, which could be a reason why breastfed babies are less likely to become overweight children later on.
Equal access to high-quality antenatal classes
Authors: Bainbridge Jane
Published: May 2014

Antenatal classes may never be able to prepare women adequately for childbirth and parenthood but some are perhaps better at educating parents than others but not all women have the benefit of them.
Redeveloping milk banks: information for midwives
Authors: Hilton Sioned
Published: May 2014

In recent years the global interest in human milk banks has been reawakened. The UK has responded but further developments are needed and a wider understanding of the issues are paramount to fully address and progress the much needed redevelopment of milk banks since their abrupt closure in the 1980s. This article will provide a detailed review of milk banks, their history and current situation, how they operate, the benefits to mother and their vulnerable baby of using donated human milk. It also discusses how midwives can get involved and support the issue.
Anxiety about swine flu: consistent advice given at last
Authors: Daniel Lincia
Published: May 2014

When a story about a new virus hits the headlines it's not surprising that panic spreads among the public but inconsistent advice from the government and reports in the press only serve to heighten anxiety.
Safety of lavender oil in the treatment of perineal trauma
Authors: Jones Catriona
Published: May 2014

Essential oil therapy in wound care is gaining increasing popularity. This largely consumer-driven trend is currently being incorporated into the care of postnatal women experiencing perineal discomfort. Anecdotal evidence suggests that some midwives recommend the use of perineal pads pre-spotted with an essential oil blend containing lavender oil. Currently, the topical use of essential oils as a complementary therapy for perineal wound management is not underpinned by empirical evidence.

A review of the existing literature on lavender oil in wound care has been conducted in an attempt to explore the safety of current practices.

This review highlights that currently there remains limited evidence to support the direct topical use of pure lavender oil as an effective and safe treatment or comfort measure upon the perineum.
Maternity services in a changing world: leading the debate in practice
Authors: Clift-Matthews Victoria
Published: May 2014

To debate the current issues for midwives, mothers and babies visit the Royal College of Midwives annual conference and student conference on 16 and 17 November in Manchester
Genetic screening of eggs looks set to increase IVF birth rates
Authors: Bainbridge Jane
Published: May 2014

Births of screened babies in Italy and Germany provides ‘proof of principle’ for new genetic technique, offering fresh hope to those who struggle to conceive with standard IVF
Experiences of gay women during their partner's pregnancy and childbirth
Authors: Erlandsson Kerstin , Linder Hanna , Häggström-Nordin Elisabet
Published: May 2014

Growing numbers of openly gay women choose to have children, but there have been few studies on the topic. The aim of this study was to describe the co-mother's experiences of care provided during their partner's pregnancy, childbirth and the postnatal period.

Six co-mothers were interviewed between six weeks and three years after the birth of their child. The open interviews were analysed using content analysis.

The overall theme of the findings was ‘like everyone else, but not quite’. The following main categories were identified: need for acknowledgement, need for care designed to suit same-sex couples, and in the hands of nursing staff.

Co-mothers felt themselves to be ‘like everyone else but not quite’. In order to support the relationship of same-sex parents in parenthood it is important for midwifery staff to recognize co-mothers as an equal parent of the child.
Putting two and two together—or not
Authors: Symon Andrew
Published: May 2014

People working within a particular field sometimes make the assumption that everyone will understand how or why something is done. Their very familiarity with the subject matter can lead to a belief that certain things are self-evident. Within midwifery, a topic that springs to mind is the awareness of pregnancy: when women ‘several months gone’ finally realize that they are pregnant, midwives may scratch their heads and wonder why they hadn't thought of this sooner. Among many reasons for delayed awareness of pregnancy is that this is simply not on their radar: people don't see what they just don't expect to see.
Strengthening midwifery: harnessing the climate
Authors: Gould Debby
Published: May 2014

From a midwifery perspective, much of what is recommended in The Prime Minister's Commission on the Future of Nursing and Midwifery in England (2010) could be viewed as a simple revision of Maternity Matters, National Service Framework for Children, Young People and Maternity Services and Changing Childbirth before it. It reiterates the need for a named midwife, highquality care, the need to work in partnership with the woman and wider multidisciplinary team, and the benefits of midwifery-led care. Yet there are three significant elements within the report which may have far-reaching consequences and might strengthen midwifery.
Legal challenges to the NMC's Fitness to Practice decisions
Authors: Symon Andrew
Published: May 2014

Midwives and student midwives will be aware that accountability comes in several guises. While professional and legal accountability are usually considered distinct entities, the Nursing and Midwifery Council's (NMC) Fitness to Practice procedures are highly legal in structure and tone: the case is made, witnesses are called, and a decision made in the light of the submitted evidence and with regard to specific guidance. Practitioners may appeal against the findings of such hearings by taking their case to the civil courts.
‘Gezellig’: a concept for managing pain during labour and childbirth
Authors: McNeil Alexander , Jomeen Julie
Published: May 2014

Pain is a defining element of the labouring women's experience. This article explores and discusses the potential of gezellig as an underlying concept for the management of pain during labour. Pain is the psychological, emotional and learnt response to signals induced by noxious stimuli sent from around the body via the spinal cord, to the brain. How we react to them and perceive them is what we feel as pain and is as individual as a person is. Pain felt during labour and childbirth is a unique pain at a deeply emotional time for women. This article looks into the individual nature of a woman's labour pain and how they cope with it. It poses reasoning to practices such as birthing partners, certain complementary and alternative medicines, water births and home birth requests and their relationship to pain relief in labour based around a core concept of environmental changes in the birthing place from the Dutch word gezellig.
US study into high blood pressure in early pregnancy and birth defects
Authors: Bainbridge Jane
Published: May 2014

A US study into the effects of hypertension in mothers on babies in early pregnancy has concluded that birth defects were not due to the drugs used, but the underlying hypertension.
What does the future hold for the role of the Local Supervising Authority?
Authors: Bacon Lisa
Published: May 2014

The Local Supervising Authority (LSA) is the statutory body responsible for the supervision of all midwives practising within its boundaries and LSAs must ensure midwifery practice is safe and effective wherever it is provided. The LSA produces standards and guidance for the supervisors of midwives within its boundaries in relation to their practice, based on the requirements of the Midwives' Rules and Standards of the Nursing and Midwifery Council (NMC). Effective use of the supervisory framework leads to improvements in the standard of midwifery care and better outcomes for women. Proactive and effective statutory supervision is evident, but there are variations across the UK. While LSAs continue to face many challenges in delivering their statutory function, annual reports from all 16 LSAs received by the NMC in 2010 described examples of good practice and referred to the value of supervision for both midwives and women. Over the years, the LSA role and function have developed and strengthened significantly. While most recently, LSAs have been the responsibility of the Strategic Health Authorities in England, it is crucial that this development continues in the new NHS. The specific challenges to LSA Midwifery Officers will be to provide leadership and support in the face of the challenges to come and to be pivotal and at the centre of addressing them.
Support in high-risk pregnancy: Planning for specialist neonatal care
Authors: Hawdon Jane , Hagmann Cornelia
Published: May 2014

When planning care for women with high-risk pregnancy, account must be taken of the potential impact on the fetus and newborn baby. This may include planning the most appropriate time and place of birth, and informing parents of the likely care for the baby. While planning should always optimize wellbeing of the baby, the wishes and concerms of parents should be taken into account. As far as possible there should not be separation of baby and mother in the postnatal plan and breastfeeding should be supported if this is the mother's wish. These aims are reflected in many sources of national guidance which will be outlined in this article.
The Intrapartum Scorecard: Enhancing safety on the labour ward
Authors: Mathew Dinah , Dougall Anita , Konfortion Julie , Johnson Sara
Published: May 2014

The National Patient Safety Agency developed an Intrapartum Scorecard for labour ward coordinators to record the demand on their service and the resources available to meet that demand. The evaluation of the pilot at 11 maternity units found that staff valued having this information in one place to support decision‐making in real time. However, nearly half the labour ward coordinators reported difficulty in finding time to complete the Scorecard. Units also used information recorded on the Scorecard as an aid to understanding the pressures on the labour ward over 24 hours throughout the week. The Scorecard was launched in February 2010 as part of the National Patient Safety Agency's Intrapartum Toolkit. In a follow up survey of Heads of Midwifery, over half the respondents were either using the Scorecard or planning to use it. Maternity units would like to adapt the tool in light of their particular requirements.
Analysing adverse effects of epidural analgesia in labour
Authors: Tamagawa Kana , Weaver Jane
Published: May 2014

Epidural analgesia is a widely available method of pain relief in labour in Western countries. This article analyses the various adverse outcomes of labour and birth after the administration of epidural analgesia. A literature review found that the use of intrapartum epidural analgesia for women with low-risk pregnancy has not only disempowered women but can also lead to maternal and fetal morbidity connected with major obstetric interventions, such as operative deliveries. Epidural analgesia also interferes with breastfeeding success and effective oxytocin circulation in the maternal blood-stream, and may even impact on childhood behavioural development.
The legacy of a self-reported negative birth experience
Authors: Mercer Jenny , Green-Jervis Cordelia , Brannigan Catherine
Published: May 2014

Aim: To consider accounts of first time mothers with a self-re ported negative birth. Within these self reports, the analysis explored the role the midwife might play in the negative birth experience and discusses the importance of birth narratives for mothers. Background: For first time mothers who report negative births, the reality of the experience is typically incongruent with expectations. Limited research has explored the narratives of such women, especially after a long period of time has elapsed after the birth. Method: Semi-structured interviews were conducted with five participants who had reported a negative birth experience at least 1 year previously. An interpretative phenomenological analysis (IPA) of the data was performed. Results: Feelings of depersonalisation, a struggle to make sense of what happened and a sense of betrayal remained vivid in the participants' narratives long after the event. Participants indicated that they would have welcomed an opportunity to informally discuss and attempt to understand the events of their birth, either while still in the maternity unit, or with their GP at the post-natal follow up. Conclusions: The findings highlight that participants reported sharing post-birth stories could go some way to negating the legacy of a negative birth experience.
What is the significance of delayed cord clamping?
Authors: Rees Rachel
Published: May 2014

This article uses the Gibb's reflective cycle (1988) to explore the consequences of the timing of the clamping of the umbilical cord. Recent evidence is critiqued to conclude that the immediate clamping of the cord in an actively managed first stage is not evidence-based.