Practising Midwife最新文献

Guideline commentary is a series to help readers make sense of published guidelines by offering a detailed appraisal of a guideline, or a specific section of a guideline, in a careful and considered manner. In doing so we can advance our knowledge and understanding of reviewing guidelines to inform our practice.This process is designed to assess the usefulness of the guideline and underpinning evidence, in terms of decision making and implications for practice.

In the United Kingdom, Australia, the United States of America and Europe, universal and routine screening is recommended for pregnant women, extending into the postnatal period. However, the lack of self-confidence among midwives and midwifery students, in implementing diagnostic domestic violence screening, is consistent within the contemporary literature, and has significant implications for the health of women and their families.The evidence for this lack of confidence centres around three professional issues surrounding domestic violence screening from a midwifery context: time constraints; midwifery education; and midwives as recipients of domestic violence.

Using theatre methods and techniques in post registration education has the unique advantage of facilitating learning that is based in the reality of practice yet in a safe space free from the demands and pressures of the work place. It offers compassionate insights that allow participants to reflect on others' behaviour and how their behaviours can impact on the culture in which they work. This article offers a description of how this has been implemented within an acute NHS trust as part of a preceptorship programme in three ways: using a professional theatre company, with other educators and as an individual educator.

Consider the impact on your pregnancy, birth and puerperium of living in a remote or rural area. A substantial minority of people in Scotland live in such areas, which has considerable implications for provision of health services and the staff at the front line of the profession. In the winter of 2011, Jo Lironi joined the team of midwives at Caithness General Hospital (CGH) in the North East Highlands of Scotland. Four years later, the process to review the model of care on grounds of safety began.This led to the immediate introduction of emergency interim measures while the public health review was initiated. Having left the unit after publication of the review, Jo reflects on her experience in a rural consultant-led unit and its transition into midwifery-led care.

Working environments ultimately shape and influence all that we do as maternity care professionals. The place in which we work becomes a large part of our lives, and the influences around us shape our professional ethos and practice. Limited research surrounds this 'hidden'aspect of maternity care, yet the phenomenon is real. For some, the work place represents a duty, a calling, an escape, a sanctuary; yet at times it can seem limiting, frustrating and a challenging place to be. It is important to consider how working environments for front-line practitioners affect working practices and experiences. To empower women, we ourselves must be empowered to create a positive working environment for ourselves and our colleagues.

The 1980 edition of Oxorn and Foote (1980) urges the midwife not to be hasty in employing cosarean (CS) for face presentation because, with patience, babies are usually born vaginally, with better outcomes. Reviewing how to manage face presentation can prepare the practitioner for this rare event, and decrease CS management. A hundred and ninety six midwives from the US, UK, Hungary and Israel were emailed, asking them to describe their experience, if any, with face presentation. Twelve midwives responded, demonstrating the rarity of the event. Face presentation was most often diagnosed at full dilation. Mode of birth was dependent on the size of the fetus, the motivation of the woman and the experience and motivation of the practitioner, not on the position of the chin. Where the posterior chin was blocking birth, CS could be avoided by rotating the head to occiput anterior (OA) or by swimming for 45 minutes in a large birthing pool.

Studying for a doctoral degree can be an exciting, invigorating and ultimately satisfying process but equally it can be a long, arduous, frustrating and lonely journey. In this article I speak of my own experience of the process and offer some thoughts about the 'what, why, when and how' of studying at this level. I consider the excitement of developing your own ideas and project alongside the challenges inherent in doctoral level study, such as coping with uncertainty and rarely having a sense of closure, and I offer some practical challenges to help you decide whether doctoral study is for you.

Obstetric anal sphincter injuries (OASIS) can have a very negative impact on women's health and quality of life. Literature exists concerning the role of the surgeon and physiotherapist after OASIS, but there is a dearth of literature pertaining to the role of the midwife in the management of women following an obstetric anal sphincter injury. This article examines the midwife's role and describes a new service instituted at Hadassah-Hebrew University medical centre, Jerusalem, utilised in the early postpartum period while the woman is still in hospital, entitled Special Services for Perineal Trauma.

Current changes in midwifery raise concerns about the erosion of women's choices and midwives' autonomy. This article is an exploration of women's legal rights that relate to consent and declining care. Using examples of poor practice, women's negative experiences are highlighted. However, this article demonstrates how midwifery practice can be grounded in the current legal framework in such a way that women's decisions are upheld and midwives feel supported in their advocacy role.

Becoming a midwife is the 16th series of'Midwifery basics'targeted at practising midwives and midwifery students. The aim of these articles is to provide information to raise awareness of the impact of professionalism on women's experience, consider the implications for midwives'practice and encourage midwives to seek further information through a series of activities relating to the topic. In the sixth article of the series, Jancis Shepherd explores issues of supporting students with health and specific learning difficulties while recognising the need for safe and competent practice.