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