bluuebunny/crossref_metadata_2025 huggingface dataset:
Letters
Authors: Carla Beatrice
Published: May 2014

Thank you

I am sending the enclosed photographs to convey my sincere thanks for the kind and generous payment made by the BJM for use of the earlier photo (see cover ‘International Issues’ supplement, Br J Midwifery 10(4), April 2002).
Teenage pregnancy and the law
Authors: Dimond Bridgit
Published: May 2014

This paper considers the legal issues arising from under age pregnancies including the right of self determination of the teenager, the conflicts with parents, the right to refuse treatment or insist upon a termination, confidentiality and the involvement of police and social services, and the impact of the Human Rights Act.
Midwives and perinatal mental health
Authors: Stewart Christine , Henshaw Carol
Published: May 2014

The terms perinatal mental health and perinatal psychiatry are becoming commonly used to relate to the various mental disorders experienced by women during pregnancy and the postnatal period. Midwives have been identified as having a role to play in screening for and educating about perinatal mental health disorders. A questionnaire survey of midwives was undertaken in two health districts in order to examine the level of knowledge they have about the prevalence of these disorders, their experience in dealing with them, whether they felt they had the necessary skills, and what further skills were required. Exploration of midwives’ interest in learning more about the disorders and perceptions of their potential role were included to gauge what type of programme should be developed in the future. Results from the data of 266 (70.6%) responses showed that midwives had some knowledge of the prevalence of these disorders and most felt they had a role in management. However, very few had had specific training in this area and many identified areas of practice they would wish to improve before taking on such a role.
A bereavement counselling service for parents: part 2
Authors: Herkes Barbara
Published: May 2014

Not all parents will need or accept counselling following miscarriage, stillbirth or neonatal death. Professionals must be aware not to force parents to take this option. Parents need to be given choices and a sense of control over a situation where there may have been little of either, even if it is the choice of whether or not to take up the offer of counselling. The aim of bereavement counselling service for parents is to offer emotional support and professional counselling at their request following pregnancy loss or neonatal death. The aim for staff is to support and provide education in bereavement related issues for professionals involved in the care of bereaved families, in recognition of the challenging and demanding nature of this work.
After Bristol: Government support and rejection
Authors: Dimond Bridgit
Published: May 2014

This article considers the Department of Health’s response to the Kennedy Report, the provisions contained in the NHS Reform and Health Care Professions Bill and the Kennedy recommendations rejected by the Department of Health and the implications for midwives.
The perils of psychiatric records
Authors: Robinson Jean
Published: May 2014

The latest Confidential Enquiry into maternal deaths in the UK (RCOG, 2001) states that: ‘Deaths from mental illness are actually the leading cause of maternal death’. It recommends that a specialist perinatal health team should be available to every woman at risk of, or having, serious postnatal mental illness. Amen to that. As AIMS knows only too well, such teams are thin on the ground. We have seen far too many cases where women are inadequately diagnosed, ineffectively treated, and are damaged by under-trained counsellors attached to GP practice who are way out of their depth.
Webwatch
Authors: Bass Janice
Published: May 2014

This month’s website was launched in November 2001 and is: www.midwivesonline.com
Breastfeeding support in Scotland
Authors: Britten Jane , Broadfoot Mary
Published: May 2014

During the 1990s, the Scottish Office set breastfeeding targets and issued guidance to health providers on promotion and support for breastfeeding, and the Baby Friendly Initiative. By 2000, 80% of health boards in Scotland had a breastfeeding strategy, and 67% of respondents reported breastfeeding targets in place. Nearly all maternity units (94%) were providing training on breastfeeding for midwives and 88% were participating in the Baby Friendly Initiative, with 6 units (18%) having achieved UK Baby Friendly status. The Scottish breastfeeding rate at 6 or 7 days increased by 2.5% between 1995 and 1999. Less than a third of this increase can be accounted for by the increased age at which women are giving birth.
Midwifery practice in Australia
Authors: Glover Pauline
Published: May 2014

Australia is an island continent 7686848km square. It is divided into six states and two territories and is a land of contrast, from the warm tropical north to the more temperate south. The population is currently 19.5million people and in 2001 the birth rate was 250000. The vast nature of our continent, with large regions with small scattered communities and the remote and isolated areas, make practising midwifery a challenge.
Step 43: Legal aspects of research 3
Authors: Dimond Bridgit
Published: May 2014

The last two steps articles have looked at the midwife's obligation to protect her clients who are being used as data subjects in a research project. This article looks at the international declarations governing research and the legal issues which arise when a midwife is herself involved in carrying out research. Rees (1997) has published a useful introductory guide to research for midwives.
How's your spiritual life going?
Authors: Walsh Denis
Published: May 2014

Not a question you are likely to be asked routinely if having a baby soon, as the expression of spirituality in the context of contemporary childbirth is uncommon, particularly in hospital birth. From an anthropological perspective, this is astounding given the seminal experience that childbirth is to mothers, babies, partners and families. A cursory glance through Kitzinger's wonderful book Rediscovering Birth (2000) tells us that western culture is unusual in not having spiritual rituals marking birth because they are invariably present in indigenous cultures. Institutional birth tends to endorse and re-enforce the biomedical model of birth to the exclusion of other models and within this model, clinical marks of birth dominate. It dominates the relationships, the environment, the written and the spoken word.
The UKCC higher level of practice pilot
Authors: Price Sally
Published: May 2014

The UKCC conducted a year long pilot project to identify how those working at a higher level of practice should be assessed and regulated. Of the 350 candidates who began the pilot, less than 200 survived the assessment process through to the end. This article will outline the background of the project, describe the experience of participating, and discuss some of the implications for midwifery practice.
Building for a better birth
Authors: Page Lesley
Published: May 2014

The architectural plans have been signed, and we are now finding the builders to rebuild our labour ward. About this time next year we will be moving into our new birth centre. The chance to rebuild a labour ward from scratch doesn't come often. So this opportunity to create an environment where birth can be better, is important.
Service evaluation of the Teenage Clinic
Authors: Gee Louise , Lackey Jan
Published: May 2014

The Teenage Clinic is a multidisciplinary service designed to cater to all the needs of pregnant and postnatal teenagers. Using the grounded theory approach, the present study evaluated the clinic from the service users' perspective. Six pregnant or postnatal teenagers aged between 15–20 years were interviewed to determine what they liked or disliked about the clinic and how the clinic could be improved and better advertised. Interviews lasted between 15 and 45 minutes from which the following seven themes emerged: (1) preparation and reduction of anxiety, (2) reduction of stigmatisation, normalisation and maintenance of self-esteem, (3) peer support, (4) acceptance of partners and other family members, (5) involvement in the process, (6) need for a practical element to sessions and, (7) inadequate promotion of the clinic. Attitudes towards the clinic were very positive, but there was a clear need for a greater practical element and wider promotion of the service.
Race relations and the law
Authors: Dimond Bridgit
Published: May 2014

This article considers the impact of the Race Relations (Amendment) Act 2000 within the context of provision of the Race Relations Act 1976 and looks at the new general statutory duty placed on health authorities and the Code of Practice.
Are midwives ready for interdisciplinary initiatives?
Authors: Castledine George
Published: May 2014

It gives me great pleasure to write an opinion column to celebrate 10 years of the BJM, and I congratulate all those concerned with its success.
Webwatch
Authors: McDonnell Cheryl
Published: May 2014

This month's chosen website is that of the Department of Health (DoH):

www.doh.gov.uk
Symphysis pubis dysfunction: improving the service
Authors: Wainwright Maggie , Fishburn Sarah , Tudor-Williams Nichole , Naoum Hikmet , Garner Val
Published: May 2014

Collaborative working to generate guidelines is a recommendation from the document Making a Difference (DoH, 1999). A protocol development group was set up to address problems in the existing care pathway, which had been identified by the Oxfordshire Symphysis Pubis Dysfunction (SPD) support group. The aims of the protocol development group were to make sure that all women who experience SPD have appropriate and timely diagnosis and treatment. The objectives were to develop a protocol which bridges professional roles and service/agency boundaries, and to raise awareness of the issue and protocol with professionals and women who use the service. The SPD protocol development group consisted of all those who might be affected by a clinical guideline, as advised by the National Institute of Clinical Excellence (NICE, 2000) and included the users of the service (DoH, 2000). A strategy of change in practice was designed. The experience of a collaborative project resulted in positive benefits for both the service, through the effect of the change, and for the members of the group who experienced personal and professional growth.
Step 60: NHS Professionals
Authors: Dimond Bridgit
Published: May 2014

The NHS Plan (DoH, 2000) had the aim of increasing investment into the NHS and at the same time meeting the significant challenges of the NHS. One of these challenges was to ensure that those working within the NHS were competent to provide the necessary services, such as the NHS University (Vol 11(11): 680). It was also envisaged that there would be a major expansion of the healthcare workforce.
Haemorrhage and the third stage of labour
Authors: Walsh Denis
Published: May 2014

Childbirth and haemorrhage have a familiar association for most practitioners of maternity care and though the clinical consequences are historically well established, one wonders whether the association always serves us well in contemporary maternity care. Take the third stage of labour. Here the link is so powerful it has spawned something quite unique — a quantifiable amount of 500 ml that actually defines postpartum haemorrhage (PPH). This seems to me unprecedented. Are there any other medical specialties where haemorrhage is not something diagnosed in individuals by practitioners and treated as appropriate on the basis of symptomlogy?
The HOOP study: robust evidence for perineal care?
Authors: McCandlish Rona , Renfrew Mary , Kettle Christine , Garcia Jo , Elbourne Diana , Bowler Ursula
Published: May 2014

Effective contemporary midwifery practice often combines the use of high level analytical skills with appropriate and unbiased communication of evidence to support women's decisions and choices. Although the results of sufficiently large randomized controlled trials provide the most robust evidence about comparative effectiveness of alternatives forms of care, all evidence should be subject to rigorous quality review, irrespective of its origins. This article demonstrates how criticisms that the conclusions of the HOOP trial were flawed and cannot be used to inform midwifery care for individual women, are wrong. In fact, HOOP provides clear and enduring evidence for women and midwives about important health outcomes and should be used to underpin discussion and practice of routine perineal care.
The routine childhood immunization programme
Authors: Elliman David , Bedford Helen
Published: May 2014

Immunization has been an important part of the health care of children in the UK since the introduction of vaccination against smallpox in the early 19th century. We are now able to prevent many infectious diseases that were previously the most important causes of death and disability in childhood.
Letters
Authors: Inch Sally
Published: May 2014

Confusion surrounding breastfeeding terms ‘positioning’ and ‘attachment’

In recent years, midwifery terminology surrounding breastfeeding has become increasingly precise. At the inception of the Baby Friendly Hospital Initiative (WHO, 1989), WHO and UNICEF agreed to use consistent terms which were easy to translate and non-idiomatic in order to make teaching easier. Thus in the breastfeeding course participant's manual (WHO, 1993) a distinction is made between positioning and attachment.
Webwatch
Authors: Hassall Jenny
Published: May 2014

The 26th Triennial Congress of the International Confederation of Midwives raised some poignant issues pertaining to the realities of pregnancy and childbirth from a global perspective. While these were passionately embraced by midwives at the time, there is a danger of forgetting them once we return to the realities of our own working lives. For this reason I have chosen to review:

www.safemotherhood.org
Shaken baby syndrome — caused by hospital care
Authors: Robinson Jean
Published: May 2014

A strange and salutary story has been unfolding in the back pages of a paediatric journal. A brief history shows how two clusters of ‘shaken baby syndrome’ killed premature babies in hospitals in England and New Zealand — deaths caused not by violent parents but by well-meaning staff (Williams and Sunderland, 2002).
Freedom of information
Authors: Dimond Bridgit
Published: May 2014

This article sets out the provisions of the Freedom of Information Act 2000, the exemption to the right of access and the implications for midwives.
Step 52: Disability discrimination
Authors: Dimond Bridgit
Published: May 2014

The Disability Discrimination Act was passed in 1995 and when fully implemented will give the disabled person certain rights in relation to employment, pensions and insurance, the provision of goods and services, access to premises, education and public transport. The main provisions of the Act are set out below in Figure 1.
Webwatch
Authors: McDonnell Cheryl
Published: May 2014

In a constructive attempt by midwives to create an internet information and support forum for parents with the assistance of other health and social care workers, this month's site was launched in 2002:

www.pregnancy.uk.net
Organic food — the view of a medical toxico-pathologist
Authors: Howard Vyvyan
Published: May 2014

Fetuses and babies are vulnerable to harm from toxic chemicals in ways that are different to adults. The process of development involves the opening and closing of a series of ‘windows’ of development. Any substance which disrupts hormone levels can interfere with the development of the embryo, maybe causing irreversible lifelong damage. Many common pesticides and household chemicals have hormone-disrupting properties. Some affect fetal growth at levels which don't appear to harm adults. A pregnant woman passes on part of her ‘body burden’ of persistent chemicals, firstly across the placenta and then to the newborn in her breast milk. (However, the benefits of breastfeeding still outweigh the risks). Most of these pollutants reach us in food of animal origin. Therefore, the easiest way to reduce our intake is to eat food containing the minimum amount of industrial chemicals, namely organic food. Useful actions to minimize children's exposure to toxic substances: 1) Prepare for pregnancy by eating organically grown food 2) Avoid dieting during pregnancy 3) Feed children on certified organic food.
Step 53: Consent to treatment
Authors: Dimond Bridgit
Published: May 2014

The Kennedy Report (Kennedy, 2001) on the Inquiry into paediatric heart surgery in Bristol emphasized in its conclusions that consent is not simply a signature on a form: it is the outcome from a process of communication between clinician and patient over the nature of the treatment and investigations proposed and the risks and benefits which could occur. Communication should be a two-way process and the questions of the patient should be answered fully and honestly. The signature should be evidence that this process has been followed and that the patient consents. Consent can also be evidenced by word of mouth and by non-verbal communication, but in situations where there are risks, it is preferable to obtain the patient's signature.
Harrogate: optimism and self-promotion
Authors: Magill-Cuerden Julia
Published: May 2014

The atmosphere for the Royal College of Midwives (RCM) annual conference Promoting the Business of Midwifery at Harrrogate indicated a new level of optimism for the future of midwifery, generating a view that we must believe in what we do to convey this message publicly to others. Promoting the business of midwifery has a purposeful sense in that midwives have to define the ‘product’ they are selling. Midwives will require training and education to meet the Government agenda; to accommodate changes required, support each other in the process and market what we are doing.
Step 54: National Patient Safety Agency
Authors: Dimond Bridgit
Published: May 2014

The National Patient Safety Agency (NPSA) was set up in July 2001 following the report An Organization with a Memory (Department of Health (DoH), 2000). This report recommended that the NHS would benefit from the aircraft business and the fact that lessons were learnt from every untoward incident. The report recommended that the DoH should examine the feasibility of setting specific targets for the NHS to achieve in reducing the levels of frequently reported incidents. For example it was suggested that by 2005 the number of instances of negligent harm in the field of obstetrics and gynaecology which result in litigation should be reduced by 25% (these cases currently account for around half the annual NHS litigation bill). Following the report An Organization with a Memory, the DoH's (2001a) published Building a Safer NHS for Patients which set out details of a scheme for national reporting of adverse incidents, together with recommendations for an improved system for handling investigations and inquiries across the NHS. Subsequently in July 2001 the NPSA was set up with the aim that there would be a mandatory reporting system for logging all failures, mistakes, errors and near misses across the health services (DoH, 2001b).
Folic acid — changes in women's knowledge
Authors: Relton Caroline , Jackson Ann , Burn John
Published: May 2014

Taking folic acid supplements in the peri-conceptional period and during the first trimester of pregnancy is associated with a reduced incidence of neural tube defects. This study aimed to investigate changes in knowledge and attitudes to folic acid supplementation following advice to health professionals about the recommended use of folic acid supplements by all women of childbearing age. A questionnaire-based survey was conducted in 1996 and 2002 on 450 women. Most women were not offered folic acid before conception and but were offered supplements on confirmation of their pregnancy. There was a 2.5-fold increase in the number of women buying their own supplements, the majority of whom took these before conception. There was a decline in the number of women receiving no advice at all about folic acid supplementation and supplementation in women with a family history of neural tube defects increased 2-fold. The findings of this study support an increased awareness of the benefits of peri-conceptional folic acid supplementation, however, this was primarily observed in primagravida women and supplementation compliance decreased with pregnancy parity.
Is abortion due to handicap ethical?
Authors: Lewis Marie
Published: May 2014

Abortion up to 24 weeks gestation was made legal under the Abortion Act 1967 as amended. It is legal subject to agreement by two doctors that continuing with the pregnancy would damage the physical or mental health of the pregnant woman, or that of her existing family. The only instance where abortion is legal after 24 weeks gestation abortion is where the pregnancy represents a risk to the woman's life, or grave, permanent injury to her health, or if there is substantial risk of serious fetal abnormality. In this article the author will demonstrate why she agrees that abortion on the grounds of handicap is legal but unethical. Abortion without special exception may be ethical using a maternal rights argument, but making special grounds for handicap is not ethical. The ethical arguments for and against this will be presented under three main headings: fetal interest, the replacement argument and maternal interest. The most convincing argument is that of parental interests, especially maternal. However the premise of this argument could be applied to any abortion and therefore still does not highlight a need for a special consideration for handicap.
National champion for the three R's
Authors: Walsh Sandra
Published: May 2014

In 1993, following the publication of the Changing Childbirth report (Department of Health (DoH), 1993) the focus of the maternity services was on choice, continuity and control. A decade later, at the Royal College of Midwives conference in May 2003, Jackie Smith, Minister for Health until June 2003, announced the Government's strategy for midwifery: recruitment, retention, and return to practies.
Baby friendly: a way to accreditation. Part 1
Authors: Rogers Marilyn
Published: May 2014

In March 2002 the maternity unit at the Calderdale Royal Hospital in Yorkshire became accredited as a ‘Baby friendly hospital’. This article is a personal account of how the Calderdale Royal Hospital improved standards of care for breastfeeding mothers and documents one approach to success. It follows the collaborative process leading to accreditation and includes information regarding the guidelines and literature developed to support and implement the initiative. This is the first of two articles documenting the process, and it focuses on Steps 1 and 2 of the Ten Steps to Successful Breastfeeding programme (UNICEF, 1998).
Understanding the reasons why mothers die
Authors: Shennan Cathy , Shennan Andrew
Published: May 2014

The Confidential Enquiry into Maternal Deaths (CEMD), initially set up in 1952, is the longest example of national professional self-evaluation. It now comes under the umbrella of the National Institute of Clinical Excellence (NICE). This article summarizes its latest publication, Why Mothers Die 1997–1999, which reviews the leading causes of direct and indirect deaths and, in particular, considers some key recommendations for clinical practice.
The importance of emotional intelligence
Authors: Hunter Billie
Published: May 2014

What is an ‘emotionally intelligent’ midwife? Why do we need to be emotionally intelligent? Why now more than ever before?
Spontaneous versus directed pushing
Authors: Chalk Amanda
Published: May 2014

Much debate exists between spontaneous and directed pushing in the second stages of labour. Whilst directed pushing seems common practice in delivery rooms, there is evidence to suggest that this prescriptive technique should be avoided. Conversely, sufficient evidence exists supporting spontaneous pushing – where the woman is allowed to follow her own instincts. Furthermore, spontaneous pushing is advocated as it avoids the adverse effects to the woman and fetus that directed pushing may cause. This final article compares spontaneous and directed pushing, provided maternal and fetal wellbeing is maintained and labour is progressing normally.
Shaping maternity services in Scotland
Authors: McGuire Margaret , Dagge-Bel Fiona , Purton Patricia , Thompson Monica
Published: May 2014

This article is the first in a series which describes maternity services in Scotland. Although part of the UK, culturally and geographically Scotland is very different and this is reflected in the way health and maternity services are planned, organised and delivered. Scotland has a mainland area of 28,269 square miles (73,217 square kilometres); including inhabited islands, it has an overall area of 30,418 square miles with a population of five million. In contrast the total area of Wales is 20,768 square kilometres (8019 square miles) with a population of 3 million and Northern Ireland is 5,240 square miles in size and has a population of 1.69 million. England meanwhile, is 93,000 square miles in size with a population of 58 million people. So, although Scotland is 25% the size of England it only has 8.5% of the population. Not surprisingly, remote and rural health and maternity care figure greatly on the Scottish Executive Health Department agenda and a Remote and Rural Resource Initiative is in place to address specific remote and rural health care issues.
Caring for pregnant asylum seekers
Authors: Page Lesley
Published: May 2014

This summer I provided advice to women working with Legal Action for Women (LAW), based at the Crossroads Women's Centre, which was challenging the imminent deportation of a pregnant woman. It is still difficult to believe that a country like ours which prides itself on fair justice could create a system that is as inhumane as it is to asylum seekers. Often it takes one ‘case’ to portray the extent of the problem; this experience was a vivid reminder to me.
Good character and good health
Authors: Dimond Bridgit
Published: May 2014

Article 5.2.b of the Nurses and Midwives Order 2001 requires the NMC from time to time prescribe the requirements to be met as to the evidence of good health and good character in order to satisfy the Registrar that an applicant is capable of safe and effective practice as a nurse or midwife. A new requirement of the new register is that those coming onto the register or renewing their registration must provide a declaration of their good health and good character. An NMC consultation on how this evidence should be provided resulted in the NMC deciding that applicants for re-registration should make a self declaration and guidance on this is given in a recent NMC circular 06/2004. There is also guidance for educational bodiesaccepting students on courses that lead to NMC registration. The definitions the NMC use are:
Cot deaths: still blaming the mother?
Authors: Robinson Jean
Published: May 2014

More glaring headlines: ‘Sleeping with mother kills babies’. And this came from a study covering 12 centres in Europe, so it must be true (Carpenter, 2004). When we read The Lancet, we find that sleeping in the same bed as a non-smoking mother did not increase risk after the baby was 8 weeks old.
Development of childhood asthma and formula milk
Authors: Ram Felix , Scarlett Jane
Published: May 2014

The aim of this article is to estimate the effect of dietary avoidance of standard cows milk protein on the development of asthma and/or wheeze in infants with a family history of atopy using a systematic review of all available randomized controlled trials. Eleven trials were included in the review. The results show that risk of infants experiencing asthma or wheeze during the first year of life was reduced when using hydrolysed milk formula instead of standard cow's milk formula. Use of soya-based formulas did not reduce the risk of having asthma or wheeze. This article concludes that breastfeeding should be the treatment of choice for all babies. However, where supplemental feeding is required, hydrolysed formula (in combination with dietary restrictions and reduction in environmental allergen exposure) significantly reduces the risk of developing asthma or wheeze in the first year of life in infants with a family history of atopy. Currently, there is insufficient evidence to suggest that soya-based milk formula modifies the risk of developing asthma or wheeze.
Midwifery education in Wales
Authors: Hunter Billie , McAteer Van , Paden Liz , Thomas Nancy , Williams Gail
Published: May 2014

The geography and size of Wales presents challenges and opportunities to midwifery educationalists working in the four Schools of Midwifery. Student numbers are relatively low and most education provision is concentrated in a limited geographical area. However, the small size facilitates liaison and communication between educationalists, and between educational and clinical areas. Developing the Fitness for Practice curricula has led to new initiatives and collaborative working, culminating in the development of the Welsh Association of Midwifery Lecturers and Heads of Midwifery Education group. This has created a stronger voice for midwifery education. There are many new education developments including a proposed increase in the provision of the three year pre-registration programme, bilingual schemes designed to address the needs of Welsh speakers, and advances in E-learning. Clinical practice innovations aimed at normalising childbirth have important implications for education providers, and offer new opportunities for collaboration and research.
Webwatch
Authors: Hassall Jenny
Published: May 2014

Recent figures demonstrate encouraging results in the under-18 conception rate since the Government launched its Teenage Pregnancy Strategy. However, the UK continues to have the highest rate of teenage births in Western Europe. Current figures suggest that around one in 15 of all births will be to women aged under 18. Not only dothese women experience poorer maternity outcomes; they also experience poorer access to maternity and child health services. This has a longterm impact on the health and wellbeing of both the mothers and their babies. Research suggests that these poor outcomes are not inevitable and are affected by teenagers' low uptake of antenatal and postnatal support. It is imperative that midwives continue to take a positive approach to address this problem. Much can be learnt from the innovative projects taking place nationwide. The following website is an exemplary example of sharing such information.
When and why should cord samples be tested?
Authors: de Silva Mahes
Published: May 2014

Cord blood samples are an excellent source of blood cells from the infant and are easy to collect soon after delivery. They are taken for laboratory tests in two instances; when the mother is Rh-negative and when a woman has red cell antibodies detected during pregnancy. Two types of tests are performed on cord samples: D blood grouping to identify mothers who have delivered RhD-positive infants, so that the mother can be offered anti-D prophylaxis (RCOG, 1999); and Coombs test to identify infants at risk of haemolytic disease of the newborn (BCSH, 1996).
Exploring midwives’ attitude to teenage pregnancy
Authors: Shakespeare Debrah
Published: May 2014

Britain has a problem with teenage pregnancies (DoH, 1992) and is said to have the highest teenage pregnancy rates in Europe (Social Exclusion Unit, 1999). As a result, a commitment has been made by the present Government to reassess issues surrounding this subject. However, society appears to have adopted a belief that teenage pregnancy occurs as the result of reckless behaviour (Health Education Authority, 1998). The question is, therefore, do midwives also hold such feelings and attitudes, and does this effect the care that they deliver? This study was conducted to explore the attitudes of six community midwives working in the north of England. It adopted a phenomenological approach, examining the lived experiences offered by these midwives. Emerging themes are presented, and discussion relating to the findings, showing that the midwives had encountered some dilemmas through their experiences with pregnant teenagers. Implications for future midwifery practice are identified, including the need for support for those midwives experiencing some tough dilemmas that they encounter through their daily practice.
Collaboration is key for real changes within midwifery
Authors: Newburn Mary
Published: May 2014

The National Childbirth Trust's (NCT) vision is for women and their partners to have a positive experience of birth and the transition to parenthood. We – like midwives – work with parents by providing information, one-to-one and group support, and facilitating informal social networks.
Network approach boosts midwives' public health role
Authors: Edwards Grace , Gordon Una , Atherton Janet
Published: May 2014

There is a strong government focus on public health which is evident within the primary care trusts and a number of key national policy areas require an increasing public health focus to midwifery work. The full potential of midwives contribution’ to public health is not being realized, as there is little formal contact between midwives and public health partnerships. Midwives are ideally placed to develop their public health role, but many feel isolated and unsupported in their personal development. This paper describes the development of a network model that will support the development of midwifery and public health as part of a community-based, multidisciplinary partnership approach to the care of women and their families.
UK contributes to international development fund for African mothers
Authors: Daniels Lincia
Published: May 2014

Freelance journalist Lincia Daniel takes a look at news from across the globe on maternity care, motherhood and women's health issues.
Exploring midwives' attitudes to domestic violence screening
Authors: Barnett Carol
Published: May 2014

Women have a lifetime risk of 1 in 4 of being the victim of domestic violence and pregnancy can trigger or initiate this. The government recommends that midwives start to routinely ask pregnant women about domestic violence. However, we do not know what the attitudes of midwives are to asking these questions particularly those who have personal experience of domestic violence. 236 Midwives in Tayside, Scotland, were asked to complete a questionnaire to identify their needs when preparing to ask women about domestic violence and to disclose if they had personal experience of domestic violence. Almost 19% of midwives disclosed that they have been in violent relationships. Midwives acknowledged the need to ask women but they were anxious that a support system was in place for themselves and their abused colleagues who may face particular problems. Adequate training to prepare for asking about domestic violence would be required.
Suturing methods for perineal tears following spontaneous vaginal delivery
Authors: Blincoe Alana Juman
Published: May 2014

About 350,000 women in the UK each year need sutures for perineal injury, following spontaneous vaginal delivery, with the figure running into many millions worldwide. (Kettle et al, 2002). Perineal injury can take the form of perineal tears and/or a surgical cut (episiotomy). It is vital that the most appropriate form of suture and suturing technique is executed well, to ensure the injury is repaired well. In so doing, it may avoid prolonged pain and the incidence of incontinence in women. The best form of suture for such lacerations are absorbable sutures, which are best applied using the continuous method.
Milk advertising should not be allowed in journals
Authors: Sachs Magda , Allen Mark
Published: May 2014

Formula milks intended for babies under the age of six months cannot be advertised directly to the public in the UK. However, they can be advertised in health professional journals, as long as they contain ‘only information of a scientific and factual nature’ (DH, 1995). If the government allows journal advertisements, why argue against them?
Prenatal cleft lip and palate parent programme – phase 1
Authors: Martin Vanessa
Published: May 2014

The first child diagnosed with a cleft prenatally in a the Nottingham Cleft Lip and Palate Unit, was aborted after another parent had given misleading information. Concern over this incident led to a protocol of care being developed at the unit followed by an evaluation of expectant parents' responses to this protocol.

Ten parents were interviewed as part of a study. The aim of this research was to assess whether the information and support given to families was appropriate and helpful; explore parent's feelings about their pregnancy and their child and identify ways of further developing support for these parents.

From an analysis of parents comments the study found that in cases of cleft lip and palate, what parent wanted most was: an accurate diagnosis; prompt referral to a cleft team; support from a named clinical nurse specialist; pictures relevant to their child's diagnosis to show family and friends; and a meeting with professionals to plan the care of their child.
Ethnic minorities' access to antenatal screening
Authors: Rowe Rachel , Garcia Jo
Published: May 2014

Antenatal screening is a crucial component of antenatal care, with midwives playing a key role in offering screening and providing information which can enable women to make an informed choice. The authors carried out a systematic review to examine whether women from ethnic minority groups experience reduced access to antenatal screening, either through not being offered screening or because they are less likely to take up screening when offered. In the studies reviewed it was often not possible to distinguish between the offer of testing and whether women took up the offer. However, this review provides evidence that women from some ethnic groups are less likely to receive screening for certain conditions and that these women may also be less likely to be offered screening. These findings are discussed and the implications for midwifery practice considered.
Protecting victims
Authors: Dimond Bridgit
Published: May 2014

It was reported in December that in a UK police offensive, code named Operation Athena, 150 people were arrested in dawn raids as part of a campaign to tackle domestic violence and the rise in the number of women murdered by their partners.
Will the new NSF be more successful than Cumberlege?
Authors: Dimond Bridgit
Published: May 2014

A new maternity services standard published as part of the National Service Framework (NSF) for Children Young People and Maternity Services, published in September 2004 set out some principals that midwives may have heard before.
Tackling domestic violence during pregnancy
Authors: Morgan Jane E
Published: May 2014

Domestic violence is a serious criminal, social and medical problem that has profound effects on a person's health, well-being and development. It is often described as a ‘hidden crime’ as it is severely under-reported and, because of its complex nature, is difficult to research. This sort of violence is most commonly perpetrated by men against women and their children. The most common factor behind domestic violence is the exertion of power and control over another individual. Domestic violence has been shown to start or intensify in pregnancy and further increase in the postnatal period leading to maternal and fetal morbidity and mortality. The Department of Health advocates that the NHS incorporates policy and training for health professionals to support women who are experiencing, or have experienced domestic violence. Policy states that midwives are ideally placed to support women who may be in abusive relationships. However, in order to do so, midwives require adequate training and support within maternity services.
Consent, medical students and anaesthetized women
Authors: Robinson Jean
Published: May 2014

You don't have to be a women's health activist for long to learn that victories are never really won. They are at best partial, and when you think you have achieved an advance, you soon realise the backlash, subversion or sidelining got going before the ink was dry on the paper. It's not the exception: it's the norm, and like a good girl scout you have to be prepared.
Book Reviews
Authors: Richens Yana
Published: May 2014

Eyes Without Sparkle: a journey through postnatal illness, is one woman's experience of the turbulent journey into through and out of postnatal depression.
Fetal congenital heart disease detection and care
Authors: Blincoe Alana Juman
Published: May 2014

In the vast majority of births no problems are found. However, one out of every 125 babies is born with some form of heart defect. Congenital heart disease (CHD) can range from being so slight a baby appears healthy for many years with no symptoms, or it can be so severe that it becomes life threatening. However, the use of fetal screening at the recommended 20-week stage of pregnancy, can inform decisions on whether in utero treatment of a CHD can be carried out or whether prompt surgical procedures following birth are more appropriate. The last 40 years have seen great advances in technology and surgical procedures, which are enabling more children with CHD to live near normal to normal lives.
Ethical risks in research: the midwife's role
Authors: Robinson Jean
Published: May 2014

Those Swedish midwives must have been proud of what they did at the time. They had been asked to prepare pregnant women for tests for a research project, and when the results were published in a prestigious medical journal, each was named and thanked by the authors (Strevens et al, 2003a, 2003b).
A fond farewell from consumer comments
Authors: Robinson Jean
Published: May 2014

It was just a chance meeting at one of those conferences. I ran into Christine Henderson, BJM's editor-in-chief during the coffee break, and she asked if I would like to write a consumer piece for the journal. That was more than 10 years ago, and I have been poking, prodding and praising its readers ever since. I couldn't wait to jump on my latest hobby horse, to share my delight in the terrific book I had discovered or my indignation at the latest obstetric disaster. Now the journal is changing, and this column will end, but the work goes on.
Is there a role for midwives in family planning?
Authors: Norris Sarah
Published: May 2014

As part of their sphere of practice we, as midwives, have a duty to offer family planning advice (Nursing and Midwifery Council as specified by the EU Second Midwifery Directive 80/155/ EEC Article 4—activities of a midwife “To provide sound family planning information and advice” (Nursing and Midwifery Council (NMC), 2004). We are also required to offer information to enable women to make choices regarding screening for sexually transmitted diseases such as syphilis, hepatitis B and C and Human Immunodeficiency Virus (HIV). In my professional experience, and taking into account the predominance of articles which focus on this latter area of practice in the literature, I would question whether the maternity services place more emphasis on the midwife's role in antenatal screening for sexually transmitted diseases rather than giving contraceptive advice. From the dearth of literature regarding contraceptive advice found in the midwifery journals, it might be supposed that less value is attached to offering contraceptive advice. Perhaps we should be asking how effective we, as midwives, are in fulfilling this aspect of our role?
Optional screening for DMD: reasons given by mothers for opting in or out
Authors: Parsons Evelyn P , Israel Janet , Hood Kerry , Bradley Don M
Published: May 2014

Mothers of baby boys in three areas of the UK were offered a newborn screening test for Duchenne Muscular Dystrophy (DMD) as an extra, optional test. They were asked to complete a short questionnaire which provided data on their decision about screening, their reason and their occupation. The aim of the study was to explore the reasons women gave and any associations between reason given, uptake and occupation. The reasons given reflected three perceptions of screening: screening as a routine procedure; screening for reassurance; screening for disease detection. Women who accepted the test were more likely to give a routine reason than those who refused it. Screening was more likely to be seen as providing reassurance as one moved down the occupational hierarchy. Midwives should be aware that even though a screening test is delivered as an optional extra it may still be regarded by some women as routine.
Development of a skilled midwifery training course for Bangladeshi nurses
Authors: Tasnim Saria , Rahman Animur , Shahabuddin AKM
Published: May 2014

The experience of different programmes of the global ‘Safe Motherhood’ initiative since 1987 have identified that the presence of a skilled attendant at the time of delivery is essential in order to detect and manage obstetric emergencies and save lives. Maternal mortality is high in Bangladesh and the coverage of skilled birth attendants is inadequate. The objective was to develop and implement a task-based curriculum on skilled midwifery for nurses. The curriculum, consisting of eleven modules, was developed in the context of adopting standard procedures of curriculum development in Bangladesh and was implemented by conducting one year of training for ten diploma nurses. Evaluation was undertaken through regular assessment of trainees, eliciting the opinion of trainees regarding the readability of curriculum contents, relevance and methods and fulfillment of expectations. The curriculum contents, teaching methods and assessment procedures were found appropriate for the training of skilled nurse midwives in Bangladesh.
Desirable, achievable, but not easy: The midwife role in Kalongo Pader
Authors: Carmel Abwot Sister
Published: May 2014

There is little knowledge or understanding of the role of the midwife operating in Kalongo Pader, Northern Uganda: the rural area on which this article focuses. The midwife role has been very poorly documented, although the scale of the task is huge. Twenty years of insecurity have fortunately not lessened the commitment of these multi-skilled professionals to the care of mothers and infants in this very difficult area. The midwife role is unique in offering care and treatment throughout the birth process. In this article these comprehensive skills are described: midwives fulfil the role of teacher, technician, counsellor and a resource for colleagues and collaborate with a skilled medical team. The midwife provides a crucial bridge between the community and other service providers. The author is a midwife tutor with nine years experience of teaching midwifery skills that are focused on training students with the vision to serve in the most difficult environment and to promote integrated reproductive health care and client-provider interactions.
Ceasing to practise midwifery: Working life and employment choices
Authors: Curtis Penny , Ball Linda , Kirkham Mavis
Published: May 2014

In 2004, the National Midwifery Recruitment Retention and Return to Practice Project was launched to co-ordinate recruitment into and retention within the midwifery workforce. Findings from the Why do Midwives Leave? study (Ball, Curtis and Kirkham 2002) provide insights into the employment choices that midwives made when they ceased to practice as midwives. Two thirds of leavers continued in paid employment outside of midwifery. The overwhelming majority of these found alternative employment in a health related area. As the National Health Service redoubles its efforts to entice midwifery leavers back to practise, it is important to recognize that many have already secured alternative employment. These new jobs may be fulfilling many, if not all, of midwifery leavers work-related needs.