Practising Midwife最新文献

Report review runs alongside Guideline commentary and the other evidence series articles, examining local, national and international reports that have implications directly or indirectly for midwives. It helps readers to understand what reports mean for midwifery practice and to place report recommendations into context. As with all our evidence series articles, report reviews support you to critique recommendations and have implications for your own practice. This month, Alys Einion celebrates the common-sense approach of Sarah Buckley's 2015 report from the USA.The report summarises the ways in which the human female is physiologically designed to birth in a protected environment. The hormonal interactions around labour and birth, when fully expressed, facilitate better birth experiences and longer-term wellbeing for mothers and babies. The report shows how obstetric interventions and routine medical practices during labour and birth, many of which are not fully evidence-based, can disrupt the hormonal processes fundamental to labour, birth and maternal/neonatal wellbeing in the postnatal period and beyond, and recommends that women are educated to understand their own physiology so that they can birth confidently. It provides further evidence for a physiological basis for core midwifery practices including one-to-one care, a quiet calm environment, and extended skin-to-skin contact after birth, as part of a physiological approach to birth and the transition to parenthood.

Lactational mastitis has an incidence of around 10 per cent in postpartum women, with breast abscess complicating some of these.The key principles of treatment include: supportive counselling, warm or cold compresses, effective milk removal, oral antibiotic therapy and symptomatic treatment. Patients can be managed in the community setting; however many present to hospital. The aim of this research was to establish which areas of clinical practice can be improved to reduce hospital admission rates. Sequential cases of lactation mastitis or breast abscess admitted to hospital over two years were reviewed, and it was found that the majority of patients attending the emergency department for management self-presented. There were low rates of utilisation of available community resources. There was poor patient knowledge of the natural history and simple management strategies for the condition. Midwives can play a vital role in educating new mothers and providing advice and support for non-pharmacological therapies.

This article outlines the essentials of audit design and implementation. Effective audit can be used as a tool to advance practice for quality maternity care provision. The value of audit is presented alongside some of the possible barriers and facilitators to effective use and impact within health care settings. A detailed overview of the key stages within the audit cycle is offered to support your engagement with audits in your own midwifery practice area.

This article considers the anatomy and physiology underpinning the mechanism of labour in terms of the amazing journey the fetus completes through the maternal pelvis. In order to monitor maternal and fetal wellbeing and promote progress in labour, the midwife needs a thorough understanding of: the maternal pelvis, the external structure of the fetal skull, and how the presentation and attitude of the fetus determines the presenting diameter of the skull.

Midwifery is one of the most emotional and emotive of all the health care professions. In order to be'with woman', we give a part of ourselves to every woman that we care for. Such reciprocity is essential to create a relationship that will maximise a woman's birth experience (Hunter 2006). This relationship between the woman and midwife is considered to be one of the key elements in job satisfaction, as it emulates the very essence of being with woman. In order to meet the emotional needs of a woman, the emotional involvement of the midwife is needed (Rothschild 2006); thus there is a potential emotional cost associated with care provision. This article is the first in a series of six articles looking at the maintenance and promotion of midwives' own wellbeing and resilience. The series will cover these topics: the resilient midwife, the mindful midwife, the self-compassionate midwife, the assertive midwife, the acknowledging midwife and the relational midwife. All are aimed at embracing and encouraging a midwife's own wellbeing and resilience.

Research unwrapped is a popular series to help readers make sense of published research by undertaking a detailed appraisal of an article in a careful and considered manner. In doing so we can advance our knowledge and understanding of a research topic and apply it to our practice. This process is designed to assess the usefulness of the evidence in terms of decision making and application to practice. The research being discussed here is a qualitative study focusing on perhaps the most fundamental dimension and function of midwifery practice: that of the impact of a midwife on a woman's birth experience.

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 this fifth article of the series, Jancis Shepherd explores issues of supervision of student midwives in perineal suturing, the practical and legal implications of misadministration of medicines and accountability issues.

The accurate assessment of basic observations such as blood pressure, heart rate, arterial oxygen saturation of blood (SpO²), respirations, temperature and level of consciousness (AVPU score) underpin the fundamentals of basic midwifery care provision. However, after identifying that the signs of impending maternal collapse often went unrecognised leading to subsequent morbidities and mortalities, the confidential enquiry into maternal and child health (CEMACH) report in 2007 (Lewis 2007) recommended that all obstetric women's observations were recorded through a modified early obstetric warning system (MEOWS). This allows for the early detection of women who may become critically unwell and provides an opportunity for practitioners to act promptly and prevent deterioration (Knight et al 2016).This article provides an overview of the MEOWS scores as a tool to improve maternal morbidity and mortality within maternity care.

Becoming a midwife is the 16th series of 'Midwifery basics' targeted at practicing 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 seed further information through a series of activities relating to the topic. In this fourth article of the series, Jancis Shepherd discusses the issues of maintaining confidentiality, use of social media and veracity of students' practice assessment documents, to demonstrate the need to uphold the NMC Code (2015a) in clinical practice.