bluuebunny/crossref_metadata_2025 huggingface dataset:
Step 37: Female circumcision
Authors: Dimond Bridgit
Published: May 2014

Apart from a few extremely important exceptions, the law does not interfere with what people wish to do with their own bodies. The two exceptions are a House of Lords ruling in a case involving sadomasochists and the Prohibition of Female Circumcision Act.
Nutrition in the under-fives pack: breast-feeding advice
Authors: McLean Rachel
Published: May 2014

A recent document published by the Health Education Board for Scotland (HEBS) (2001), Nutrition in the under-fives, provides clear and digestible research about nutrition in the first 5 years of life. The document is written for health professionals giving care to women and young children but may also be of interest to strategists and policy-makers. The reader is able to update and add sections as new research and information comes to light, without having to reproduce the whole document.
Looking back at the legal developments of 2001
Authors: Dimond Bridgit
Published: May 2014

This article reviews the legislative changes which have taken place in 2001, the new cases and guidance from the Department of Health and looks to the significant developments in 2002
A bed for all reasons?
Authors: Haley Jayne
Published: May 2014

The pressures placed on the health services acute trust's bed status is no longer a phenomenon of the winter months. Many trusts encounter difficulties in propitiating care every day for acutely ill patients, as well as sustaining pressure to maintain surgical services and meet waiting list targets. As a result, there is often criticism directed at trust chief executives, as well as direction from trust boards to be innovative in the appeasement of this compromising situation in health care.
Infant colic and lactose intolerance — the confusion
Authors: Morris Adrian
Published: May 2014

Infant colic is a particularly distressing condition for both infants and their parents. Many new parents are anxious and the added stress of an unhappy and crying baby compounds their anxiety. This product focus article aims to clarify the aetiological differences between lactose intolerance and infant colic, and establish that Infacol®, is a clinically proven treatment for infant colic which has a trusted over the counter and prescription heritage.
Antenatal screening in the West Midlands
Authors: Hodgkiss Sharon
Published: May 2014

Antenatal screening provision varies across the regions of the UK, with evidence of inequality of access, quality and auditing. In line with the era of clinical governance, this government has proposed an innovative structured programme to address these issues. The National Screening Committee and National Institute for Clinical Excellence are formulating evidence-based guidelines with the objective being a national coordinated approach to antenatal screening services.
Step 39: Regulating health professionals
Authors: Dimond Bridgit
Published: May 2014

Who regulates the regulator? This is a question that is now answered in respect to the regulation of health professionals. Included in the NHS Reform and Health Care Professions Bill 2002 is provision for the establishment of the Council for the Regulation of Health Care Professionals (CRHCP). This new Council will be a corporate body with the following functions.
New pregnancy notes: let us have your views
Authors: McGeown Pat , Gardosi Jason
Published: May 2014

Personally held maternity records are used in many parts of the country. However, there is wide variation in the content and design and little consultation with what their main users feel the notes should contain. In the West Midlands, we have undertaken a major review of maternity notes and have produced a draft that has been undergoing region-wide consultation, and a field trial is in progress. We would now like to widen this consultation and ask for your ideas and feedback.
Terms and conditions: midwives hold the key
Authors: Henderson Christine
Published: May 2014

Hostile working environments, dissatisfaction, little flexibility in working patterns, and not valuing the skills of midwives were some of the reasons why midwives are leaving the profession with little hope of returning (Ball et al, 2002). The contents of the report Why Do Midwives Leave? were featured in the RCM's recent annual conference. However, all was not doom and gloom, there was plenty to celebrate.
Putting the humanity back into maternity
Authors: Page Lesley
Published: May 2014

Over 20 years ago I had an experience that radically changed my view on midwifery and maternity. Together with three other midwives and a group of supportive obstetricians, we set up the first pilot project of midwifery in Canada. (Until very recently the only place that midwives could practise within the health service in Canada was in very remote areas where there were few or no doctors. Only doctors could be licensed to practise ‘midwifery’). As we had no precedents for our practice, quite naturally we set up what we thought would be best. We worked to provide continuity of carer to women and their families. We got to know women and their families and formed strong working relationships with them.
Privacy, the Blairs and the MMR vaccine
Authors: Dimond Bridgit
Published: May 2014

This article looks at the law relating to privacy and applies it to the situation of the Prime Minister who has been criticised for not giving the public information on whether his son has been given the triple MMR vaccine.
Knowledge and skills of CTG interpretation
Authors: Stewart Jane H , Guildea Zöe E
Published: May 2014

The aim of this study was to assess how midwives acquired their knowledge and skills in cardiotocograph (CTG) interpretation, how confident they felt in this area and whether they considered they would benefit from additional training. The study design involved a survey conducted in 1999, of 1500 midwives practising in Wales. A total of 741 questionnaires were returned, representing a response rate of 49%. It was found that levels of confidence in their CTG interpretation skills are high, even those midwives who spent little time working on labour ward rated their expertise highly. The most popular methods of learning were study days, learning from experienced colleagues and reflective practice. However, 94% of respondents felt that training was insufficient and that more should be provided, particularly during work time and at no personal cost. This view is mirrored by a recent national survey conducted to examine the provision of CTG education which found that many midwives were using both their own time and money to attend relevant training (CESDI, 2000).
Researching the public health role of the midwife
Authors: Hillier Dawn , Caan Woody
Published: May 2014

There is an impressive potential for midwives (working in a variety of settings) to improve health, especially for the most disadvantaged individuals, families and communities. Skills within midwifery could advance public health in relation to: conception, pregnancy, birth, infancy, parenting and supporting families. However, there is little ‘evidence base’ for developing and deploying these midwifery skills safely, responsibly and effectively. New opportunities are arising for research to underpin the public health role of the midwife. This could also be the time for midwives to take on a leadership role in the research agenda, to advance their knowledge of how to benefit health across populations.
Step 49: The right to respect for privacy
Authors: Dimond Bridgit
Published: May 2014

In the last three steps articles we have considered the power given to the Secretary of State under section 60 of the Health and Social Care Act 2001 to make regulations on disclosure of patient information; the role of the Patient Information Advisory Group in scrutinising draft regulations permitting disclosure of patient information and the recent regulations which have been made by the Secretary of State. This steps article considers the implications of Article 8 of the European Convention on Human Rights and the right to privacy.
Registration of health-care professionals
Authors: Dimond Bridgit
Published: May 2014

This paper considers the proposed changes to the Register kept by the NMC and the requirement for good health and character for registration and re-registration. It also considers the role of the Council for the Regulation of Healthcare Professions.
We must be the first point of contact for pregnant women
Authors: Davis Dame Karlene
Published: May 2014

Midwifery, like every other profession, has seen some enormous changes over the past decade. Most of these changes relate to access to university education, including higher degrees, diversifying the arena of practice to include public health strengthening normality in childbirth, and the growth of midwifery research.
The evolution and destiny of midwifery research
Authors: Lavender Tina , Briscoe Lesley , Baker Lisa
Published: May 2014

This article will describe the developments in midwifery research over the last 10 years. A discussion of midwifery attitudes, educational and academic changes and contributions to practice will be presented. Factors currently driving the midwifery research agenda will be highlighted. The article will then explore the future direction of midwifery research and outline the possibilities for the next 10 years.
Current Issues in Midwifery
Authors: Murphy-Black Tricia
Published: May 2014

The British Journal of Midwifery conference to mark 10 years of publication started with presentations of English developments in national policy followed by three papers on the use of evidence to inform practice. A refreshing aspect was the range of speakers, an encouraging sign that midwives can both learn from and face the examination of other experts as well as ourselves.
Use of client held records in the maternity services
Authors: Hart Angie , Jones Andrea , Henwood Flis , Shiers Chris
Published: May 2014

This article reports on one aspect of a national survey of heads of midwifery regarding their views on record keeping practices in the maternity services. The use of the client held record in particular is the focus of this article. The article confirms that client held records are popular and widely used within the maternity services. It also explores the varying degrees to which clients are actively involved in the use and maintenance of their record. Findings from the survey demonstrate that client empowerment cannot simply be assumed by clients having physical access to their notes. More work needs to be done to enable clients to be properly empowered through the use of client held records. The article ends by exploring other reasons for the importance of their continued use, both within the maternity services and beyond.
The National Patient Safety Agency
Authors: Johnson Sara
Published: May 2014

This article reports on the work of the National Patient Safety Agency. It describes the purpose of the organization and highlights the importance of creating an organizational culture within the NHS that supports open and fair approach in its response to patient safety incidents.
A case of selective feticide
Authors: Webb John
Published: May 2014

A case of late gestation monochorionic twins in which one twin has a significant congenital disorder provides the basis for a consideration of the different types of decisions that need to be made. As there was potential conflict between medical opinion and the wishes of the mother in this case, and because decisions were needed urgently if a healthy twin was to be successfully delivered, this article considers the basis for decision making and highlights what are considered to be the priority questions to be asked. This priority suggests a differentiation between those questions and decisions which are principally medical, those that are legal and those that are moral and ethical. This is not proposed in order to establish any false subject demarcation, but rather to assist with the decision making processes both immediate and on reflection.
Midwifery rules and supervision
Authors: Dimond Bridgit
Published: May 2014

This article considers the consultation paper published by the NMC on new Rules for Midwives and new guidance for local supervising authorities and suggests more radical reviews for the future.
Step 50: Sex discrimination
Authors: Dimond Bridgit
Published: May 2014

Statutory rights to be protected against unlawful discrimination on grounds of sex are given by the Sex Discrimination Acts 1975 and 1986. The Acts prevent direct discrimination, indirect discrimination and victimization. The Equal Pay Act 1970 implies an equality clause into an employment contract, that a woman employed on work similar to a man is entitled to have similar terms and conditions.
Webwatch
Authors: McDonnell Cheryl
Published: May 2014

During this season of floods and inclement weather conditions it would seem timely to reconsider some of the therapeutic and health benefits of water and therefore I decided to review the website:

www.aquanatal.co.uk
Shaping the future of the maternity services
Authors: Page Lesley
Published: May 2014

It is almost 10 years since Changing Childbirth was published (Department of Health (DoH), 1993). The report undoubtedly raised awareness of what we call ‘woman-centred care’. Many innovations developed because of the report, and some of these have survived. More recently we have seen the development of a number of birth centres around the UK, these are popular, and successful. However, development has been patchy. In many ways we have lost ground. The caesarean section rate in the UK is among the highest in the world and is overtaking that of the USA. The number of midwives in practice is lower than it has ever been, and very few women have a completely ‘natural’ birth.
A review of carpal tunnel syndrome in pregnancy
Authors: Rozette Claire , Houghton-Clemmy Rob
Published: May 2014

Carpal tunnel syndrome (CTS) during pregnancy is common and distressing, however, the syndrome can be simply treated if diagnosed early. The purpose of this article is to revise the anatomy and pathology of CTS in pregnancy, enabling the midwife to diagnose the condition and instigate early treatment in the antenatal clinic. The current international literature on CTS in pregnancy is reviewed and key points are set out in the text.
Gynaecology — the labelling game
Authors: Robinson Jean
Published: May 2014

You can skip this month's piece if you like as it is not about maternity care.
An exploration of aquanatal exercise
Authors: Huber Ingrid
Published: May 2014

Aquanatal exercise has been recommended for pregnant women for the beneficial effects of immersion, its joint protective character and its psychological benefits. This research, based in the North West of England, identified the professional backgrounds of those involved delivering sessions, considered training and experience via an examination of current working practices and additionally elicited the views of participants. Midwives, physiotherapists, exercise instructors and swimming instructors were interviewed while the participants answered a short questionnaire. All instructors interviewed considered aquanatal training to be inadequate. Midwifery attendance was seen as important, with instructors appearing to view it as an informal ‘insurance policy’. Aquanatal exercise would benefit from the setting up of a professional, multidisciplinary framework for agreed professional standards of training and development, professional guidelines and a register of qualified instructors. Maximizing interprofessional skills would benefit participants, the status and profile of the service and could help to facilitate further research.
A framework for advancing practice
Authors: Lewis Paul
Published: May 2014

In the final months of the UKCC's term of office, the then Statutory Midwifery Committee (SMC) considered a number of emerging roles with which the midwives of today are confronted. As a profession we remain challenged by what we mean by specialist and advanced practice in midwifery, as opposed to specialist skills allied to our work as midwives. We are constantly revisiting where the traditional notions of what midwifery is, how it fits with the changing needs of health and social care and how we can ensure that in the interests of public protection, midwives are best prepared for the work they do.
Can hypnosis reduce postnatal depression?
Authors: Mantle Fiona
Published: May 2014

The estimated incidence of postnatal depression (PND) is between 10–15% of postpartum women and its effect on family relationships can be far reaching. As a condition it is therefore worthy of attention, not only in regard to its treatment but also to its prevention. Of particular note is its precipitation by obstetric interventions in response to: (1) normal labour in order to shorten its length and so reduce maternal exhaustion; or (2) abnormal labour or malpresentations. This article discusses the potential role of hypnosis in ameliorating these conditions leading to the possible reduction of PND. Of particular value is the use of hypnosis as a general preparation for childbirth, provided it does not lead to unwarranted expectations about pain relief or of the ‘naturalness’ of the birth process. It is suggested that the value of hypnosis in reducing the incidence of PND needs to be evaluated by clinical trial, using the well-validated Edinburgh Postnatal Depression Scale as an outcome measure.
The European Court of Human Rights and removal at birth
Authors: Duerden Jean
Published: May 2014

The article by Robinson (2002) and the letter by Baldwin (2002) about the removal of a baby from its mother at birth make interesting reading in that they bring to the attention of the profession a case at the European Court of Human Rights (ECHR) with serious implications for all midwives. However, I do urge a substantial amount of caution in taking the decision as set out in either or both articles. Only a full reading of the report of the Court itself will permit a proper understanding of the case and the issues it raised. In particular, it will not only allow the reader to understand the workings of the Court's mind, which was not entirely unanimous, but also will permit an overview of the facts giving rise to the involvement of the local social services department which led it to take care proceedings.
Employment law: new provisions
Authors: Dimond Bridgit
Published: May 2014

Significant changes to statutory rights in employment came in to effect in April 2003. The rights to have paternity leave and pay, adoption leave and pay, paternity leave and pay for adoptees and maternity leave and pay are discussed together with new procedures for dispute resolution at work.
Premature babies: the CESDI report
Authors: Robinson Jean
Published: May 2014

Somewhere out there is a little boy who thinks he is a week younger than he actually is. His mother told me she could not put on a happy face, produce presents, or have a cheerful party on the anniversaries she dreaded — reminders of his traumatic birth. His life as her son began a week later, the day she took him home, and away from the staff who, she felt, had taken him over. From then on, she said, he was ‘mine’, and that is the day they celebrate.
10 years of the BJM: let's celebrate!
Authors: Richens Yana , Lavender Tina
Published: May 2014

The year 1993 was momentous for many reasons. Take That won the Brit Awards for the Best British Single with ‘Could It Be Magic’, Tom Hanks was awarded an Oscar for his leading role in ‘Philadelphia’ and Rita Dove was Poet Laureate, one of her poems being ‘Mother Love’. On a more academic note, Richard Roberts and Phillip Sharp were awarded the Nobel Prize in Physiology and Medicine for their discovery of ‘split genes’, the discovery of which has been of fundamental importance for today's basic research in biology, as well as for more medically oriented research.
Evidence into practice for midwifery-led care: part 3
Authors: Munro Jane , Spiby Helen
Published: May 2014

This is the third article in this series describing the development, implementation and evaluation of evidence-based guidelines for midwifery-led care in the labour ward of an inner-city university teaching hospital. This article presents two final strands of the evaluation: 1) measurement of changes of practice through the use of routinely available data and 2) views of users of the maternity services. Perceptions of changes in practice previously identified by midwives, in the areas of electronic fetal monitoring and amniotomy, were also demonstrated in the routinely available data. Local user groups found the guidelines both ‘acceptable’ and ‘useful’. The Maternity Forum spoke positively about a cultural change they felt the guidelines represented. This initiative took place in one setting and the outcome is of greatest relevance to this locality. However, acknowledging that and the relatively small numbers involved in certain elements of the evaluation, both the process and the findings may be applicable to similar initiatives in other settings.
Risk management is not objective
Authors: Walsh Denis
Published: May 2014

Risk management affects profoundly maternity services in the UK, and some large units now have a full-time risk manager post, commonly a midwife. The official line on the advent of risk management is its dovetailing with clinical governance, ensuring quality in care and the avoidance or diminution of risk in clinical care and the working environment. Commonly, complaints management will form part of its strategy.
Learning not to teach: part two
Authors: Brunt Christina
Published: May 2014

Part one of this series of two articles sought to explain what happens within the inquiry-based learning tutorial group of one midwifery curriculum (vol 11(6): 376–9). In part two, important elements of the review tutorial are discussed. The development of a positive self-identity is achieved through peer and self-evaluation. This is fundamental to effective accountability and advocacy in midwifery practice. Facilitation of the small group process requires skills which have not been part of the lecturer's traditional responsibilities. Inquiry-based learning helps to address those things which may be ‘known’ but are not easily taught.
Webwatch
Authors: McDonnnell Cheryl
Published: May 2014

Midwives find themselves in a period of transition as both professionals and employees. A series of consultations undertaken by the Nursing and Midwifery Council and the first wave of developments driven by Agenda for Change (2002) ( www.doh.gov.uk/agendaforchange ) are likely to produce simultaneous changes in professional regulation and employment. This promises to be an exciting but uncertain time for individual midwives, and one in which they may increasingly seek the guidance of unions, possibly through the pages of a website such as that of the Royal College of Midwives (RCM):
NHS redress scheme: clinical negligence compensation
Authors: Dimond Bridgit
Published: May 2014

Considerable criticism has been made of the current scheme of claims compensation for clinical negligence. This article reviews a consultation paper published by the Department of Health for a new NHS redress scheme.
Flashbacks, nightmares and panic attacks after birth
Authors: Kitzinger Sheila
Published: May 2014

Unhappiness after childbirth is usually hidden. Think of all thebooks with photographs of shining, starry-eyed women cradling their beautiful babies. Women who are distressed feel that they have a shameful secret they must keep to themselves. They often believe that they are different from all other new mothers, and feel isolated. When they try to describe how they are feeling they may be told: ‘Be grateful that you've got a perfect baby’. Their unhappiness is explained away as ‘the blues’ or ‘upset hormones’. If they go to their GPs they may be diagnosed as depressed and prescribed anti-depressants, which for a woman who is anxious and on red alert all the time, makes her feel much worse.
Human fertilization and embryology
Authors: Dimond Bridgit
Published: May 2014

The Warnock Report in 1984 was the foundation for the Human Fertilization and Embryology Act 1990, but the law does not provide formany recent developments, and others where the law has been criticised.
Changing the culture: normalising birth
Authors: Cooper Tracey
Published: May 2014

This article shows how a midwifery-led unit has used evidence, statistics and audit to maintain its survival. It is supported by local women choosing midwifery-led care and wanting to keep a separate midwifery-led unit. The midwives working in the unit support and promote physiological birth.
Improving assessment of perineal tears: the Peri-Rule
Authors: Metcalfe Alison
Published: May 2014

The launch of the Peri-Rule, a new and simple tool used for the assessment of second degree perineal trauma took place in July 2004. The conference delegates heard from keynote speakers about the effects perineal trauma can have on women's health and the need for improved assessment of perineal tears and treatment interventions. The development of the Peri-Rule and its uses for improving clinical practice with audit, education and research was described. It offers significant benefits for women's postpartum health and could reduce the costs of litigation by improving the assessment of perineal trauma. The development of the Peri-Rule offers an excellent opportunity to undertake a randomized controlled trial comparing suturing versus non-suturing of second degree tears, where consideration for the size of tear can be included in the outcomes.
New NMC Rules for LSA and the supervision of midwives
Authors: Dimond Bridgit
Published: May 2014

The new midwives Rules and standards include new provisions for the regulation of local supervising authorities and the supervision of midwives (NMC, 2004), and reflect the thinking of the NMC in its consultation document on standards for LSAs. Under article 43 each LSA shall:
Prolonged midwifery care: where will we find midwives?
Authors: Robinson Jean
Published: May 2014

There is so much meat in the new National Framework (and a fair bit of gristle I want to spit out) that it is even harder than usual to restrict my comments to the one page I am allocated. So I will start with para. 9.4: ‘Midwifery-led services should provide for the mother and her baby for at least a month after birth or discharge from hospital, and up to three months or longer depending on individual need’ (DoH, 2004).
Development of antenatal HIV test guidelines
Authors: Reynolds Kate E
Published: May 2014

The virus which causes Acquired Immune Deficiency Syndrome (AIDS) was first identified in 1984 and the following year a test to identify antibodies to the virus was made available. Since then, the rate of newly diagnosed Human Immunodeficiency Virus (HIV) infection in women has significantly increased, particularly in those of childbearing age. This article focuses on the developments in HIV testing in antenatal care and the information required for effective pre- and post-HIV test discussions. In addition, the author suggests that midwives play a pivotal role in health education, necessitating clinical updating and exploration of attitudes in this emotive field. Finally, the article argues that midwives should refer to a specialist HIV team, to optimise the care of HIV-infected clients.
Web Watch
Authors: Hassall Jenny
Published: May 2014

Much has been written recently about how we might effectively promote normal childbirth. Certainly, anything that can enhance women's confidence in their bodies is vital in these days of high tech living and high tech birth. Exploring the benefits of complementary therapies is one approach especially with the increasing acceptance of these treatments in midwifery. The site chosen for review is:
Provision of antenatal care during Ramadan
Authors: Pearce Alison , Mayho Pauline
Published: May 2014

The holy period of Ramadan can change a Muslim woman's lifestyle. We look at the setting up and running of what may be the country's first ‘Ramadan Clinic’, the reasoning behind the idea and the processes involved in establishing the clinic. The article focuses on women's reasons for attending the clinic. The opinions of the women were recorded for audit reasons; and because their opinions could have an effect on the way the service would be provided in the future.
Sutures, surgical needles and perineal trauma
Authors: Mainstone Adrian
Published: May 2014

Modern technology has enabled the manufacture of a range of suture materials to ensure good wound closure, efficient healing and prevention of surgical site infections. Although there is evidence that episiotomies are to be discouraged as a routine procedure, where perineal trauma does necessitate stitching, the clinician is able to select the most appropriate suture material to achieve the best results with the least amount of discomfort to the mother.
Midwives’ indemnity: covering the cost
Authors: Dimond Bridgit
Published: May 2014

On 1 August 2004 additions were made to the Nursing and Midwifery Council's (NMC) Code of professional conduct and it was renamed the Code of professional conduct: standards for conduct, performance and ethics. The NMC intends to undertake a fundamental review of the Code which will involve extensive consultation with stakeholders and will not be completed till 2005.
Maternal deaths: midwives in the middle
Authors: Robinson Jean
Published: May 2014

Somehow the most poignant section in the latest maternal deaths enquiry (Lewis, 2004) was the comment on orphaned children: at least 800 existing and newborn children lost their mothers, and if late deaths are counted, the total is probably around 1,100.
The use of Doppler in fetal monitoring
Authors: Mainstone Adrian
Published: May 2014

Mothers must be made aware of the importance of recognising any decrease in fetal movements and of notifying immediately their appropriate carers. Failure to do so featured significantly in a report on the incidence of stillbirths in the UK (CESDI, 1997). Electronic fetal heart monitoring provides accurate information of fetal wellbeing during antepartum and parturition but machines are confined to hospital premises and their use during delivery limits the mother's choice of birthing position. The rise in the use of Doppler devices has enabled midwives to monitor fetal heart rates in a mother's own home and even during a waterbirth delivery. Many mothers experience anxiety during the time in between obstetric examinations, especially following a previous problematic pregnancy. Low-cost Dopplers are available for purchase or hire by a mother for home use to reduce such worry.
Breastfeeding and the transmission of HIV
Authors: Wright Hayley
Published: May 2014

Mothers known to be human immunodeficiency virus (HIV) positive who choose to breastfeed their babies present a highly emotive debate. Portrayed by society as irresponsible and dangerous, HIV positive mothers face ignorance, social disapproval and exclusion. The choice to breastfeed is every mother's right and midwives play a fundamental role in supporting women's choices. This article aims to provide an evidence-based plan of action enabling the mother to reduce the risk of HIV transmission by breastfeeding, whether or not the HIV status of the infant is known. Research has shown antiretroviral therapy, exclusive breastfeeding, the prevention of mastitis and abrupt early weaning significantly reduce the risk of vertical transmission of HIV. Milk banks and home pasteurization of breast milk are potential alternatives for women with HIV who do not want to breastfeed but prefer their babies to enjoy the benefits of breast milk. Further research and financial input are necessary to make these possibilities a real choice for mothers with HIV.
Fundal height measurement and low birth weight
Authors: McAllion Deborah
Published: May 2014

Research has shown that poor fetal growth is a risk factor in perinatal morbidity and mortality, and fetal wellbeing is an important consideration for professionals working in maternity care. The detection of the small baby is a constant challenge for health professionals. Abdominal palpation — the commonest form of screening — is only one of the clinical means practised in the detection of fetal growth. Other techniques are also available, yet there is lack of clear evidence and consensus in the debate of fundal height measurements. Although recommendations are available, the most appropriate screening tool for fetal growth surveillance is still not available.
Antenatal guideline: that sinking feeling
Authors: Flint Caroline
Published: May 2014

Every time a new NICE guideline is produced, the impression I get is that invariably they are based on expediency and vested commercial interests, and although they assure us that they are based on good research evidence, the evidence is not apparent from the documents. My heart sank into my boots when I read the latest antenatal care guideline.
Routine vitamin supplements for pregnancy
Authors: Price Sally
Published: May 2014

Midwives have a role in promoting healthy eating during pregnancy, particularly as pregnant women are faced with constant media messages about a healthy diet. However, health education information about nutrition may be misinterpreted or not fully understood. Many women choose to use routine vitamin supplementation in pregnancy to ensure an adequate nutritional intake. A variety of products are available as over-the-counter preparations. This article gives midwives the opportunity to familiarise themselves with some of the commonly available products, and to consider the advice and information for pregnant women in relation to their diet and vitamin supplements.
Webwatch
Authors: Carr Natasha
Published: May 2014

Many midwives and students are now being asked to be, or are actually actively involved in research.
How I became a ‘consumer’
Authors: Robinson Jean
Published: May 2014

My favourite jar sits on the kitchen shelf, advertising its contents in large embossed letters: ‘Eye of Newt’.
Cot deaths and midwifery responsibility
Authors: Dimond Bridgit
Published: May 2014

The death of a child must be the worse nightmare for parents, but that horror would be even further magnified if the parent were wrongly convicted of that death. Yet this is the situation hundreds of mothers. The acquittal of Trupti Patel and the freeing of Sally Clarke and more recently Angela Cannings by the Court of Appeal after successful appeals against convictions for the deaths of their children has had significant repercussions:
Royal College of Midwives conference
Authors: Elliot Maggie
Published: May 2014

As you are preparing to attend the Royal College of Midwives conference in Cardiff, I am sure that you will be looking forward to a week of debate, professional stimulation, the renewing of old acquaintances and some socialising. My feelings and expectations this year are very different to those normally experienced because on Tuesday 18 May I will be inaugurated as the next president of the Royal College of Midwives. My overwhelming feeling is that I have been given a great honour, together with an opportunity to build on the outstanding success of Dame Lorna Muirhead in representing and taking forward the work of the College throughout the UK and internationally.
Normal births in Wales: Realising the Potential
Authors: Cooper Dawn
Published: May 2014

At the moment in Wales there is a gradual sense of optimism and a renewed passion for the art of midwifery. This can, in part, be attributed to a sense of ownership and the clear direction provided by the publication of a midwifery briefing paper (Welsh Assembly Government, WAG, 2002). The impetus for developing the midwifery briefing paper was provided when the Nursing Division of the Welsh Assembly Government published the Strategy for Nursing, Midwifery and Health Visiting Realising the Potential (WAG, 2000).
Female genital mutilation: consequences for midwifery
Authors: Daley Anna
Published: May 2014

There is little doubt that all women who undergo female genital mutilation (FGM) have a high risk of experiencing adverse outcomes. Midwives have a responsibility to be aware of the specific factors that will ensure that the care they give to women with altered genitalia is safe, informed and sensitive. It is, therefore, essential for midwives who have contact with this client group to have an understanding of the complex issues that surround FGM. The purpose of this article is to examine FGM and its consequences to women's health, particularly in relation to childbearing. The article aims to give midwives a fuller understanding of why it occurs, thus enhancing their practice and facilitating empathetic and appropriate care.
Candidly speaking
Authors: Muirhead, DBE Lorna
Published: May 2014

After being President of the Royal College of Midwives for 7 years, and a clinical midwife for 39, retirement from these roles is imminent. It has been a great responsibility and huge privilege to represent midwives, but it is now time to hand the presidency over to Maggie Elliot to whom I give my good wishes, and to leave midwifery to all of you.
Childbirth: home or hospital?
Authors: Dunn Peter
Published: May 2014

Pregnant women, revealed by good antenatal screening to be without obstetric risk, may prefer to deliver at home rather than in hospital. However, the possibility of unanticipated complications requires for their safety the presence of two health professionals in the home and the existence of an emergency flying squad. As these may not always be available, it is suggested that such deliveries might alternatively be conducted in ‘maternity homes’ close to, but independent and separate from, the maternity hospital. These homes would be staffed by midwives and family doctors. Expectant mothers would occupy their own suite (with or without partner and family). Should complications then arise, obstetric/paediatric skills would be readily available nearby.
Medical device training in maternity care: Part 2
Authors: Sinclair Marlene , Crozier Kenda
Published: May 2014

The use of technology in modern childbirth is invisible to the everyday user. Medical devices/birth technologies fill our stores and clutter our work space, offering more efficient use of precious time and better birth outcomes. In this article we argue that midwives function in a world of technology that is ‘invisible', and that the role of the midwife in birth with technology typically falls into three broad categories: ‘midwife as spectator'; ‘midwife as controller'; and ‘midwife as enabler'. Birth technology usage has hidden layers of risk which need to be managed.
Disability discrimination
Authors: Dimond Bridgit
Published: May 2014

The Disability Discrimination Act 1995 envisaged a long period of implementation and the final parts of the Act come into force in October 2004.
Is the delegation of midwifery tasks ever legal?
Authors: Dimond Bridgit
Published: May 2014

Midwife shortages mean some units are restricting the activities of midwives (including ending home births services) to minimize risks to women and their babies. Where there is a shortage of registered midwives, the staffing situation could be alleviated if support workers were trained to assist registered midwives and carry out activities that they are competent to do as a result of their knowledge, supervised practice and experience. Is such delegation, however, lawful?
Do midwives know the facts about women who are HIV positive?
Authors: Beland Paul
Published: May 2014

The complaints made by the Healthcare Commission in its recently published report recently about (among other things) dirty toilets on maternity wards, reminded me of a curious discussion I had recently with some hospital midwives. Members of our HIV support service had been asked to speak at a study day about the experiences reported to us, by mothers with HIV, of maternity care.
Mothering the mother, midwife and baby: A personal account
Authors: Byrom Sheena
Published: May 2014

In many parts of the world, women return to the homes of their own mother to give birth, where they can be safe and protected by those who love them (Jackson, 2005). My first born has recently arrived home to us to give birth to her first baby, at home. She is radiant, happy, strong and confident. Most of all she is excited beyond imagination about the forthcoming event.
Can midwives make a difference to women suffering domestic violence?
Authors: Bainbridge Jane
Published: May 2014

Jane Bainbridge, freelance writer and mother gives a consumer's view on the issues facing maternity services. This week she looks at domestic violence during pregnancy.
How long is too long? Prohibitions on the length of labour
Authors: Walsh Denis
Published: May 2014

Australian childbirth practices like the UK and many other western countries have prohibitions on the length of labour. Having just returned from Australia it is clear to me that the ‘progress mentality’ has been exported there from Europe and the USA and is now well entrenched.
Japanese guidelines on weight gain in pregnancy
Authors: Bainbridge Jane
Published: May 2014

Freelance health writer Jane Bainbridge looks at midwifery news and and events from around the world.
Children need fathers too: Helping fathers to get involved
Authors: Daniel Lincia
Published: May 2014

Lincia Daniel, a freelance writer and mother gives a consumer's view on the issues facing maternity services. This week she looks at the pregnancy, birth and the father's role.
Maori maternity in the land of the long white cloud
Authors: Cairns Jo Beth
Published: May 2014

This article discusses cultural sensitivity in healthcare amongst rural Maori women and childbirth in New Zealand. My intention is not to stereotype or generalize Maori in any way. My admiration and respect for these women stems from my own personal experience of working as a midwife alongside them. These stoical women strive to exist and maintain their culture within their own birthing beliefs. Possible explanations for misconceptions within two diverse cultures living together are highlighted and reasons for inequality of health care are discussed with proposed achievable solutions. The overall emphasis is on cultural awareness and sensitivity in caring for rural Maori women during childbirth within their own community.
Prenatal cleft lip and palate parent programme – phase 2
Authors: Martin Vanessa
Published: May 2014

In Phase 1, a protocol of care was set up for parents whose children were diagnosed prenatally with a cleft lip/palate and their responses to this protocol researched. Phase 2 looks at how, following this research, standards were developed from parents' requests and audited over eight years. Parents wanted a leaflet and referral to the cleft team when told the diagnosis. They wanted more preparation for breastfeeding, a meeting with their primary care team before the birth and they wanted the scan diagnosis to be accurate. Audit results showed that a number of sonographers were diagnosing cleft lip and palate with considerable variation in their accuracy. The audit results also highlighted a noticeable improvement in breast feeding rates and the giving of expressed breast milk (EBM) by bottle when parents were well prepared for their child's birth. It also showed that aprotocol of care that was parent-led and included parental and professi onal education positively improved parent's confidence, bonding and feeding management.
Psychiatric misdiagnosis and maternal deaths
Authors: Robinson Jean
Published: May 2014

One of the commonest themes in our postbag comes from mothers who describe serious complications in their labour, which midwives did not take seriously. Staff automatically responded with the ‘there, there’ reassurance act without checking. It’s lovely to have a reassuring midwife – but women need her to be a watchful clinician as well.
Fetal monitoring challenges and choices for midwives
Authors: Blincoe Alana Juman
Published: May 2014

The use of fetal heart monitoring (FHM) to diagnose the well-being of the fetus has been practised for centuries. There have been many technological FHM advances to aid midwives in monitoring the fetal heart. The use of the Pinard stethoscope or hand held doppler for intermittent auscultation (IA) is recommended in low-risk mothers-to-be. For high-risk pregnancies, electronic fetal monitoring (EFM) offers continuous surveillance. However, since the introduction of EFM in the 1970s, its widespread use is causing much debate in the field of obstetrics, particularly because it is sometimes being routinely used to observe even low-risk cases. There is a call from regulatory bodies for a balanced use of EFM, and unnecessary intervention. regular EFM training for midwives will help them to interpret EFM data. According to some studies, EFM reassures expectant mothers and their technical advances are offering mothers more accurate information and freedom of movement during labour.
Webwatch
Authors: Carr Natasha
Published: May 2014

There are many physiological changes that occur in the female body during the childbearing process. Although the result of entirely normal physiological adaptations, these changes are often accompanied by what is referred to as `minor disorders in the antenatal period.
Controlled drugs to be tightly regulated
Authors: Dimond Bridgit
Published: May 2014

Following the conviction of Dr Harold Shipman for the murder of 15 patients, an inquiry was set up under the chairmanship of Dame Janet Smith DBE. The fourth report which was published in July 2004 considered the regulation of controlled drugs in the community.
Fifth report on professional regulation eyes complaints
Authors: Dimond Bridgit
Published: May 2014

On page 169 of this journal, the fourth report of the Shipman Inquiry is discussed. The fifth report of the inquiry was published in December 2004. Its publication marks an extensive inquiry into a wide range of areas of disquiet raised by the appalling tragedies of possibly over 200 deaths at the hands of Dr Harold Shipman. The fifth report considers the handling of complaints against general practitioners, the raising of concerns about GPs, the procedures of the General Medical Council (GMC) and the revalidation of doctors.
A guide to healthy eating during pregnancy
Authors: Blincoe Alana Juman
Published: May 2014

Government guidelines stress the need for pregnant women to have a balanced diet and to take certain vitamins and minerals. Many women who have difficulties in maintaining a healthy diet come from low-income backgrounds and the government is trying to promote improved nutritional standards through its Healthy Start programme. Midwives are in an ideal position to advise all women on the dos and don’ts of eating when pregnant and to make sense of the variety of supplements currently on the market. Folic acid is a ‘must have’ supplement for the first 12 weeks of pregnancy as it proven to reduce the incidence of neural tube defects in babies. Essential fatty acids (EFAs) are fast becoming more widely recognized as an important supplement for mothers, to ensure good brain development and the health of the mother.
Improving breastfeeding data collection
Authors: Battersby Susan , Bennett Kay , Sabin Karen
Published: May 2014

The Department of Health has expressed concern over the decline in the breastfeeding rate for many decades. When reviewing recent government figures it can be argued that, since 1985 there has been a further decline in the breastfeeding initiation rates. People in lower socioeconomic groups have been shown to have the poorest initiation rate. Programmes have demonstrated that breastfeeding peer support can reverse this trend and, as a consequence, the Sheffield-based Sure Start Foxhill and Parson Cross groups initiated peer support through the Breastfeeding is Best Supporters (BIBS) project. It was considered that a major way that the success of the project could be judged would be by looking for improvements in breastfeeding rates. This task proved problematic due to uncoordinated collation of infant feeding data in the project area – an issue that requires urgent attention.