bluuebunny/crossref_metadata_2025 huggingface dataset:
Fertility treatment: How old is too old for pregnancy and parenthood?
Authors: Daniel Lincia
Published: May 2014

Advances in reproductive technology without restrictions on age have re-ignited the debate on elderly mothers. Lincia Daniel examines the medical and social issues raised and the double standards exposed by our response to this growing trend.
RCM 2006 conference report: Midwifery is bruised but not beaten
Authors: McGuinness Fiona
Published: May 2014

Midwives descended on a beautifully sunny Torquay in May to attend the 124th Annual Conference and Exhibition hosted by The Royal College of Midwives. The theme of the conference, ‘Where now for midwives?’ reflects the uncertainty widely felt in the profession about the changes that have taken place in the NHS and the challenges midwifery faces in a harsh economic environment.
Chlamydia screening in pregnancy: A missed opportunity?
Authors: Fletcher Joanne , Ball Glynis
Published: May 2014

Chlamydia trachomatis (C. trachomatis) is one of the most common sexually transmitted infections worldwide, with over 100,000 new cases diagnosed annually in the UK. This article examines the incidence and prevalence of C. trachomatis, the signs and symptoms, the potential complications associated with untreated chlamydial infection particularly in relation to pregnancy and childbirth and available treatment options. Implications for practice are discussed along with the argument for a more proactive approach to chlamydia screening in pregnancy.
The Link Clinic: Promoting innovative practice through partnership
Authors: Akeju Dorcas
Published: May 2014

Women from ethnic minority groups have particular needs and requirements which historically have not been met by NHS patterns of routine antenatal care. For cultural or religious reasons, for example, this group of women would not like a male obstetrician to examine them. This paper will highlight how a special antenatal clinic was set up to fulfil the needs of this group, and to provide a holistic approach to health care. The paper will also show that by working in partnership with the communities, users and other providers a service could be developed.
Doppler sonography: Improving outcome in high risk pregnancy
Authors: Blincoe Alana Juman
Published: May 2014

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

Since the late 1970s midwives and others in the UK have held strong, negative views of Nestlé, based on reports that they were causing the deaths of many babies in third world countries. A boycott on their products started in Minneapolis in 1977 and spread internationally. However, despite its formal end in the USA in 1984, and further rejection in 1989, it continues to this day in the UK. A group of midwives, with various backgrounds, embarked on a fact-finding visit to Nestlé in 2005. Along with some background information, the views of this group are encapsulated in this article.
Policing Pregnancy: The Law and Ethics of Obstetric Conflict
Authors: Symon Andrew
Published: May 2014

This book examines health care law as it applies to pregnancy. The chapters are Pregnant women and the law; Power imbalance in court; Is the law being used to enforce compliance with medical advice?; Undermining capacity to consent – another route to compliance; Questioning child welfare – protection or punishment?; Other threats – continuing challenges to autonomy.
Vulvectomy and clitoridectomy: A woman's guide to FGM
Authors: Richens Yana
Published: May 2014

An increasing number of women are now presenting for maternity care in the UK who have undergone FGM in their countries of origin and their daughters are also at risk. Yana Richens urges the judiciary, government and midwives to strengthen their stand.
Assessing midwifery practice from the mentor's perspective
Authors: Darra Susanne
Published: May 2014

Following the development of a midwifery skills framework (Darra et al, 2003) which arose from the (then) UKCC aims to improve ‘fitness for practice’ and Welsh Assembly Government aims to achieve an ‘All Wales I nitiative’, this paper explains the further development of this framework to reflect everyday midwifery practices, teaching and learning in practice and the curriculum itself. The framework began as a tool to guide the formative assessment of the students’ development of midwifery skills. With its increasing popularity with staff and students alike, as well as an increased focus on practice in a recent NMC consultation relating to fitness for practice, further development of the framework was implemented. This article describes a tool which is embedded in the perspective of the practicing midwife, but which addresses the practice-theory gap by guiding learners and their mentors to what needs to be learned and to what level.
Evaluating bilingual peer support for breastfeeding in a local Sure Start
Authors: Ahmed Shamoly , Macfarlane Alison , Naylor Jo , Hastings Joy
Published: May 2014

In Tower Hamlets, the Bangladeshi women have a very low rate of breastfeeding and the difference between their intentions to breastfeed and actually breastfeeding is far wider than for women from other ethnic groups. In Bangladesh, breastfeeding is well rooted in its own traditional culture. A Sure Start local programme funded a Bangladeshi support worker to work with childbearing Bangladeshi women in the area; many of whom are not fluent in English. A short evaluation of this work was conducted to assess the impact of bilingual breastfeeding support to women's uptake and duration of breastfeeding. The majority of women found the support worker to be the most helpful breastfeeding advisor and felt she influenced them to breastfeed. Despite this, a minority of women exclusively breastfed and most reported having problems feeding during hospital stay. This evaluation highlighted the need for further work in this area.
Services for women with disabilities: mothers' and midwives' experiences
Authors: McKay-Moffat Stella , Cunningham Cliff
Published: May 2014

Only a limited amount is known about the childbirth experiences of m thers with disabilities and even less about the experiences of midwives providing such services. To obtain details about experiences semi-structured interviews were carried out with five mothers with mobility limiting disabilities and eight midwives. The five themes from mothers: The quest for normality and independence, the disability as paramount, midwives’ lack of disability knowledge, the need for midwives to have disability awareness and positive attitudes, and the importance of effective communication. Three themes from the midwives were: The midwives’ varied knowledge and experiences and how this influenced their feelings, midwives generally positive attitudes towards the mothers, and challenges to effective communication. Midwives need the opportunity to enhance their knowledge and helping skills whilst taking a proactive approach to care and maternity service provision for this small but increasing group.
TENS: Non-invasive pain relief for the early stages of labour
Authors: de Ferrer Gina
Published: May 2014

Transcutaneous Electrical Nerve Stimulation (TENS) is a natural, non-invasive drug free analgesic widely used in obstetrics. Despite studies which fail to prove conclusively that the device alleviates pain, it has become a popular tool for women in the early stages of labour. Although opinion among users varies, anecdotal evidence suggests that it generally provides some benefits. With no side effects for both mother and baby the portable unit allows the labouring woman control and management over her own pain relief, an important factor in her overall experience of childbirth.
Anaesthetists' perspective on oral intake for women in labour
Authors: Parsons Myra , Nagy Sue
Published: May 2014

Vast improvements in drugs and techniques for obstetric general anaesthesia over the last 50 years have seen the incidence of anaesthesia-related aspiration all but eradicated. However, oral intake restrictions for labouring women, instituted following Mendelson's (1946) study, continue despite these improvements. A survey of 30 obstetric anaesthetists explored their aspiration prevention strategies for caesarean section and recommendations for the oral intake of labouring women with an epidural in situ. The findings showed that a majority of these anaesthetists continued to request the fasting of all labouring women in case general anaesthesia was required and there was little consensus regarding gastric content preparation or for the oral intake of epiduralised labouring women. There is no research to support the use of oral intake restrictions in preventing aspiration. There is also no consistency among anaesthetists or supporting research for any dietary regime prescribed for labouring women with an epidural.
Effective communication is the core of effective practice
Authors: McGuinness Fiona
Published: May 2014

If communication is a word often used in this journal that will be because professionals understand its importance, as clearly as they understand that its absence is a barrier to effective care. This month, in our focus on optimizing care, the journal addresses two quite different areas where failure to communicate clearly, or to be able to, is explored. These articles also demonstrate the importance of communication, not just between midwives and mothers, but also between midwives, fellow professionals and any other agency that might be involved.
Are older mothers the new teenagers?
Authors: Richens Yana
Published: May 2014

Recent newspaper headlines read ‘Late motherhood as big a problem as teenage mums’ (Sunday Times), ‘Mother of all insults’ (Independent), ‘Older mothers are a drain on the NHS’ (Daily Mail). These follow on from the recent comments by Dr Susan Bewley, consultant obstetrician at Guy's and St Thomas’ Hospital, London. Her observations have renewed the debate on the older mothers, and have now unleashed the pens of or should I say keyboards of many older mothers, fathers and journalists.
Internet research in midwifery: Practical considerations and challenges
Authors: Stewart Sarah
Published: May 2014

The Internet is an exciting tool for midwifery research; however there are a number of unique challenges that must be addressed. The global and transient nature of the Internet sometimes makes it difficult for the researcher to ensure best practice, but international guidelines provide direction in dealing with these issues. The Internet researcher must ensure anonymity and confidentiality, as well as gain informed consent from research participants. Copyright and intellectual property regulations must be observed, rules of online communities should be respected and an endeavour must be made to ensure that research results are disseminated to all the study participants.
New roles for midwives devalue traditional skills
Authors: Lavender Tina , Edwards Grace
Published: May 2014

Over the last century the midwife's role has continually evolved. Some would say it has been enhanced but there is a danger that midwives are becoming ‘Jills of all trades and mistresses of none.’
Development of an Integrated Care Pathway for natural birth
Authors: Clarke Paula , Bowcock Malcolm , Gales Philomena
Published: May 2014

Birmingham Women's Hospital aspired to extend the choice of childbirth options available for women to include natural birth for all who met the clinical criteria.

The development of a purpose-built midwifery-led birth centre prompted the authors to review the care they provided for women anticipating a normal birth. They were confident that the physical attributes of the birth centre, namely the provision of a homely, relaxing environment would support natural birth. However, they also acknowledged that environment alone would not guarantee that physiological birth would be protected, particularly bearing in mind the location of the birth centre within a large regional unit. The development of an Integrated Care Pathway (ICP) was an opportunity the authors embraced to assist with supporting natural birth. This article will describe the adoption of the care pathway model and discuss the planning and development process as well as reporting on progress so far.
Promoting skilled attendance for all during childbirth
Authors: Maclean Gaynor D
Published: May 2014

The paper outlines the current global situation in respect of making childbirth safer through the promotion of skilled care during this critical life event. The implications of the fifth Millennium Development Goal (MDG5) are discussed and a hypothesis offered that has been derived from an analysis and synthesis of a vast quantity of literature. Examples of policy and practice from numerous countries are shared and the possible implications for midwifery practice in the UK contemplated.
Access to health services: room for improvement?
Authors: Daniel Lincia
Published: May 2014

Rural midwives in New Zealand are to receive new funding; and in Pakistan, health experts are calling for improvements to primary health care; meanwhile Swaziland records a decrease in its HIV infection rate.
Compulsory HPV vaccination for pre-teen adolescents?
Authors: Griffith Richard
Published: May 2014

A recent editorial in the Lancet (Anon, 2006) called for the compulsory vaccination of girls aged 11–12 against the Human Papilloma Virus (HPV). HPV is a very common, often sexually transmitted, infection of the cervix. Over 70 subtypes have now been identified and types 16 and 18 have been confirmed as high risk types responsible for some 70% of cases of cervical cancer (Ciotti et al, 2004). Despite being subject to a national smear test screening programme cervical cancer still results in the deaths of 1,000 women in the UK each year (Office for National Statistics (ONS), 2006).
‘Should I come in now?’: a study of women's early labour experiences
Authors: Cheyne Helen , Terry Rohini , Niven Catherine , Dowding Dawn , Hundley Vanora , McNamme Paul
Published: May 2014

In spite of the advice from midwives to stay at home for as long as possible after the perceived onset of labour, many women still present at hospital in the very early stages of labour. In this qualitative study, 21 women discussed their early labour experiences, and factors which influenced their decisions regarding when to go to hospital. The data were transcribed and analysed using latent content analysis. We found a combination of uncertainty, pain and anxiety influenced women's early labour decisions. While many felt they were coping well with their labour on admission, women often wanted to be in hospital ‘just in case’ and lacked the confidence to cope with labour at home. We suggest that the relationship between anxiety and timing of admission should be investigated further and that the value of midwifery support and reassurance in the latent and early stages of labour should not be underestimated.
Male infertility and emotional wellbeing
Authors: Bainbridge Jane
Published: May 2014

When a couple are seeking infertility treatment it is usually the woman who is the focus of medical procedures and emotions but what about the emotional wellbeing of the men involved?
Private maternity care: perspective from a hospital midwife
Authors: Hurl Marie Therese
Published: May 2014

Growing up in a rather noisy, happy household had a few disadvantages. Being the third eldest of ten children, I became rather adept at changing nappies, making up feeds and winding babies. By the age of fifteen I vowed that when I ‘grew up’ I would have a job working in a child-free environment but that was not to be.
Hospital birth, the environment and social networking
Authors: Magill-Cuerden Julia
Published: May 2014

In many parts of the country there are plans to reorganize the maternity services within specialist hospitals that would be larger, but also to develop midwifery-led services in smaller units with community services (Healthcare for London NHS, 2007; Department of Health, 2007). In some cases units may close. These plans may increase the number of women who require care within a specialist institution. There is a caveat that the more that birth becomes technicalized the number of women considered to need these specialist services will increase. The more that medical care is improved the greater the number of women with problems who will become pregnant.
Legal status of the unborn child: a case for reform?
Authors: Griffith Richard
Published: May 2014

The dilemma of how the courts respond to women who refuse caesarean operations is likely to come to a head when the Mental Capacity Act 2005 comes into force in April 2007. This Act will give statutory force to advanced decisions refusing health care that will enable competent adults to refuse medical treatment even if their life is at risk and to have effect at any subsequent time when they are without capacity to refuse (Mental Capacity Act 2005, section 24). This advanced decision may be used by women with strongly held views on the use of caesarean sections setting out their objections beforehand and obliging health professionals and the courts to respect their wishes even if it leads to the death of the woman and her unborn child.
‘Hypothetical facts’ and the balance of probabilities
Authors: Symon Andrew
Published: May 2014

The law of clinical negligence rests on the civil law test of ‘the balance of probabilities’. This is different to the criminal law standard of proof which is ‘beyond reasonable doubt’. In other words, civil claims are decided on whether there was more or less than a 50% chance of something being the case.
Maternal nutrition during pregnancy and folic acid
Authors: Hale Rachel
Published: May 2014

Government guidelines stress the need for pregnant women to have a balanced diet and to take certain vitamins and minerals. Midwives have a role in promoting healthy eating during pregnancy, particularly as pregnant women are faced with constant media messages about a healthy diet. Many women who have babies with a low birth weight are from low income backgrounds and are unable to provide themselves with an adequate diet. It is well documented that babies born underweight are more likely to suffer from illnesses and disabilities. Folic acid is an essential supplement for the first 12 weeks of pregnancy as it is proven to reduce the incidence of neural tube defects in babies. Essential fatty acids (EFAs) are fast becoming recognized as an important supplement for mothers, to ensure good brain development in the baby and a longer gestation period which increases birth weight.
Chlamydia infection, alcohol and sexual behaviour in women
Authors: McMunn Valerie A , Caan Woody
Published: May 2014

This investigation explored the impact of alcohol on sexual behaviour in relation to the possible increased risk of chlamydia trachomatis. A sample of 208 women were recruited aged 16–24 years who had been tested at a pilot site for the national chlamydia screening programme. This formed a prospective community case series using questionnaires, case note review and focus groups. Eight women took part in the focus group discussions. The questionnaire contained quantitative details of past and present alcohol use (e.g. ‘binge-drinking’) sexual behaviours and partners and beliefs related to chlamydia. The results of chlamydia screening and the answers to a question about having had treatment for chlamydia were grouped in relation to alcohol use. The main findings were that three variables were associated with increased risk of chlamydia. These were age at which they first drank alcohol; number of lifetime partners and alcohol consumed on a ‘heavy’ night by the sub-group who displayed binge-drinking.
Domestic abuse: the role of the law
Authors: Griffith Richard
Published: May 2014

The government recently announced extra funding to combat the increasing problem of domestic abuse in the UK (Martin and Clout, 2006). About one in four women experience domestic abuse at some time in their lives, and it claims the lives of two women every week (Taket, 2004; Simmons and Dodd, 2003). A third of women report that their first episode of abuse occurred during pregnancy.
Implementing the NICE guideline on postnatal care
Authors: Richens Yana
Published: May 2014

When implemented into clinical practice guidelines can have a positive effect on the quality of care provided to mothers and babies. This article highlights some of the key points for implementation of a national guideline into clinical practice.
Professional accountability for student midwives
Authors: Roughley Gwen
Published: May 2014

The recent press report in the Southern daily Echo (Hoskins, 2007) about the student midwife who gained false access to computer information at work and then falsified her EU directive records in order to qualify is both shocking and sad. No one but she can fully understand why she felt the need for deception in this way but I suspect there must have been underlying problems and perhaps failures within the system. While the midwifery profession as a whole is likely to feel only contempt for her actions, we must not lose sight of the immense pressure that student midwives are under in order to ‘get their numbers’ especially in the current climate where competition for jobs are at an all time high. This story led me to look at the Nursing and Midwifery Council (NMC) website and check how student midwives are expected to behave and manage their own learning experiences.
Desperate women abandon babies
Authors: Daniel Lincia
Published: May 2014

Many women suffer from postnatal depression following childbirth but some suffer from severe mental illness. Those with bipolar disorder can be at high risk of puerperal psychosis but it's in the genes.
Delivery suite assessment unit: auditing innovation in maternity triage
Authors: Nolan Sheila , Morgan Jane , Pickles Jacky , Haith-Cooper Melanie , Phipps Fiona MacVane
Published: May 2014

A Delivery Suite Assessment Unit (DSAU) has been established at a large Northern teaching hospital. This was as a recommendation of ASQUAM (achieving sustainable quality in maternity) to reduce antenatal admissions to delivery suite and provide a more appropriate environment for women attending for antenatal or labour assessment. The DSAU has also provided an effective teaching environment where skills such as effective telephone triage, diagnosis of labour and care of women with pre-labour spontaneous rupture of membranes (SROM) have been developed by junior staff.

The first twelve months' audit results indicate that the establishment of the DSAU has been successful in reducing antenatal admissions to delivery suite by increasing the transfers of clients home, rather than to the antenatal wards. This may reflect the confidence of the highly skilled midwives working in this environment and the confidence women feel about their ability to obtain prompt and accurate advice over the telephone.
Hyperemesis gravidarum: providing woman-centred care
Authors: Turner Malissa
Published: May 2014

Hyperemesis gravidarum is a complex, life-altering condition that can be associated with maternal and fetal morbidity and mortality. However, it is not easy to diagnose or manage and there is still no defined cause or cure. Many women have long suffered at the mercy of this condition and have been left feeing confused, unwell and isolated by it. Midwives are ideally placed to recognize the suffering of these women, to provide tender support and to inform and educate them about their condition and their choices. This article presents an overview of the evidence surrounding the causes and management of hyperemesis gravidarum so that midwives may provide the very highest quality woman-centred care to those who suffer with it.
Stone soup for the heart
Authors: Gould Debby
Published: May 2014

Words are powerful, almost magical the way they weave meaning into our lives. In the story of the stone soup (Wikipedia, 2007) some hungry travellers come to a village where the people are also hungry with no work. The travellers promptly light a fire, fill a pan with water and place a stone in the water and start boiling it up. The travellers sit in anticipation, licking their lips. When approached by one of the villagers and asked what they are doing they say that they are making some ‘delicious’ stone soup. The travellers mention that it is even more delicious with cabbage, and so the villager offers a cabbage. Later another villager approaches and enquires what they are making and they say delicious stone soup with cabbage but it is even more delicious with carrot, and the villager goes off and returns with a carrot. The story continues until, from the donations of many, a hearty stew is made which feeds everyone.
Cochrane reviews with no trials: pointless or pragmatic?
Authors: Kingdon Carol , Lavender Tina
Published: May 2014

The Cochrane Collaboration is internationally renowned as the leading organization for the production of systematic reviews of healthcare interventions. Since the mid-1990s, Cochrane reviews have become synonymous with randomized controlled trials (RCTs), contributing to the elevation of RCTs as the gold standard for research in healthcare. However, this article demonstrates how the inclusion of non-randomized data in Cochrane Reviews is now up for debate. The Cochrane Review of ‘Caesarean section for non-medical reasons at term’ is the first from the Cochrane Pregnancy and Childbirth Group (PCG) to strongly recommend research methods, other than an RCT, to gather future data. Here, two of the review authors assert that Cochrane reviews with no trials may have their place in the work of the PCG.
Exploring changes in practice: when midwives and nurses become mothers
Authors: Redwood Tracey
Published: May 2014

The impact motherhood has on midwives and nurses should be understood by both those professionals within its own ranks and the greater UK health sector. These professions remain predominately female (89.3%) (NMC, 2007), and at some stage during their professional lives 90% become mothers, directly impacting on staffing levels and ultimately the care given to women and patients.

The aim was to explore transition to motherhood for midwives and nurses, including their perceptions of its impact and implications on their professional lives.

Twenty-two participants volunteered from the health professions of midwives and nurses (including health visitors) providing narratives through two sets of interviews.

This article focuses on midwives' and nurses' knowledge levels and changes in professional practice resulting from their experiences of becoming a mother, childcare and treatment on return to work.

Understanding these midwives' and nurses' unique perspectives may contribute to allaying the stress related to returning to work, and ensure these professionals are retained as the valuable practitioners they become as a direct result of motherhood.
Optimum maternal nutrition for a healthy pregnancy
Authors: Juman Blincoe Alana
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.
China is forced to improve food safety after baby milk scandal
Authors: Bainbridge Jane
Published: May 2014

A chinese health ministry official called for a new system for food safety supervision after tainted milk powder led to the hospitalization of almost 13000 children.
HypnoBirthing. The breakthrough approach to safer, easier, comfortable birthing
Authors: Jones Shirley
Published: May 2014

This book is easy to read; it is written for parents-to-be and those supporting the woman; therefore, it is not in academic or professional language. Although it is the third edition in the USA, suggesting popularity within a niche market, it is its first publication in the UK. The author has been a certified hypnotherapist in the field of counselling since 1987 and, having applied her knowledge to childbirth for her daughter in the preparation and birth of her first grandchild, she became the ‘mother’ of hypnobirthing, which she describes as a ‘philosophy of birth’, in 1989.
Examining a newborn baby: are midwives using their skills?
Authors: McDonald Sharon
Published: May 2014

Midwives across the UK have been undertaking the discharge examination of newborn babies for more than ten years. The perception is that many have the examination of the newborn qualification but do not use it. An audit was undertaken of 100 midwives, neonatal nurses and health visitors known to have the appropriate qualification in one area of the UK. The aims of the audit were to ascertain if midwives in this one area were in fact discharging newborn babies and to gain a better picture of local needs to improve the quality of local training. The audit sought to determine how many of the midwives, neonatal nurses and health visitors were discharging newborn babies, the number of babies they had discharged in one given month. What prevented them from using their skills and how best the training could be moved forward in the light of the changes in hospital based paediatrician working hours and GP service provision.
Late pregnancy: a rare bit of good news?
Authors: Bainbridge Jane
Published: May 2014

By leaving motherhood until later in life because of practical reasons, emotional or simply circumstance, parents put their baby's health and the woman's own at greater risk, but are there benefits for children?
Triumph over the barricades and put the evidence into practice
Authors: Hollins Martin Caroline J
Published: May 2014

In some instances midwives find it difficult to implement research into practice (Albers, 2001). For example, evidence informs of the benefits of providing continuous support during labour (Hodnett et al, 2003), yet one midwife to one woman is not compulsory in every maternity unit in the UK. Olsen (1997) meta-analyzed research that relates to the relative safety of home birth compared to hospital birth. Results found no difference in survival rates between babies born at home and those born in hospital. Amniotomy is still a common procedure, yet contra-indicated since fetal heart abnormalities are more likely in the healthy term fetus (Fraser et al, 1993). Such examples serve to sharpen awareness that some research is being overlooked. Consequently ideas about how to narrow the theory–practice gap become salient. With this in mind a model is proposed to help midwives implement change into practice. Changing behaviour is possible when logical structured approaches are taken at a number of levels.
Women seeking asylum: are communication needs being met?
Authors: Houghton Gillian
Published: May 2014

Caring for a woman who has recently arrived in the UK, speaks little or no English and often has complex care needs, is a common occurrence for many midwives in the UK today. In the past I have found my own experiences of providing care during labour elicit a series of emotions. I worry that I will not understand women's cultural needs and that the services available will not easily allow us to communicate in a language we both understand. At the same time these experiences have been proved extremely satisfying; an opportunity to pull out all the stops and use the real communication skills of midwifery. I have always believed that most communication between a woman and her midwife during labour does not involve the use of words. Touch, eye contact and other non-verbal communications often say much more and work better towards building a relationship of trust and nurturing a caring environment.
Acute fatty liver of pregnancy
Authors: Pateman Katie , O'Brien Patrick
Published: May 2014

Acute fatty liver of pregnancy (AFLP) is a rare condition affecting women primarily in the third trimester of pregnancy. It is potentially life-threatening to both mother and fetus. This article discusses the clinical features, how to diagnose the condition and how to manage it.
No beds for new mothers in New Zealand
Authors: Daniel Lincia
Published: May 2014

A national survey in New Zealand revealed a shortage of some 200 midwives, an extreme situation that led one Health Board to offer mothers a cash gift to leave hospital early putting vulnerable mother at risk.
Statutory Supervision of Midwives: A resource for midwives and mothers
Authors: Davies Louise
Published: May 2014

This is a wonderful resource for midwives, supervisors of midwives and those who are training to be supervisors. Its contents builds on the previous work of the Nursing and Midwifery Council (2002) and aims to link the statutory framework of supervision to practice.
International Confederation of Midwives 28th Triennial Congress
Authors: Clift-Matthews Victoria
Published: May 2014

The Royal College of Midwives invites midwives from all over the world to attend the ICM Congress held in Glasgow, beginning on 1 June. This is an international event and the opening ceremony is not to be missed. It includes performances from those all over the UK and the presentation of national flags.
Maternal resuscitation: how to resuscitate mothers who die
Authors: Madams Mark
Published: May 2014

Only a few mothers each year die in hospital or at home in the UK and many women deliver safely (CEMACH, 2007). It can be a terrifying situation for those who provide care to women who need resuscitating and training in basic in-hospital resuscitation once a year does not fully prepare an individual to perform with skill or confidence in such a stressful and emotionally charged situation. Updating skills regularly and practising them in a clinical environment by means of drills or scenarios is the best method in preparing individuals for this rare but catastrophic emergency (CEMACH, 2007). In this article the problems and unique difficulties in resuscitating women are examined the necessary modifications to standard CPR guidelines are described.
Unnatural selections
Authors: Daniel Lincia
Published: May 2014

MPs have voted to allow parents to conceive, test and select embryos which provide a tissue match for a sick child with a genetic disease, but is it unethical to create one child in order to save another?
Pushed, the painful truth about childbirth and modern maternity care
Authors: Mead Marianne
Published: May 2014

In 2006 the USA recorded a 31.1% caesarean section rate, an increase of 3% over 2005, an increase of 50% over the last ten years (Hamilton et al, 2007). For anyone wishing to know why this may be the case, this book will provide some answers. Jennifer Block, a former editor of the Ms Magazine and of the revised edition of the book ‘Our Bodies, Ourselves', has produced a very readable book on the topic. She explores the various factors that have led to an increased medicalization of childbirth, but systematically parallels the arguments for this increase with research that has demonstrated just as systematically that many interventions have little proof that they may be beneficial but, indeed, often plenty of information that demonstrates harm associated with such interventions.
Reflective practice in postgraduate midwifery education
Authors: Phillips Diane , Morrow Jane
Published: May 2014

The literature is abundant with the benefits of reflective practice in midwifery education and other disciplines. At Deakin University, Victoria, Australia, students enrolled in the Graduate Diploma of Midwifery have embraced reflective practices by means of computer mediated learning applications. Students enrolled in this course reside in metropolitan, regional and rural areas of Victoria and had previously experienced issues of ‘distance’ and ‘isolation’ from peers and academics. Since 2007 two computer modalities, Elluminate Live and Deakin Studies Online have been incorporated into the lecture timetables for the Graduate Diploma of Midwifery to allow students to participate in online discourse and maintain an online reflective journal space. This innovation for the promotion of reflective practices supports and upholds the oral tradition midwives are renowned for by increasing cohesion of each student course cohort, collaboration between peers and access to midwifery academics.
Abortion: sticking with the 24-week limit
Authors: Bainbridge Jane
Published: May 2014

Abortion is a contentious and emotive subject which has been hotly debated at length recently, in particular, the 24-week limit with many saying that it makes abortion too easy because the numbers are rising.
Pregorexia: body image over baby?
Authors: Bainbridge Jane
Published: May 2014

Size-obsessed women can go to extreme lengths to avoid weight gain in pregnancy, spending hours at the gym and excessively controlling their diet, but it's not only their health at stake—what about baby's?
Group dynamics and the challenge of redesigning maternity services
Authors: Gould Debby
Published: May 2014

We are in financial recession and cutbacks in the NHS are without question. How to design affordable maternity services that are fit for purpose not just today but well into 2020, taking account of the rising birth rate and increasing expectations, is under the spotlight. What seems incredibly obvious but so difficult to convey, is that the ‘one size fits all’ approach actually fits very few, and an obstetric-driven service is financially exorbitant.
Non-invasive techniques for fetal monitoring in pregnancy and labour
Authors: Hale Rachel
Published: May 2014

Electronic fetal heart monitoring provides accurate information of fetal wellbeing during the antenatal and intrapartum periods, but the monitoring equipment is usually large and therefore confined to hospital premises. During labour the use of a traditional fetal heart monitor (CTG machine) can often limit the mother's choice of birthing position. The rise in the use of hand-held doppler devices has enabled midwives to monitor fetal heart rates in the community setting and even underwater during a waterbirth delivery. Many expectant mothers, especially those who have experienced a previous difficult pregnancy, experience anxiety between obstetric appointments. Hand-held doppler devices are now available for hire or purchase for the mother to use herself.
Supervisory issues: lessons to learn from a home birth
Authors: Richardson Jamie
Published: May 2014

This is a reflective article exploring the supervisory issues surrounding a planned home birth through use of a case study. Issues from the case study, such as decision making and record keeping, are highlighted and analysed and recommendations for practice are included.
British midwives' views on rising caesarean section rates
Authors: Churchill Helen , Francome Colin
Published: May 2014

The rate of caesarean births in the UK has risen significantly in the last half a century. This article presents the results of a major national survey of midwives' views on the rising caesarean section rate, including their views on the reasons for this growth and measures to reduce it. Midwives' views on vaginal birth after caesarean (VBAC) are explored, as well as potential conflicts between medical staff.
Untapping midwives' potential is the future
Authors: Clift-Matthews Victoria
Published: May 2014

The goal of the Prime Minister's Commission (2009) on the future of nursing and midwifery is to fulfil the potential of nurses and midwives so that families and communities achieve the best possible health and wellbeing. Its vision is that nurses and midwives will be central to a number of aspects of health care, including health-care delivery, leadership, research, education, service design and management, and policy making. The aim is for nurses and midwives, which are professions ‘rooted in compassion’, to deliver services locally, providing high-quality physical and psychological health, and for them to be valued members of the community.
Protecting the perineum: have we been duped by HOOP?
Authors: McCarthy Rosemary
Published: May 2014

The maintenance of an intact perineum following vaginal birth is a fundamental objective of the midwife. Traditional techniques adopted to protect the perineum were evaluated by McCandlish et al's (1998) pivotal ‘HOOP’ study some ten years ago. The findings have largely been interpreted as suggesting that the custom and practice ‘hand on’ approach, adopted by many midwives, was inconsequential in preventing perineal trauma. This finding has impacted practice significantly. Management of the perineum during the second stage of labour is now varied and largely dependant on the preference of the midwife in attendance. Consequently student midwives are taught an assortment of approaches but appear to lack clear understanding of the rationale, let alone evidence, on which their practice is based.

Corresponding with changes in practice, there is local audit evidence to suggest that the incidence of significant perineal trauma, involving damage to the external anal sphincter, anal sphincter complex (external and internal anal sphincter) and in the worst cases also involving the ano-rectal mucosa, is increasing. Given the considerable implications of this, perhaps it is time to re-visit HOOP and challenge the notion that traditional protective measures are of little value in preventing substantial trauma.
Somebody to love
Authors: Daniel Lincia
Published: May 2014

The highest rates of teenage pregnancy are found in areas of greatest deprivation but why is it that so many young people fall pregnant and are their parenting skills any better or worse than those of older mothers?
Still life
Authors: Daniel Lincia
Published: May 2014

Stillbirth or neonatal death are tragedies that many people believe to be rare, yet they actually occur around 17 times a day in the UK and the support that bereaved parents need is not always available.
Contraception overview
Authors: Clift-Matthews Victoria
Published: May 2014

Midwives are ideally placed to inform and help women choose the best method of contraception for them. It is perhaps better if this deiscussion takes place antenatally when women are not focused pon the care and demands of a new baby. However, when it takes place before of after childbirth during a postnatal check midwives need to be aware of the methods available and be informed about which are suitable for women who choose to breastfeed.
Building healthy bodies
Authors: Daniel Lincia
Published: May 2014

Parents have a huge influence on the eating habits their children develop, which continues right through to adulthood. Setting them a good example can go a long way to improve their health and your own.
Gaining competence and confidence as a midwife
Authors: Steele Rosaline
Published: May 2014

This is an extract from An Essential Guide for Student Midwives Preparing for Professional Practice, edited by Sue Jacobs and Tina Lavender, published by Quay Books.
Stress in pregnancy: identifying and supporting women
Authors: Alderdice Fiona , Lynn Fiona
Published: May 2014

Most women adapt well to pregnancy and current psychological and physiological research findings suggest that as pregnancy progresses many women are less reactive to stress. However research exploring the effects of stress on pregnancy suggests women who experience high levels of stress are at increased risk of adverse outcomes, in particular, preterm birth. Midwives play a key role in identifying and supporting women through stressful experiences. Exploring with women factors associated with stress and the coping skills they use can enhance care and provide an opportunity to promote healthy coping skills. Awareness needs to be raised about the potential impact of stress on pregnancy and how stress might be managed. Further consideration also needs to be given to stress reduction interventions to help women manage their experience of stress.
Postpartum management of the perineum
Authors: Bick Debra
Published: May 2014

This is an extract from Perineal Care: An international issue, edited by Christine Henderson and Debra Bick, published by Quay Books.
Nutrition for maternal and fetal wellbeing: folic acid and iron
Authors: Edwards Joanne , Thomas Grace , Wyn-Davies Janine
Published: May 2014

Prospective parents generally aspire to give their child the best start in life and, if their babies are born healthy, this good health is more likely to continue into adulthood (Barker, 2003). There is no better way to facilitate this than being in an optimum state of health before conception and throughout pregnancy (Hunt, 2004). For many years it has been recognized that maternal environment and adequate nutrition are imperative for the development of the fetus and the wellbeing of the mother (Tiran, 2004a). Over the past decade, evidence has been accumulating showing that insufficient maternal nutrition can result in low birth weight, which increases risk of chronic non-communicable disease in later life such as coronary heart disease, hypertension and non-insulin-dependent diabetes (Godfrey and Barker, 2001; Barker, 2003).

This article is part of a literature review for a BSc dissertation that seeks to appraise some general aspects of nutrition during pregnancy and, specifically, the effects that folic acid and iron can have on the mother and fetus.
Female genital mutilation and the law
Authors: Griffith Richard
Published: May 2014

It is estimated that 100–140 million girls and women worldwide are currently living with the consequences of female genital mutilation (FGM) (World Health Organization, 2008).
Twittering on about social networking and babyfeeding matters
Authors: Guy Caroline , Paterson Aileen , Currie Heather , J Lee Amanda , P Cumming Grant
Published: May 2014

The aim of this pilot study was to investigate whether or not social networking increases traffic to a website offering support and advice on infant feeding and whether or not this technology is potentially more useful than the existing online forum. Profile accounts were set up on Bebo, Facebook and Twitter and people who might be interested in infant feeding were contacted through the search facility on each of these sites over a 6-week period. If interest was expressed, they were invited to complete an online evaluation on www.babyfeedingmatters.co.uk. A total of 250 invitations were issued and 136 surveys were completed. The study found that www.babyfeedingmatters.co.uk is meeting its aims and is both easy to navigate and understand. However, the current forum may be outdated and would benefit from being incorporated into a social networking platform to provide informal peer support. Overall, social networking increased web traffic and responder feedback from the ‘wisdom of the crowd’ and has led to further refinement of the website.
Changing attitudes to improve maternal mortality in Burkina Faso
Authors: Daniel Lincia
Published: May 2014

A recent Amnesty International report highlights the risks to childbearing women and the high maternal death rate, but to make changes women need to be supported as equals in the home and by the government.