Efnisyfirlit

• Cover image
• Title page
• Table of Contents
• Copyright
• Contributors
• Foreword
• Preface
• Acknowledgements
• PART 1. The midwife in context
  • 1. Global midwifery—an international perspective
    • Introduction
    • Global policy context for midwifery in the 2030s
    • Gender and gender-related issues
    • The concept of agency
    • Factors affecting equality and equity
    • Promoting health and wellbeing
    • Perinatal mortality
    • Inequities associated with being a mother
    • The significance of the Human Development Index
    • Coverage and skilled attendance at birth
    • Socioeconomic factors affecting coverage of midwifery care
    • Midwifery in humanitarian and complex situations
    • International perspectives and challenges
    • Important considerations for midwives working cross-culturally
    • Conclusion
  • 2. An introduction to midwifery history in the United Kingdom
    • Please note
    • Introduction: history — why bother?
    • Historical veracity
    • ‘Doing history’
    • Women’s voices
    • Vital statistics as a historical lens
    • Interpreting texts
    • Men midwives: the early medicalisation of childbirth
    • The changing face of midwifery in Britain
    • Midwifery registration
    • Uncovering 20th-century discriminatory attitudes in midwifery
    • Pelvic theory—an exercise in sexism and racism
    • Learning from the past to build the future
    • Conclusion
  • 3. The regulation of midwives
    • Introduction
    • The legislative framework of regulation
    • Conclusion
  • 4. Clinical governance and the midwife
    • Introduction
    • Clinical governance
    • The healthcare safety investigation branch
    • Maternity risk management
    • Maternity leadership
    • Conclusion
  • 5. Learning, being, and developing as a midwife
    • Introduction
    • Learning to be a midwife
    • Courses, programmes, and curricula
    • The cost of education
    • Lifelong learning ... and in practice ...
    • Pre-registration programmes and learning
    • Learning
    • Learning theory
    • After qualification and registration: continuing professional development and revalidation
    • Impacting issues
    • Computers, e-learning, and the Internet
    • Changes and developments
    • Mentorship, coaching, and the midwife as a role model
    • Conclusion
  • 6. Being a student midwife
    • Introduction
    • Choosing midwifery as a career
    • Towards application and selection
    • Preparing to apply
    • A growing workforce
    • Becoming a student midwife
    • Balancing information and evidence
    • The challenges
    • Representation matters
    • Calls for change—changing curricula... challenging assumptions
    • The student midwife cohort
    • Learning
    • Digital technology
    • Clinical practice placements
    • Assignments and assessments
    • Dealing with difficult situations as a student
    • Conclusion
  • 7. Evidence-based practice and research for practice
    • Introduction
    • Defining research and ‘midwifery’ research
    • Evidence-based practice in nursing and midwifery
    • Process steps to improve practice
    • Conclusion
  • 8. Leadership and management in midwifery
    • Introduction
    • Leadership and management: two sides of a coin?
    • Leadership: traditional and contemporary thinking
    • Leadership and management in the NHS
    • Leadership in midwifery
    • Conclusion
  • 9. An introduction to ethics for midwifery practice
    • Introduction
    • What is ethics?
    • Principles
    • Conclusion
  • 10. Law and the midwife
    • Introduction
    • The accountable midwife
    • The law
    • Judicial function
    • Prudent patient test
    • Material risks
    • Trespass to the person
    • Obtaining consent
    • Best interests
    • Who determines a person’s best interests
    • Determining a best interest
    • Guidance from the Court of Protection
    • Welfare order
    • Independent mental capacity advocate (IMCA)
    • Circumstances where the best interests doctrine does not apply
    • Duty of confidence
    • Duty of candour
    • Conclusion
  • 11. Pharmacology and the midwife
    • Introduction
    • Therapeutics in pregnancy and childbirth
    • Transgenerational adverse reactions
    • Drug administration and absorption
    • Drug distribution
    • Elimination / clearance of drugs
    • Pharmacodynamics
    • Drugs in labour
    • Legal aspects
    • Conclusion
• PART 2. Childbirth in context
  • 12. Sociocultural and spiritual context of childbearing
    • Introduction
    • Cultural competence, culture, and ethnicity
    • Midwives and cultural competence
    • Cultural awareness: the influence and relevance of cultural identity
    • Aristotle’s golden mean and wise compassion
    • Family and gender
    • Religion and spirituality
    • Conclusion
  • 13. Psychological context of childbirth
    • Introduction
    • Psychological adjustment across the perinatal period
    • Midwife–woman relationship
    • Conclusion
  • 14. Sex, gender, sexuality, and childbearing
    • Introduction
    • Sex, gender, and sexuality
    • Sexual health and sexuality
    • Sexual violence and abuse
    • LGBTI+ families
    • Breastfeeding and chest-feeding
    • Conclusion
  • 15. National Health Service policy and midwifery
    • Introduction
    • Legislation and policy—an overview
    • Standards of proficiency for midwives and the policy context
    • Special advisers and media managers
    • Think tanks
    • The influence of academics
    • Adverse events
    • A highly politicised service
    • Affording the NHS—the political football
    • Conclusion
  • 16. Maternity service provision
    • Introduction
    • What makes up a maternity service?
    • Models of care
    • Those who use maternity services shape it
    • Responding to the needs of local communities
    • Conclusion
  • 17. Legal frameworks for the care of the child
    • Introduction
    • The Children Act 1989
    • Support for children and families
    • Family support services
    • Children with disabilities
    • Assessing children ‘in need’ and their families
    • The emergency protection order (EPO)
    • The child protection conference
    • Conclusion
• PART 3. Public health, health promotion and childbirth
  • 18. Epidemiology
    • Introduction
    • Pregnancy outcome
    • Maternal mortality
    • Stillbirth and infant mortality rates
    • Care in pregnancy and at birth
    • International comparisons
    • Conclusion
  • 19. Infection prevention and control in maternity care
    • Introduction
    • The chain of infection
    • The reservoir of infection
    • Mode of transmission
    • Infection prevention and control
    • Conclusion
  • 20. Nutrition for a healthy pregnancy
    • Introduction
    • Dietary requirements
    • Healthy eating for pregnancy
    • Nutritionally vulnerable pregnant women
    • Maternal weight in pregnancy
    • Weight managment in pregnancy
    • Conclusion
  • 21. Complementary therapies and natural remedies in pregnancy and birth
    • Introduction
    • Complementary therapies commonly used in pregnancy and birth
    • Midwives’ responsibilities regarding complementary therapies
    • Conclusion
  • 22. Public health, health promotion, and education
    • Introduction
    • Definition of the meaning of health
    • Health promotion
    • Health inequalities and social determinants of health
    • Midwives’ role in health promotion
    • Barriers to behaviour change
    • Communication tools to support health promotion activities
    • Health promotion activities
    • Tobacco use during pregnancy
    • Obesity in pregnancy and the role of the midwife
    • COVID-19 and the health promotion role of the midwife
    • Evaluation
    • Conclusion
  • 23. Preconception care
    • Introduction
    • Preconception care challenges
    • Aims and objectives of preconception care and interventions
    • Conclusion
  • 24. Education for parenthood
    • Introduction
    • Modern parenthood education
    • Empowering women
    • Curriculum and lesson planning
    • The learning group
    • Group activities
    • Tailoring education
    • Conclusion
  • 25. Physical preparation for childbirth and beyond
    • Introduction
    • Maternal movement important for labour and birth
    • Relaxation and breathing
    • Physical activity and exercise during pregnancy
    • Monitoring exertion
    • Occupational activity
    • Pregnancy-related lumbopelvic pain
    • Postnatal recovery
    • Conclusion
  • 26. Vulnerable women and families
    • Introduction
    • Domestic violence and abuse
    • Substance misuse (alcohol and/or drugs)
    • Pregnant teenagers and young parents
    • Parents with learning disabilities/intellectual disability
    • Black, Asian, and minority ethnic women
    • Gypsy, Roma, and Traveller women
    • Poverty and destitution
    • Conclusion
• PART 4. The anatomy and physiology of fertility, conception and pregnancy
  • 27. Anatomy of male and female reproduction
    • Introduction
    • The pelvis
    • Female reproductive anatomy
    • Fetal development
    • Male reproductive anatomy
    • Midwifery implications
    • Conclusion
  • 28. Female reproductive physiology — cyclical changes in the ovaries, uterus, and mammary gland, across the infertile cycle
    • Introduction
    • Hypothalamic control of reproduction
    • Neuronal orchestration of GnRH pulsatility
    • The ovarian cycle
    • Cyclical changes in the reproductive system
    • Conclusion
  • 29. Genetics and genomics
    • Introduction
    • Genes, chromosomes, and DNA
    • The human genome
    • Cell division
    • Chromosomal analysis and anomalies
    • Modes of inheritance
    • Introduction to genomics
    • The midwife and genomics
    • Gathering information
    • Family Health History (FHH) (‘pedigree’)
    • Genetic red flags (GRF)
    • Genetic referral
    • Laboratory Techniques
    • Conclusion
  • 30. Fertility and its control
    • Introduction
    • The role of the midwife in the provision of contraceptive advice
    • Resuming sexual relationships following childbearing
    • Methods of fertility control
    • Intrauterine devices
    • Tubal sterilisation
    • Special groups
    • Conclusion
  • 31. Infertility and assisted conception
    • Introduction
    • The Human Fertilisation and Embryology Authority
    • Causes of infertility
    • Male infertility
    • Female infertility — treatment and management
    • Outcomes from IVF treatments
    • Stress and infertility
    • Conclusion
  • 32. From fertilisation to feto-placental development
    • Introduction
    • The fallopian tubes - where life begins
    • The deciduochorial placenta - from embryo to fetus
    • Conclusion
  • 33. The fetal skull
    • Introduction
    • Development of the fetal skull
    • The external structures of the newborn skull
    • The skull
    • Sutures
    • Fontanelles
    • Sinuses
    • Measurements of the fetal skull
    • Internal structures of the fetal skull
    • Moulding of the fetal skull during labour
    • Injuries to the fetal skull and surrounding tissues
    • Internal injuries
    • The relevance of the fetal skull to parents
    • Conclusion
• PART 5. Pregnancy
  • 34. Maternal cardiovascular, respiratory, haemodynamic, uterine, and gastrointestinal-mammary adaptations to the fertile cycle
    • Introduction
    • Maternal central and peripheral adaptations to fertility
    • Cardiovascular and pulmonary adaptations
    • Adaptations in fluid and electrolyte regulation
    • Renal haemodynamic adaptations
    • Cardiovascular adaptations
    • Cardiovascular adaptations to fertility
    • Adaptations in the vascular renin-angiotensin-aldosterone system
    • Conclusion
  • 35. Antenatal care
    • Introduction
    • Confirmation of pregnancy
    • Estimated date of delivery
    • Initial appointment (Booking)
    • Assessments in pregnancy
    • Physiological changes—‘minor disorders of pregnancy’
    • Fetal wellbeing assessment
    • Conclusion
  • 36. Antenatal investigations
    • Introduction
    • Screening and diagnosis
    • Blood tests
    • Antenatal maternal blood tests to assess the fetus
    • Assessment of fetal wellbeing
    • Ultrasound
    • Invasive tests
    • Conclusion
  • 37. The choice and personalisation agenda: place of birth and care
    • Introduction
    • Choice rhetoric and maternity care
    • Managing risk or facilitating safety?
    • Human rights and birth choice
    • Facilitating choice: what can the midwife do?
    • Conclusion
• PART 6. Labour and birth
  • 38. Neuroendocrinology of parenting: from nocturnal uterine activation to suckling-lactation and emotional connectivity between parents and infant
    • Introduction
    • Adaptations in maternal stress, immune response, and emotional sensitivity
    • Maternal sleep
    • Placental steroids, CRH, fetal cortisol, and uterine activation
    • Uterocervical myometrium
    • Maternal-fetoplacental regulation of circadian uterine activation
    • Circadian pattern of labour and birth
    • Active labour
    • The stress of being born: fetoplacental adaptations for labour, birth, and suckling
    • Conclusion
  • 39. Care in the first stage of labour
    • Introduction
    • The continuum of labour
    • Characteristics of labour
    • Physiology of the labour continuum
    • Onset of labour
    • Care during the first stage of labour
    • The birth environment
    • Individualised care and assessing needs
    • Planning individualised care
    • General midwifery care in labour
    • ‘Being with’, not ‘doing to’ women in labour
    • Nutrition in labour
    • Assessing the fetal condition
    • Evaluation of care
    • Conclusion
  • 40. Care in the second stage of labour
    • Introduction
    • Signs of progress of labour
    • Physiology of the active second stage of labour
    • Mechanism of labour
    • Duration of the second stage of labour
    • Positions in the second stage of labour
    • Midwifery care
    • Preparation for the birth
    • The activities of the midwife during the birth
    • Observations and recordings
    • Future research in this area
    • Conclusion
  • 41. Supporting choices in reducing pain and fear during labour
    • Introduction
    • An exploration of pain in labour
    • The birthing environment
    • Antenatal education and preparation for birth
    • Continuous support in labour
    • Complementary and alternative therapies
    • Pharmacological pain relief
    • Conclusion
  • 42. Care in the third stage of labour
    • Introduction
    • Physiology of the third stage
    • Management of the third stage of labour
    • Care after birth (the fourth stage)
    • Record keeping
    • Abnormalites of the placenta
    • Abnormalities of the umbilical cord
    • Conclusion
  • 43. The pelvic floor
    • Introduction and background
    • The pelvic floor
    • Considerations for midwifery practice
    • Perineal trauma
    • Episiotomy
    • The principles of perineal repair
    • Systematic assessment of perineal trauma
    • Conclusion
• PART 7. Postnatal care and the care of the newborn baby
  • 44. Women and family-centred postnatal care
    • Introduction
    • Aims of postnatal care
    • The organisation of postnatal care
    • The role of the midwife and other health professionals in postnatal care
    • The content of postnatal care
    • Care of women’s health during the postnatal period
    • Care of women’s psychological health
    • Conclusion
  • 45. Physiology, assessment, and care of the newborn
    • Introduction
    • Applied physiology
    • Care at birth
    • Examination of the newborn
    • Daily examination
    • Identifying and managing pain and stress in the term newborn
    • Mother–baby attachment
    • Postnatal Care
    • Metabolic diseases
    • Vaccinations
    • Follow-up
    • Record-keeping
    • Conclusion
  • 46. Thermoregulation
    • Introduction
    • Physiology of thermoregulation
    • Neonatal heat production
    • The role of the midwife
    • Monitoring and maintaining temperature
    • Minimising the risks of hypothermia
    • The sick neonate
    • Equipment
    • Conclusion
  • 47. Infant feeding and relationship building
    • Introduction
    • Importance of human milk and breastfeeding
    • Public health and infant feeding
    • The UNICEF UK Baby Friendly Initiative (BFI)
    • The United Nations Convention on the Rights of the Child (UNCRC)
    • The needs of the newborn baby – food and love
    • Physiology of the infant gastrointestinal tract
    • Physiology of lactation
    • Common challenges
    • Formula feeding
    • The International Code of Marketing of Breastmilk Substitutes
    • Conclusion
• PART 8. Women and babies with complex needs
  • 48. The preterm baby and the small baby
    • Introduction
    • Prematurity
    • Problems of the preterm baby
    • Low birthweight
    • Long-term complications in the preterm and low birthweight baby
    • Caring for the family of the preterm or low birthweight baby
    • Conclusion
  • 49. Respiratory and cardiac disorders in the neonate
    • Introduction
    • Normal respiratory and cardiac development
    • The fetal circulation
    • Transition to extrauterine life
    • Normal neonatal circulation and respiratory function
    • Compromised fetal cardiac and respiratory development
    • Resuscitation of the newborn
    • Respiratory disorders in the newborn
    • Cardiac abnormalities
    • Parental care
    • Conclusion
  • 50. Neonatal jaundice
    • Introduction
    • Physiology
    • Physiological jaundice
    • Evaluation of jaundice
    • Unconjugated hyperbilirubinaemia
    • Prolonged jaundice
    • Conjugated hyperbilirubinaemia
    • The role of the midwife with the parents
    • Follow-up
    • The future
    • Conclusion
  • 51. Neonatal infection
    • Introduction
    • Acquisition of infection
    • Newborn immunity
    • Management for early-onset neonatal sepsis
    • Parental education reflection
    • Infections acquired around the time of birth
    • Conclusion
  • 52. Congenital anomalies and metabolic and endocrine disorders
    • Introduction
    • Aetiology
    • Abnormalities of the alimentary tract
    • Disorders of the respiratory system
    • Disorders of the central nervous system
    • Disorders of the genitourinary system
    • Kidney disorders
    • Disorders of sexual development
    • Chromosomal abnormalities
    • Abnormalities of the skeletal system
    • Neonatal pain management
    • Disorders of metabolism
    • Conclusion
  • 53. Pregnancy loss and baby deaths
    • Introduction
    • Background
    • Human, social, and financial impact
    • Sources of information relating to perinatal and infant mortality
    • Datasets
    • Reasons why babies die
    • Sudden unexpected death in infancy (SUDI) and sudden infant death syndrome (SIDS)
    • Reducing perinatal and infant mortality
    • Public health messages
    • Health and social inequalities
    • Conclusion
  • 54. Nausea and vomiting
    • Introduction
    • Conclusion
  • 55. Bleeding in pregnancy
    • Introduction
    • Bleeding before the 24th week of pregnancy
    • Abortion
    • Gestational trophoblastic neoplasia (hydatidiform or carneous Mole and choriocarcinoma
    • Ectopic or extrauterine gestation
    • Heterotopic pregnancy
    • Secondary abdominal pregnancy
    • Bleeding from associated conditions
    • Bleeding after the 24th week - antepartum haemorrhage
    • Placenta praevia
    • Placental abruption
    • Management of antepartum haemorrhage and the midwife's role
    • Conclusion
  • 56. Hypertensive and medical disorders in pregnancy
    • Introduction
    • Hypertensive disorders
    • Gestational hypertension
    • Pre-eclampsia
    • Anaemia
    • Haemoglobinopathies
    • Cardiac disorders
    • Thyroid disorders
    • Renal disorders
    • Diabetes
    • Respiratory disorders
    • Epilepsy
    • Intrahepatic cholestasis of pregnancy
    • Conclusion
  • 57. Sexually transmitted infections
    • Introduction
    • Chlamydia
    • Gonorrhoea
    • Syphilis
    • Herpes
    • Genital warts: human papillomavirus
    • Hepatitis B virus
    • Human immunodeficiency virus
    • Conclusion
  • 58. Abnormalities and anomalies of the genital tract
    • Introduction
    • Developmental anomalies
    • Displacements of the uterus
    • Female genital mutilation
    • Transgender people and childbearing
    • Conclusion
  • 59. Multiple pregnancy and birth: implications for midwives, women, and their families
    • Introduction
    • The incidence of multiple births
    • Determination of zygosity
    • Diagnosis of a multiple pregnancy
    • Antenatal screening
    • Antenatal preparation
    • Complications associated with a multiple pregnancy
    • Fetal abnormalities associated with monozygotic twins
    • Antenatal care
    • Intrapartum care
    • Postnatal care
    • Conclusion
  • 60. Preterm labour and birth
    • Introduction
    • Definition
    • Incidence and outcomes
    • Identifying preterm birth risk factors
    • Prelabour rupture of membranes (PROM) and preterm prelabour rupture of membranes (PPROM)
    • Management of preterm labour
    • The midwife’s role in caring for women with preterm babies
    • Conclusion
  • 61. Induction of labour and post-term pregnancy
    • Induction of labour
    • Induction of labour at term
    • Assessing the need for induction
    • International perspectives
    • Post-term pregnancy
    • Conclusion
  • 62. Presentation and prolapse of the umbilical cord
    • Introduction
    • Causes
    • Predisposing factors
    • Diagnosis
    • Management of cord presentation
    • Management of cord prolapse
    • Bladder filling
    • Psychological care
    • Conclusion
  • 63. Rhythmic variations of labour
    • Introduction
    • The partogram
    • Prolonged labour
    • Overefficient uterine action (precipitate labour)
    • Tonic uterine action
    • Cervical dystocia
    • Conclusion
  • 64. Malpositions and malpresentations
    • Introduction
    • Malpositions
    • Clinical assessment
    • Malposition of the occiput
    • Fetal Positioning
    • Malpresentations of the fetus
    • Postnatal and neonatal implications
    • Conclusion
  • 65. Obstructed labour and uterine rupture
    • Introduction
    • Obstructed labour
    • Uterine rupture
    • Conclusion
  • 66. Obstetric interventions
    • Introduction
    • Assisted vaginal deliveries/birth (AVD/AVB)
    • Caesarean section
    • Conclusion
  • 67. Shoulder dystocia
    • Introduction
    • Mechanism
    • Incidence and risk
    • Manoeuvres for the management of shoulder dystocia
    • Other procedures
    • Maternal outcomes
    • Birth injury and fetal outcomes
    • Notes and record keeping
    • Education, training, and development
    • Conclusion
  • 68. Complications related to the third stage of labour
    • Introduction
    • Postpartum haemorrhage
    • Hypovolaemic shock
    • Prolonged third stage and retained placenta
    • Acute uterine inversion
    • Amniotic fluid embolism
    • Psychological considerations
    • Conclusion
  • 69. Maternal morbidity following childbirth
    • Introduction
    • The midwife’s role
    • Life-threatening health problems
    • Haemorrhage
    • Common health problems
    • Longer-term implications
    • Culturally and linguistically diverse considerations
    • Lesbian, gay, bisexual, transgender, queer, intersex, asexual and more (LGBTQ+) community
    • Conclusion
  • 70. Mental health and well being in pregnancy and childbirth
    • Introduction
    • Global perspectives on women’s mental health
    • Violence against women
    • Sexual assault, rape, sexual violence, and mental health
    • Who is ‘at risk’?
    • The midwife’s role
    • Pregnancy assessment
    • Recognising risk and suicide
    • Coordinated maternity care
    • Childbirth mental illness
    • Postnatal depression
    • Puerperal psychosis
    • Fear and trauma
    • Tokophobia
    • Post-traumatic stress disorder (PTSD)
    • Generalised anxiety disorder (GAD)
    • Conclusion
  • 71. Pregnancy loss and the death of a baby: grief and bereavement care
    • Introduction
    • The National Bereavement Care Pathway (NBCP)
    • Understanding perinatal loss and grief
    • Coping with bereavement
    • Different parental responses in bereavement
    • The role of the midwife
    • Miscarriage
    • Termination of pregnancy for fetal anomaly (TOPFA)
    • Stillbirth
    • Neonatal death
    • Multiple loss
    • Preparing for labour and birth
    • Birth
    • Spiritual care
    • Creating memories
    • Seeing and holding the baby
    • Explaining to and involving siblings
    • Family and friends
    • Postnatal care
    • Seeing the baby and taking baby home
    • Investigations
    • Postmortem
    • Coroner's postmortem
    • Placental histology
    • Aftercare and the months ahead
    • The follow-up appointment
    • Subsequent pregnancy
    • Looking after ourselves as professionals
    • Training and education
    • Conclusion
  • 72. Midwifery—practising in a complex world
    • Introduction
    • Reviewing maternity services
    • Working with women
    • Educating midwives
    • Human factors
    • Clinical governance
    • The midwife leader
    • The global pandemic
    • The global midwife
    • Conclusion
• Index

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