bluuebunny/crossref_metadata_2025 huggingface dataset:
Breastfeeding, co-sleeping and the prevention of SIDS
Authors: Pemberton Denise
Published: May 2014

This article discusses some of the cultural and ethical issues with regard to co-sleeping in the promotion of breastfeeding and the prevention of Sudden Infant Death Syndrome (SIDS), in the light of current evidence, within present UK culture. It explores the issue of ‘informed choice’ for parents, with particular regard to working within the UNICEF UK Baby Friendly Initiative best practice standards in the UK. A description of the work, within a local area, to establish evidence-based guidelines following heightened awareness of the conflict between two important health promotion issues. The conclusion reflects on the health promotion initiative, the effect it has already achieved and is likely to achieve in the long term, and how it is likely to be evaluated.
Community midwives and obstetric equipment
Authors: Mainstone Adrian
Published: May 2014

In an age of modern technology the community midwife relies on her own professional skill and some fairly basic equipment. Although certain equipment is provided by NHS trusts, much of the content of a midwife's car boot is a collection of items assembled by her/himself. With a growing emphasis on the return to home births it is imperative that the community midwife has the correct equipment to ensure the well being of the mother and baby. Trusts should ensure that their community midwives are provided with the most practical and up-to-date tools to effectively realise their expertise in the best possible way.
Informing women during vaginal examinations
Authors: Lewin David , Fearon Brenda , Hemmings Valerie , Johnson Gail
Published: May 2014

In a small, multi-centre study conducted in three maternity units in Cambridgeshire, England, a prospective, analytical survey design employing postal questionnaires was used to investigate women's experiences of vaginal examinations in labour. An unselected, consecutive, random sample of 104 primiparae participated in the research of whom 73 returned completed questionnaires, a response rate of 70%. Regarding information-giving during vaginal examination in labour, approximately two thirds of women rated the information provided by midwives as good or very good, the equivalent figure for doctors being one third. A Likert scale addressing ten broad elements of information-giving generated a total of 715 responses of which 63% were positive, 18% were negative and 19% were in between. These findings suggested, on average, that while three fifths of women reported positive experiences of information giving, almost a fifth had negative experiences overall and a further fifth also had, mediocre communication experiences related to their vaginal examinations in labour.
Registration of stillbirths: What midwives need to know
Authors: Jones Shirley R
Published: May 2014

For the last thirteen years, midwives and doctors across the UK have worked with the following definition of a stillbirth: ‘A child which has issued forth from its mother after the 24th week of pregnancy and which did not at any time after being completely expelled from its mother breathe or show any other signs of life.'
Professional power and maternity care: The many faces of paternalism
Authors: Walsh Denis
Published: May 2014

Paternalism in the wider health services, though frowned on by many practitioners and consumers, has been widespread in the past and remains endemic in some areas in the present. This may be because it has a benevolent face: the desire to protect the public from information or situations that the professionals deem potentially injurious to them.
RCM Welsh Board delivers on the future
Authors: Jones Kath , Tinsley Lorna
Published: May 2014

Following the success of last year's Royal College of Midwives (RCM) annual conference in Wales, midwifery in the principality has been the topic of much discussion and debate. The conference did much to dispel the ‘fluffy sheep’ myth and the ‘swollen head syndrome’ almost took over as we enjoyed the praise for the proactive culture of midwifery in Wales. We sang: ‘We’ll keep a welcome in the hillsides’ and we extend that welcome once again to the RCM UK Board for Wales annual conference which takes place in March ahead of the general RCM conference in Harrogate in May.
Challenges of caring for homeless pregnant women – 1
Authors: Wood Tracey , Watts Kim
Published: May 2014

This is the first in a series of two articles on how homelessness can affect a pregnant woman's access to maternity care and the quality of care that she receives. It will look at the impact of homelessness on pregnancy and health and examine the role of the midwife when caring for homeless pregnant women, in the context of the new public health strategy. It will also focus on the public health role of the midwife in terms of existing policy and social strategy on homelessness.
The booking visit – a tick box takeover?
Authors: Robinson Jean
Published: May 2014

Complaints about postnatal care in hospitals are common, especially from women who have had caesareans or instrumental births. But complaints about the very first contact with hospital antenatal care? That's fairly recent, and although we haven't had many so far, they seem to be increasing.
The question is how many my lord?
Authors: Richens Yana , Creighton Sarah
Published: May 2014

In the House of Lords on 3 March 2005, Baroness Ruth Rendell of Babergh asked Lord Goldsmith the Attorney General: ‘How many prosecutions have there been under the Female Genital Mutilation Act which received Royal Assent on 3 March 2004?’ The reply was that no such prosecutions have taken place. (House of Lords (HL), 2005).
Webwatch
Authors: Carr Natasha
Published: May 2014

The Nursing and Midwifery Council (NMC) stipulates that to maintain professional registration as a midwife it is necessary to fulfil Post Registration Education and Practice (PREP) requirements. PREP is designed to help midwives keep up to date with new developments in practice and encourage thinking and reflection by practitioners.
Webwatch
Authors: Hassall Jenny
Published: May 2014

The use of self-help remedies in pregnancy is widespread and evidence suggests that it may well be on the increase as women are actively encouraged to take more responsibility for their health and information becomes more widely available on the web. There is an inherent danger that non-pharmaceutical remedies may be taken without due care or appreciation of their potential impact on pregnancy and labour.
Symphysis pubis dysfunction: a hidden cause of morbidity
Authors: Shepherd Jancis
Published: May 2014

This exploratory study used a Heideggarian phenomenology to describe the experiences of women suffering from Symphysis Pubis Dysfunction (SPD) during pregnancy and three months after childbirth. Data were collected from a purposive sample of nine women, one and three months after birth, using a semi-structured interview schedule. Analysis was based on Colaizzi's (1978) framework for phenomenological analysis. Four main themes emerged: pain, lifestyle adaptation, emotions and health professional's support and information. Each theme illustrated the wide ranging effects of SPD on women and their families. Postnatally, pain prevented the women from caring for themselves, their families and homes.
Book Reviews
Authors: Casey-Hardman Corina
Published: May 2014

I opened this book with trepidation, having previously waded through an array of research textbooks and having come out none the wiser. However, I was pleasantly surprised. Fortuitously, this book was published while I was completing my masters dissertation and I used it as my lifeline to research theory and process.
Learning from the past: a midwife's tale
Authors: Robinson Jean
Published: May 2014

There was a pile of official reports I should have been reading but I am always hooked as soon as midwives start talking about their work. I could not resist the memoirs of a midwife who had trained and worked in the 1950s in the East End of London – the area where my grannie had borne and raised eight children. With memories of visits where I marvelled at her big pots of stew, shining brass bedstead and snowy white bed valances, I was unprepared for Jennifer Worth's vivid account of the devastating poverty and cramped, filthy living conditions in the area in such recent times (Worth, 2002). And this was soon after the 1939–45 World War, when there was full employment and the population, though battle-scarred, was far more prosperous and better fed than in pre-war days. The nuns who trained her, lived and worked in a deprived area around the London docks, where policemen went in pairs, but the highly respected midwives were safe to cycle alone.
Non-invasive chlamydia testing of pregnant teenagers
Authors: Hay Sima , Oakeshott Pippa
Published: May 2014

This article looks at a pilot study to assess the acceptability of non-invasive chlamydia testing using self-administered vaginal swabs in pregnant adolescents attending a Teenage Antenatal Clinic. Forty pregnant teenagers were asked about their views on chlamydia screening in a cross sectional questionnaire based survey. We used quantitative methods to determine the acceptability of non-invasive chlamydial testing. The majority of the teenagers involved in the stufy found doing the swab easy. The main reasons given for acceptance of testing were the simple non-invasive self-administered screening procedure and the potential benefits for their own health and that of their baby. All 40 chlamydia tests were negative, but four teenagers had recently been treated for chlamydia infection.
Midwifery in Scotland 4: the shaping of postnatal care
Authors: Reid Lindsay
Published: May 2014

This is the fourth and concluding article in the series on midwifery in Scotland from 1916-1983. It explores aspects of midwifery practice during the postnatal or lying-in period. Postnatal care is a wide field encompassing care of both mother and baby. This article will give a brief overview of CMB Rules on postnatal care and examine the custom of keeping mothers in bed for ten days postnatally and how this changed. With early ambulation of mothers coinciding chronologically with rising hospital birth rates and a shortage of hospital beds, the next step was early discharge home for mothers and their babies. Where appropriate and where space allows oral testimonies from midwives are used. This examination of midwives' historical postnatal practice illustrates how much autonomy midwives maintained in an area of great importance to mothers and their babies.
Changes to rules on complaint handling
Authors: Dimond Bridgit
Published: May 2014

Research commissioned by the Department of Health (DH) into the effectiveness of the complaints system set up in 1996 under the Wilson recommendations has resulted in new regulations on complaints being introduced. A statutory complaints procedure came into force on 30 July 2004 in England, which midwives and other health professionals must now observe.
Dealing with breast and nipple soreness when breastfeeding
Authors: Bainbridge Jane
Published: May 2014

One of the most likely reasons for women to stop breastfeeding in the early stages is because of discomfort and pain in the nipples and breasts. The primary cause of this pain is that the baby is not latching on properly and so it is a critical time for midwives to offer advice on the correct positions and techniques for feeding. Most pain is alleviated quickly once the baby is latching on properly. There are some products available to help ease the symptoms and pain associated with breastfeeding and engorgement such as gel packs, nipple cream and shields. Others, such as breast pads and shells, can help with milk leakage. While the success of these products varies from mother to mother the most crucial factor for ensuring feeding is comfortable is breastfeeding technique.
Those ‘wicked’ maternity issues
Authors: Gould Debbie
Published: May 2014

David Nicholson, new Chief Executive for the NHS, stated in his first speech (Carvel, 2006) that it was now time to deal with the ‘wicked’ issues of maternity services while announcing far-reaching reforms which will close maternity units and help to relieve the NHS's £512 million deficit. He said ‘redesigning’ services will ‘improve’ care and these improvements will come about by ‘concentrating key services in fewer hospitals’. He is confident that the public will support the changes if ‘doctors’ are won over to give their ‘support’. Will doctors support centralisation of maternity services? Of course they will because the professional dominance will continue and maternity care will become more medicalized. Obstetric practices thrive in the mass consumer market rather than the small entrepreneurial units of midwifery-led birth centres.
USA imprisons pregnant women to protect their unborn babies
Authors: Daniel Lincia
Published: May 2014

Lincia Daniel reports on the US trend for prosecuting pregnant women with drug and alcohol problems because of the risk to the fetus. Also at risk are the clay-eating women of Senegal and the African women whose birth attendants need training.
Primary care of women: A guide for midwives and women's health providers
Authors: McKay-Moffat Stella
Published: May 2014

This weighty tome of 938 pages, at £44.99, addresses a diverse list of issues relevant to the health of women today. It has been edited by three American certified nurse midwives who hold professorships. Contributors to the book appear to have a multiplicity of qualifications, expertise and clinical and academic experience. This has resulted in a book that contains high quality information. Although written with American nurse midwives in mind, it will fill a distinct void in the availability of comprehensive text for British midwives on women's health issues. Similarly it would be useful for midwives who work comparably in other countries, as well as other health professionals with an interest in women's health. Student midwives will find the detail significantly beneficial.
The curtain: for privacy or safety?
Authors: Magill-Cuerden Julia
Published: May 2014

If you visit postnatal or antenatal wards you will find that within bed bays, each bed is shrouded by curtains. This, in effect, affords privacy to each woman, her baby and her visitors. If you attempt to pull back the curtains they will be drawn to again within a very short space of time. This habit appears to have crept into an accepted routine over a period of years.
Maternal mortality in Ethiopia: tragedies we can prevent?
Authors: Clift-Matthews Victoria , McKenna Nancy Durrell
Published: May 2014

We're all loving the stunning pictures in the new BJM 2007 calendar taken by Nancy Durell Mckenna. In this interview Nancy talks about the work of the charity she set up called ‘Safe Hands for mothers’.
Survey identifies acute risk to infant and maternal health in Iraq
Authors: Bainbridge Jane
Published: May 2014

Freelance health writer Jane Bainbridge takes a look at news from across the globe on midwifery, maternal and infant health and reproductive issues.
Be prepared, expect the unexpected and above all, communicate
Authors: Bainbridge Jane
Published: May 2014

Expectant parents entertain great hopes for the birth experience, but the actual event may turn out to be very different. Freelance writer Jane Bainbridge discusses realistic preparations for birth.
Are we transferring women into the community too quickly?
Authors: Baker Lisa
Published: May 2014

Length of postnatal hospital stay has declined dramatically in the past 50 years. However, there is ongoing controversy concerning whether or not staying less time in hospital is harmful or beneficial to both mothers and babies. This article proposes to examine the relevant literature, debate the opposing views and offer a personal opinion on the subject. The focus is on the discharge of healthy mothers and term infants only, not those with health needs.
What are the qualities of a good intrapartum midwife?
Authors: Muirhead Dame Lorna
Published: May 2014

The move into mainstream midwifery from a training environment presents many challenges. Dame Lorna Muirhead offers her view on the skills and wisdom the practising midwife needs to develop.
Optimum maternal nutrition for a healthy pregnancy
Authors: Blincoe Alana Juman
Published: May 2014

Although there is conflicting research on maternal nutrition and birth outcomes, government guidelines stress the need for pregnant women to have a balanced diet and to take certain vitamins and minerals. Many women who have babies with a low birth weight are usually from a low-income background and unable to provide themselves with an adequate diet. It is well noted that babies born underweight are more likely to suffer from illnesses, disabilities or die. Midwives are in an ideal position to advise all women on the best nutritional diets when pregnant and to make sense of the variety of supplements currently on the market. Folic acid is a ‘must have’ supplement, which is proven to reduce the incidence of neural tube defects in babies. While essential fatty acids (EFA's) are fast becoming the next essential supplement for mothers to ensure brain development and a longer gestation period, which increases birth weight.
The effects of sexual abuse on childbearing: Antenatal care
Authors: Simpkins Rachel
Published: May 2014

High levels of female sexual abuse means that many survivors will utilise maternity services. This brief paper examines the physical and emotional difficulties experienced by sexual abuse survivors during pregnancy. A literature review was implemented to avoid sexual abuse survivors reliving past abuse through interview and themes were identified and analysed. Loss of control during pregnancy may present problems for sexual abuse survivors and they may have difficulty trusting staff. All women should be asked about a sexual abuse history. Documentation of disclosure must be with the woman's consent.
Can domestic violence be considered a violation of human rights law?
Authors: Hughes Breedagh
Published: May 2014

Steiner ' Alston (2000) claim that domestic violence exists “in all regions classes and cultures” and that “domestic violence is a common and serious problem in developed and developing countries alike”.
Approaches to sociology within midwifery education
Authors: Church Sarah , Earle Sarah
Published: May 2014

The research on which this article is based has been stimulated by debates on whether sociology should be included in the curricula of the allied health professions. This article examines the role of sociology within midwifery education by drawing on a study of 29 providers of pre and post-registration midwifery education in England who participated in a survey conducted by postal questionnaire. Questionnaires explored how sociology was integrated into the curriculum focusing on course delivery, content and organisation. Overall attitudes to the role of sociology within midwifery education were also examined. Analysis of the questionnaires reveals that sociology teaching is most likely to be delivered by lecturers in midwifery with a special interest in sociology, or related discipline. The role of sociology within the curriculum is valued although it is thought that student midwives can find the subject ‘difficult’ or ‘uninteresting’. The research also demonstrates that sociology teaching focuses more on ‘social problems’, rather than on ‘sociological concerns’ and that it is most likely to be integrated within the curriculum rather than delivered as a subject in its own right.
How do midwives achieve a balance in the relationship of care?
Authors: Stephenson Susan
Published: May 2014

The relationship between midwife and mother can be complex and raises many questions about professional responsibility and objectivity when close bonds and friendships have developed.
Vaginal birth after caesarean section: Seeing the bigger picture
Authors: Cohain Judy Slome
Published: May 2014

Recent research has recommended that vaginal births after caesarean section (VBAC) should not be carried out in birth centres. The authors of that study did not quantify the effects of their recommendations on maternal and fetal mortality in future pregnancies. The current US repeat caesarean section (CS) rate of 90% and the UK repeat CS rate of 67% present us with the fact that for women who will have more than two pregnancies, the increased mortality experienced in downstream pregnancies due to repeat CS negates the advantages of attempting the first VBAC in hospital rather than a birth centre. Of those women with two CS scars attempting VBAC in hospital, 3.7% experience uterine rupture, and 20% of these, hysterectomy. The risk of third trimester unexplained stillbirth is increased by 1 per 1000 after one CS birth. No one has yet researched the rate of increase in stillbirths after two or more caesarean sections. If no further pregnancies occur after the VBAC, hospital VBACs have an advantage over birth centre VBACs. However, when further pregnancies are considered, this 1/1000 advantage has to be set against the increase of 1/1000 unexplained stillbirths after CS, and increased maternal morbidity and mortality due to uterine rupture, hysterectomy and placental praevia and accretas.
Waterbirth: from ordinary to extraordinary
Authors: Gould Debbie
Published: May 2014

I have been intrigued for a long time about the difficulty midwives seem to have in making the use of immersion in water easily accessible for labouring women. We know from a National Childbirth Trust survey that as many as 60% of women are simply not offered waterbirth. What we do not know is what is stopping midwives offering women waterbirth? Is it the midwives themselves or the environment they work in? My latest experience in opening a new birth centre, where we have three birthing pools, has convinced me that given the right environment midwives will offer the use of the pool and women, across cultures, not only accept it but positively enjoy it.
Book Reviews
Authors: Davies Louise
Published: May 2014

This book aims to do exactly was it says in the title; namely make CTGs easier to understand. It is aimed at student midwives, junior midwives, medical students and junior doctors who are looking after labouring women.
Complications of catheterization
Authors: Richens Yana
Published: May 2014

This article highlights the ways in which women may be catheterized during pregnancy. This procedure should not be undertaken without taking into consideration the possible complications that may occur. To help reduce these complications it is recommended that an appropriate anaesthetic, antiseptic, lubricating gel is used.
Grace's story: an analysis of ethical issues in a case of informed consent
Authors: Dann Leona
Published: May 2014

Maternity care in New Zealand, a contemporary Western society, is provided by self-employed midwives, hospital employed midwives and/or medical practitioners. Midwifery practice is governed by the New Zealand College of Midwives Code of Ethics (2005) which places importance upon the establishment of a relationship and partnership with the woman. This assists with upholding maternal autonomy, informed choice and maternal decision-making. However, at times this can result in a dilemma for midwives and medical practitioners when the woman makes a decision that could pose risks to the fetus. Three principal ethical themes are drawn from a narrative: maternal versus fetal rights where the definition of the fetus is explored and whether the fetus has any legal rights; preservation of maternal autonomy and the dilemma encountered by the midwife and obstetrician with their mutual need to prevent harm to the fetus, while appreciating the need to inform and respect maternal decision making; the midwife–woman relationship and the significance of the midwife advocating for the woman. These ethical themes are also discussed regarding implications for future practice. Grace's story explores the paradigm shift in maternity services in New Zealand, which occurred at the end of the 20th century. A feminist ethic of care from a midwifery perspective is discussed and the universal principles upon which obstetricians and the New Zealand College of Midwives base ethical decision making and codes of practice is explored.
Raising the profile of maternity care assistants
Authors: Hood Adele
Published: May 2014

The role and function of maternity care assistants (MCAs) is a crucial and essential one that compliments the role of the midwife and many midwives really do value their role and support. However, in recent months the role of the MCA has attracted much negative media attention because of reports that some were performing procedures that exceeded their qualification. The aim of this article is to shed a positive light on the role of the MCA and share recommendations on how to raise their profile and thus value the contributions they make in supporting midwives, women and babies.
Promoting maternal health: gender equity in Bangladesh
Authors: Afsana Kaosar , Rashid Sabina Faiz , Chowdhury AMR , Theobald Sally
Published: May 2014

Gender roles and relations, that is, the social constructions of what it means to be female or male and the multiple and complex power relationships between females and males affects women's experiences of maternal health and maternal health outcomes. In the Bangladeshi context, the social construction of gender means that the sexuality and reproductive capacity of women is seen as belonging to husband, family or community.
Managing cardiac disease in pregnancy
Authors: Mooney Mary
Published: May 2014

More women with congenital heart disease now reach their adult reproductive years in good health. It is likely therefore that the number of those who present for care during pregnancy will continue to increase. The physiological changes that normally occur in pregnancy can compromise the conditions of women with heart disease, often leaving them with minimal cardiovascular reserve. There are particularly high risks associated with certain cardiac conditions and pregnancy in these women is contraindicated. Women with congenital heart disease can be physically very ill in pregnancy and most have added emotional requirements. The needs of these women are often complex and diverse with many potential complications. Midwives caring for these patients are consequently challenged to remain not only competent in midwifery but also competent in many aspects of cardiology, together with the need to remain sensitive to the emotional care requirements that accompany these conditions.
Can we afford to raise our children?
Authors: Daniel Lincia
Published: May 2014

It isn't just property prices than have risen dramatically in recent years, the cost of raising children continues to soar and how much is the government's Child Trust Fund really helping parents?
Breast health and pregnancy
Authors: Graham Helen
Published: May 2014

The breasts go through many normal changes throughout development, the menstrual cycle, pregnancy and ageing. Many of these changes are influenced by our fluctuating hormone levels and the natural ageing process of the breast. The changes commonly seen include tenderness/pain, lumpiness/lumps and nipple changes (Dixon, 2006). Unlike the many other normal changes occurring to the breasts, pregnancy offers many visible signs that the breasts are changing. Initial changes experienced by many women include tenderness of the breast and nipple and an increase in the size of the breasts. Sensations such as tingling and soreness are commonly experienced. As the pregnancy progresses other visible signs such as a darkened colour of the nipple and areola and prominent veins on the surface of the breast are seen seen (Stoppard, 1996). For many women changes such as breast lumps and bloody nipple discharge developing during pregnancy can cause uncertainty with many women fearing they have breast cancer. For most women breast lumps seen during pregnancy will be benign (non-cancerous). This article outlines breast changes in pregnancy as well as the different kinds of breast lumps which can be found.
Grief Unseen – healing pregnancy loss through the arts
Authors: Melnyczuk Rena
Published: May 2014

This is a beautifully written account of how feelings of grief can be expressed creatively through the arts. The author herself has suffered first a miscarriage and then a full term stillbirth in the late 70s and early 80s. She recounts the process of remembering, expressing her feelings and reaching out to others in the art form of writing.
South African government to cut HIV infection rates by 2011
Authors: Bainbridge Jane
Published: May 2014

The dire situation in South Africa might at last improve with a new strategy to treble the number of people receiving treatment. Elsewhere India is aborting more female fetuses and will soon overtake China.
Fat is a pregnancy issue
Authors: Daniel Lincia
Published: May 2014

The government estimates that by 2020 around a third of adults will be obese and as British women are already the fattest in Europe, this could have alarming consequences for the nation's fertility.
Reducing multiple births: IVF and single embryo transfer
Authors: Bainbridge Jane
Published: May 2014

For those desperate to conceive, single embryo transfer must be a chilling thought given the difficulties many women experience undergoing cycles of IVF, but multiple births are a strain on the health service.
Does epidural analgesia affect the second stage of labour?
Authors: Odibo Linda
Published: May 2014

Epidurals are becoming an important part of obstetric analgesia, with growing demand for this service in labour. It is however still uncertain if epidural analgesia has adverse consequences in the second stage of labour. This literature review aims to evaluate these potential effects and the possible implications for practice.
Choice in childbirth: a realistic expectation?
Authors: Jomeen Julie
Published: May 2014

Choice has been an enduring theme of maternity policy since the advent of Changing Childbirth (1993). Maternity Matters outlines four national choice guarantees, which aim to give women choice about how to access maternity care, the type of antenatal care they receive, choice of place of birth and choice of postnatal care. This paper presents some key findings of a study which sought to explore and advance the understanding of maternity care choice through actual women's experiences. Ten women took part in conversational in-depth interviews at four time points, 12–16 weeks and 32–34 weeks pregnant and 14 days and 6 months postnatal in order to explore their choices for care, the rationale for those choices and their experiences and feelings at that point in in time. The key themes that emerged revealed that choice is not an equitable concept for women, it is constrained by inequalities but also by the health care professionals that women are in contact with, the social discourses that surround pregnancy and birth and obstetric complications. Models of care which offer choice need to be designed to take into consideration the dangers of offering choices that may not be fulfilled and the importance of choice in the postnatal environment. Above all choice needs to be presented in an honest and realistic manner.
Improving pregnancy outcomes: mothers and substance misuse
Authors: Leggate Joyce
Published: May 2014

The data for this retrospective quantitative audit was collected from 1999–2006 from a caseload of 324 pregnancies in Fife and was informed by a literature search undertaken while studying for a Post-Graduate Certificate in Addictions. The aim of the study was to determine whether enhanced midwifery support within a multi-disciplinary team affected pregnancy outcomes in drug and alcohol using women. Ethical approval was not required. Partnership working improved and women were offered intensive support from specialist midwives, addictions nurses and social services from pregnancy booking until at least 12 weeks postnatal. This article explores pregnancy outcomes for this client group in regard to substance misuse, gestation at delivery, BBV infection, criminality, employment, housing and criminal behaviour and breastfeeding rates, neonatal abstinence and birth weight in neonates in a geographical area of significant social deprivation.
Neonatal abstinence syndrome
Authors: Lall Abhimanu
Published: May 2014

Neonatal abstinence syndrome (NAS) is the withdrawal response that occurs when an infant is exposed in utero to maternal drugs of addiction. NAS is characterized by irritability, tremors, hypertonicity, tachypnoea, vomiting and diarrhoea. Although NAS is more typically seen in opiate withdrawal, similar symptoms are seen when withdrawing from benzodiazepines, barbiturates and alcohol. The incidence of NAS has been reported as 54%–94% of all babies who have been exposed to opiates in utero. Although there are few controlled trials in drug therapy of the infant with NAS, opiates have been proven to be effective in the management of infants with NAS following withdrawal from methadone or other opiod agents. Drug exposure in utero has been shown to reduce the birth weight and head circumference of the affected infant. There are also long-term cognitive and behavioural problems in infants with NAS, making follow-up essential.
Maintaining healthy infant skin
Authors: Hale Rachel
Published: May 2014

Maintaining the health of a newborn's skin is an essential part of infant care and the choice of both nappies and hygienic nappy care play an important role in achieving this. The critical care points where compromise can occur are identified as the time the infant spends in a wet nappy (leading to mechanical, chemical and microbial trauma), the cleansing routine of the skin at nappy change time, the steps taken to preserve the skin's own defence mechanisms and control of infection through avoiding contamination of clothes, bedding and carers by faeces and urine. The purpose of fitting a nappy to an infant is to reduce the risk of clothes, bedding and carers becoming contaminated with faeces and urine and to help the baby's skin stay healthy by preventing soreness. However, great care needs to be taken to establish a routine to maintain skin health and hygiene whether at home or in a hospital setting.
A tool to measure fathers' attitudes and needs in relation to birth
Authors: Hollins Martin Caroline J
Published: May 2014

The aim was to develop a scale—the Birth Participation Scale (BPS)—which midwives can use to measure fathers' attitudes and needs in relation to birth participation. The objectives were to use the BPS to: detect whether fathers genuinely want to be present at the birth; identify localized perceptions and fears fathers may have about birth participation; and ascertain whether being present at the birth was a rewarding experience. A quantitative survey was carried out with data collected from York District Hospital Maternity Unit (UK). The participants were a stratified sample of first-time (n= 42) and second-time fathers (n= 36). Measurements and findings: the BPS was issued at two observation points: prior to birth participation and post birth participation. Difference in scores between conditions assessed the fathers' attitudes towards birth participation in a positive or negative direction. Scores post birth showed a small shift in attitude in a positive direction for first-time (p= 0.01) and second-time fathers (p= 0.02) with only 4% finding birth partnering more difficult than they had anticipated. Key conclusions are that midwives are facilitating the majority of fathers towards a positive birth experience. Implications for practice are that the BPS may prove useful for: identifying whether fathers genuinely want to be present at the birth; ascertaining fathers' personal concerns in relation to birth participation; and tailoring birth preparation to meet fathers individualized needs.
Role modelling in the clinical workplace
Authors: Armstrong Nicola
Published: May 2014

To ensure pre-registered midwifery students are fit for practice, it is recommended that when students attend their clinical placements they are allocated to work alongside mentors who have undertaken mentorship training and, more recently have fulfilled additional criteria, that ensures they are fully qualified (Nursing & Midwifery Council (NMC), 2006). This article aims to assist midwives who are considering enrolling on a mentorship programme. The paper illustrates how Bandura's (1977) model of behavioural and social learning theories can be used to facilitate student learning with an emphasis on using role modelling as a teaching and learning strategy. A clinical scenario is used to demonstrate the link between theory and practice.

It is also suggested that existing mentors should be updated on the value of role modelling and the application of additional teaching and learning strategies that support students' learning within the clinical setting.
Essential nutrition for babies
Authors: Mainstone Adrian
Published: May 2014

There is no doubt that human breastmilk is the perfect formulation for growth, development and the establishment of an infant's immunity. Sometimes breastfeeding is not an option so if a mother chooses to partially or totally feed her baby with formula there is no reason for her to feel guilty. The research that has been carried out by formula manufacturers ensures that a baby is fed the next best thing to breastmilk. If an infant is intolerant to either breastmilk or formula, a mother can be confident that there is an alternative suitable for her baby. This article examines some of the essential ingredients in breastmilk and lists the ingredients incorporated in formula feed as a comparison. It also identifies certain specialist feed for babies with ingredient intolerance.
Home birth at the center of debate:reflecting on a lifetime of practice
Authors: Stephens Liz
Published: May 2014

I have been reading with interest the furore caused by the publishing of a meta-analysis of home births in America (Wax et al, 2010). The meta-analysis suggested that planned home birth is associated with less medical intervention and a tripling of the neonatal mortality rate; this assertion is based on evidence open to challenge and has caused a wide range of comment in the British press. The Lancet (2010) published an editorial suggesting that women who chose to give birth at home had no right to put their babies' lives at risk. This prompted The Guardian to interview Cathy Warwick who described the editorial as 'sweeping' and 'misogynistic' (Ramesh, 2010). This was followed by a poorly researched and biased article in The Daily Mail (Fraser, 2010) accusing women who choose a home birth of being selfish and reckless. This is a popular daily paper read by many women.
Pre-conception care: essential advice for women
Authors: Calleja-Agius J
Published: May 2014

Pre-conception care is based on educating future mothers on issues that can influence neonatal morbidity, both in the short and long term. Of major importance is advice on optimal body mass index, as well as lifestyle and diet. This is essential both for women with low risk, and even more so in cases where there are specific medical conditions. The quality of this advice can have a huge impact on public health. The midwife, whether in the community or in hospital, has an important role in providing this information.
Fatherhood: doing the right thing
Authors: Bainbridge Jane
Published: May 2014

Proposed changes to the law mean that registering both parents regardless of marital status may soon become a legal requirement, so fathers can neither be excluded at birth nor shirk their responsibilities.
Coping with stress: it's all in the mind
Authors: Clift-Matthews Victoria
Published: May 2014

If you're having a bad day, the stress is getting on top of you, and all you've eaten since breakfast, which was hours ago, is a couple of chocolate digestives or a slice of birthday cake from a work colleague, then it's quite likely your mood is going to feel a little low. Mood fluctuations are perfectly normal, regular occurrences and are not necessarily the result of such obvious triggers. One can feel low for what seems to be no reason at all—who can fathom the mysteries of the mind and body? But you could be going through one of life's well-known stressful events, such as the death of a loved one, getting divorced or dealing with a debilitating and life-threatening illness, for example. A low mood may become sustained leading to lack of motivation, hope and retreating from the world by cutting yourself off from those around you. But in cases such as these, not everyone will be affected by depression. There seems to be no way to predict who will be affected and who won't.
Thousands of women in India are dying in childbirth
Authors: Daniel Lincia
Published: May 2014

Maternal health care is so poor in Northern India that no one knows how many women are dying in childbirth and although the government is trying to improve the situation, initiatives are often sabotaged by corruption.
Dangers of pregnant women relying on personal fetal monitors
Authors: Daniel Lincia
Published: May 2014

Portable fetal monitors have become widely available to purchase over the internet and are proving popular but they cannot provide reassurance because their use in inexperienced hands can lead to tragedy.
Bump or bulge? Battling obesity in pregnancy
Authors: Clift-Matthews Victoria
Published: May 2014

We are well into the year now and at the point where the new year's resolutions have tailed off. For some people the vows to eat healthier and go to the gym have instead become promises to give up chocolate or wine for Lent and exercise can wait until the weather's better. Following a healthy eating programme is a way of life, not a diet to be discarded when bored of it.
Holding a stillborn baby: mothers' feelings of tenderness and grief
Authors: Rådestad Ingela , Säflund Karin , Wredling Regina , Onelöv Erik , Steineck Gunnar
Published: May 2014

Actions by health professionals and the atmosphere surrounding the birth of a stillborn baby may determine the nature of the mother's contact with her baby. A questionnaire studied mothers' feelings when holding their stillborn baby. A total of 33 mothers of stillborn babies born after 22 weeks completed the questionnaire three months after the birth. All mothers saw their baby. Before meeting the baby, 23 women had feelings of being afraid. Thirty-one mothers held their baby. When holding their baby all mothers felt tenderness and grief, 29 warmth and 25 prides. Fifteen mothers at the same time felt insecure when holding the baby, 12 had feelings of discomfort and 11 feelings of fear. A hypothesis for future investigations is that the more that a mother can be prepared for what is to come after birth, the better the chance that feelings of fear or discomfort can be diminished.
DNA profiles at birth: preventing problems or causing more?
Authors: Bainbridge Jane
Published: May 2014

Technology capable of giving complete DNA profiles at birth might be widely available in the next ten years for a cost of under £700, but what if this information falls into the wrong hands?
Book Reviews
Authors: Prain Maggie
Published: May 2014

This book is a comprehensive resource for those wishing to develop and maintain their skills in maths and drug calculations. Tyreman is a nurse with experience of teaching numeracy to adults and this experience is evident within the text. Though the target audience is nurses the basic principles are transferable to midwifery practice at all levels.
Providing high-quality midwifery care
Authors: Clift-Matthews Victoria
Published: May 2014

Normal birth, woman-centred care and ‘being with woman’ are only some of the much-used phrases in midwifery when it is a subject for discussion, particularly where the role of the midwife is concerned. These are not merely words to be bandied about of course, they encompass an entire belief system of best practice, which doesn't sound very scientific but that is the paradox of midwifery; it is an art and a science. As well as being an academic subject in universities, it is clinical, evidence-based practice on the wards and in the community, the ability to draw on previous experiences, and it is the skill of being personable, supportive, empathetic—someone a woman feels she can trust with her own life and that of her baby.
Introduction of e-learning into the pre-registration midwifery curriculum
Authors: Clarke Elinor J
Published: May 2014

This article identifies the introduction of interprofessional e-learning into the pre-registration midwifery curriculum. It provides a personal reflection of the experiences of using e-delivery of the interprofessional teaching and learning pathway at Coventry university. E-learning is not new, yet, there has been a lack of information (research, literature and evidence) about e-learning and information technology and pre-registration midwifery education. This article provides insights into the modern midwifery curriculum, contextualizing the need for interprofessional education and identifying some of the challenges to the midwifery profession, educators and students inherent in this method of delivery. The article also suggests some solutions to the challenges and offers insight into possible technologies for delivery of the midwifery curriculum in the future.
Advanced intrapartum monitoring
Authors: Royle Denise
Published: May 2014

The most dangerous journey we ever undertake is when we are born. Fatalities in high-risk labour can be reduced if we are brave enough to embrace improved technology.

The latest figures for infant mortality indicate that there is still room for improvement. It is with this in mind that fetal pulse oximetry should be an important tool in the delivery suite. The Nonin ‘Fetal Sat’ pulse oximeter incorporates important technological improvements when compared with earlier comparable products.

The ‘FetalSat’ is a totally affordable product, which can assist the clinician and midwife, and has the potential to reduce neonatal and maternal morbidity.
Limited choices in NHS care
Authors: Clift-Matthews Victoria
Published: May 2014

Last month the NHS came under scrutiny when Barak Obama announced plans to reform US health care. Republicans and other conservative campaigners have been reported making comparisons between the proposed reforms and the UK NHS system and in the process they have slammed the NHS for its long waiting lists and made accusations about it rationing the more expensive treatments. Examples of poor treatment have been paraded in the press to support these ideas. A number of hypothetical comments have been made about popular public figures with claims that they would not receive treatment because of age restrictions and would die if the USA followed a system similar to the NHS. It doesn't help when a report from the Patients Association highlights appalling standards in NHS care, mainly relating to basic nursing when caring for the elderly. Although the reports are not representative across the NHS, they give a very bad impression of our service.
Normal birth is the core business of our profession
Authors: Stephens Liz
Published: May 2014

It occurred to me recently that I have been facilitating workshops exploring the evidence to support normal birth for about ten years now. As midwives we speak proudly of our professional autonomy based upon an expertise in normal childbirth, so why is it we need workshops in our core business? There is nothing new in the evidence discussed at these sessions, they are based on the best available evidence and, in recent years, largely supported by the National Institute of Health and Clinical Excellence guidelines (NICE, 2007).
Help for South Africa to treat growing number of HIV-positive patients
Authors: Daniel Lincia
Published: May 2014

An estimated 5.7 million people suffer from AIDS in South Africa but new policies and extra funding mean HIV-positive pregnant women will receive treatment earlier and those breastfeeding will also be entitled.