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Fundamentals of Midwifery (eBook)

A Textbook for Students

Louise Lewis (Herausgeber)

eBook Download: EPUB
2014
983 Seiten
John Wiley & Sons (Verlag)
978-1-118-52807-5 (ISBN)

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Fundamentals of Midwifery: A Textbook for Students makes the subject of midwifery accessible, informative and motivating, ensuring that it is an essential text for the aspiring midwife!

This resource brings together knowledge from a collection of clinical experts and experienced academics to support your learning and prepare you for the challenges faced in contemporary midwifery healthcare. It presents you with the 'must-have' information that you need concerning both the theoretical and practical aspects of what it means to be a midwife. With extensive full colour illustrations throughout, as well as activities and scenarios, this user-friendly textbook will support you throughout your entire education programme. Fundamentals of Midwifery is essential reading for all pre-registration student midwives, as well as newly qualified midwives.

KEY FEATURES:

• Broad and comprehensive in scope, with chapters on: team working; antenatal care, intrapartum and postnatal care; infant feeding; public health and health promotion; perinatal mental health; complementary therapies; pharmacology and medicines management; and emergencies.

• Interactive and student-friendly in approach, with activities throughout.

• Brings together professional and clinical topics in one user-friendly book.

• Ties in with the latest NMC Standards for pre-registration midwifery education.

• Supported by an online resource centre featuring interactive multiple-choice questions, additional scenarios and activities, and links to further reading.



ABOUT THE EDITOR
Louise Lewis is a Lecturer in Midwifery in the Faculty of Health and Social Care at the University of Hull.

ABOUT THE EDITOR Louise Lewis is a Lecturer in Midwifery in the Faculty of Health and Social Care at the University of Hull.

About the series xii

Contributors xiii

Foreword xv

Preface xvi

Acknowledgements xvii

How to use your textbook xviii

About the companion website xxii

Chapter 1 To be a midwife 1
Nicky Clark and Carol Paeglis

Introduction 1

The professional status and regulation of midwifery 2

The NMC 2

European Union 3

The International Confederation of Midwives 6

Key midwifery concepts 6

Interpersonal skills and attributes 7

Professional expectations 9

Life as a student midwife 9

The programme 10

The statutory supervision of midwives 12

Raising and escalating concerns 13

Quality assurance 13

Student support 14

Health screening 14

Criminal record 15

Life as a midwife 16

Career routes 16

Conclusion 16

End of chapter activities 17

Glossary of terms 19

References 20

Chapter 2 Team working 22
Mary Beadle and Sue Townend

Introduction 22

Woman-centred care 23

Effective team working 23

What is a team? 24

Leadership 25

Management 25

Communication 28

Collaboration 29

Power dynamics 31

Regulation 32

Escalating concerns 33

Team player 34

Conclusion 35

End of chapter activities 36

Glossary of terms 38

References 38

Chapter 3 Sociology applied to maternity care 42
Mary Beadle and Sarah Wise

Introduction 42

Overview of sociological perspectives 42

Definition of society 43

Domestic abuse 46

Poverty 47

Gender and sexuality 49

Ethnicity and race 51

Disability 52

Health and wellbeing 53

Conclusion 56

End of chapter activities 56

Glossary of terms 58

References 58

Chapter 4 Psychology applied to maternity care 61
Julie Jomeen and Lynda Bateman

Introduction 61

Defining psychology 62

Theories of psychology 62

Psychology and public health in maternity care 64

Health beliefs and behaviours 65

Social cognition models 66

Emotions across the childbearing experience 68

Birth 70

Postnatal considerations 71

Women and midwives: relationships and communication 74

Initiating, building and maintaining relationships 76

Bonding and attachment 78

Conclusion 82

End of chapter activities 82

Glossary of terms 84

References 84

Chapter 5 Parenthood 90
Olanma Ogbuehi and Jacqui Powell

Introduction 90

Parenthood 91

Genetic, biological and social parents 95

Conception across the lifespan 102

Disability and parenting 109

Parenting styles and expert advice 110

Conclusion 112

End of chapter activities 113

Glossary of terms 114

References 115

Chapter 6 Antenatal midwifery care 120
Julie Flint and Carol Lambert

Introduction 120

National policy on care provision in the United Kingdom 121

Individualised care of a woman 123

Being pregnant 124

Booking for care 125

Fetal health screening and monitoring 126

Inherited factors and disorders 127

Routine care for all pregnant women 128

Body changes 129

Deviations from normality 129

Wellbeing 129

Women's self-identity and decision-making about care 131

Midwife-woman relationship for decision-making 133

Influencing women in their decision-making 133

Birth preparation and parent education 134

Conclusion 135

End of chapter activities 136

Glossary of terms 137

References 139

Chapter 7 Intrapartum midwifery care 142
Julie Flint and Sue Townend

Introduction 142

Facilitating and maintaining normality in childbirth 143

Place of birth 145

Birth preparation for coping with labour 145

Onset, process and progress of labour 146

Care and compassion 152

Birth partners 153

Assisting the normal physiological process 154

Outside the parameters of normality 154

Pain management in labour 154

Midwifery craftsmanship 155

Medical intervention 156

Meeting the baby 157

Third stage management 157

Perineal care 158

Decision-making 159

Conclusion 159

End of chapter activities 161

Glossary of terms 162

References 163

Chapter 8 Postnatal midwifery care 166
Louise Lewis and Lisa Lachanudis

Introduction 166

The history of postnatal care 167

Anatomy and physiology of the puerperium 168

Immediate postnatal period 171

Venous thromboembolism 172

Changes to postnatal care 173

Physiological maternal morbidity 174

Quality standards infl uencing postnatal care provision 175

A time-honoured tradition or a dying art? 175

Care and compassion: promoting a healthy psychological adaptation to motherhood 176

Engaging fathers 177

Safeguarding vulnerable adults and babies 178

Where to get help 181

Reducing the risk of sudden infant death syndrome 181

Postnatal exercise advice for new mothers 182

Other responsibilities of the midwife in the postnatal period 182

Conclusion 183

End of chapter activities 183

Glossary of terms 184

References 185

Chapter 9 Care of the newborn 188
Liz Smith and Brenda Waite

Introduction 188

Transition to extra-uterine life 188

Fetal circulation 189

Apgar scoring 189

Basic resuscitation of the newborn 192

Immediate care of the newborn 193

Maintaining health in the fi rst few days of life 195

Skin care and hygiene of the newborn 197

Jaundice 199

Neonatal screening 202

Advice for parents 203

Detailed neonatal examination by the midwife 204

Conclusion 206

End of chapter activities 206

Glossary of terms 207

References 208

Chapter 10 Infant feeding 210
Louise Lewis and Liz Mason

Introduction 210

Why breastfeeding is important 211

The way breastfeeding works 213

Supporting effective infant feeding 217

Biological nurturing - a different breastfeeding approach 221

Getting enough milk 222

Reasons for expressing breastmilk 224

Identifying and managing common breastfeeding problems 228

When breastfeeding is not recommended 229

Supporting mothers to formula feed 230

Conclusion 231

End of chapter activities 231

Glossary of terms 233

References 234

Chapter 11 Public health and health promotion 237
Olanma Ogbuehi, Fiona Robinson and Catriona Jones

Introduction 237

The concept and definition of health 238

Epidemiology 240

Demography 241

Conception rates 241

Fertility rates 241

Birth and death statistics 241

Domains of public health 243

Health improvement: the midwife and health promotion 244

Health surveillance 245

Improving health services through clinical audit: confidential enquiries into maternal and child health 245

Health inequalities 246

Determinants of health 247

Guidance for public health 248

Revisiting the midwife's role in public health 249

Domestic abuse 256

Conclusion 257

End of chapter activities 259

Glossary of terms 260

References 261

Chapter 12 Contraception and family planning 266
Liz Smith and Sarah Wise

Introduction 266

What is meant by 'family planning'? 266

Appropriate timing of advice 267

Psychosexual issues 268

Cultural aspects 268

Providing advice 268

Methods of contraception 270

Further advice and treatment 277

Conclusion 277

End of chapter activities 278

Glossary of terms 279

References 280

Chapter 13 Perinatal mental health 281
Julie Jomeen and Nicky Clark

Introduction 281

The importance of mental health in a maternity context 282

Putting PMI into perspective 282

Identification and assessment 285

Identifying risk factors 285

Antenatal, postnatal or a continuum 286

Prevalence and incidence 287

Categories of PMI 288

Serious mental illness (SMI) 293

Care provision 294

Conclusion 295

End of chapter activities 296

Glossary of terms 297

References 298

Chapter 14 Complementary and alternative medicines applied to maternity care 302
Catriona Jones and Jane Marsh

Introduction 302

Definition of complementary and alternative medicines (CAM) 303

The field of CAM 304

Why is CAM important to know about? 307

The CAM philosophy 309

The growth of interest in CAM 309

CAM and patient satisfaction 310

Women, midwifery and CAM 311

Promoting normality and reducing unnecessary intervention 312

Evidence for the safety and efficacy of CAM 313

The role of the midwife in CAM administration 315

Regulation 316

Conclusion 317

End of chapter activities 318

Glossary of terms 319

References 320

Chapter 15 Pharmacology and medicines management 323
Mary Beadle and Andrea Hilton

Introduction 323

Medicines management 324

Pharmacology 328

Monographs 333

Numeracy 337

Conclusion 340

End of chapter activities 341

Glossary of terms 343

References 344

Chapter 16 Emergencies in midwifery 346
Liz Smith and Brenda Waite

Introduction 346

Assessment 347

Shock 347

Maternal resuscitation 350

Basic life support 351

Antepartum haemorrhage 354

Postpartum haemorrhage 356

Obstetric interventions 359

Pre-eclampsia and eclampsia 360

Shoulder dystocia 363

Thromboembolism 366

Conclusion 368

End of chapter activities 369

Glossary of terms 370

References 371

Chapter 17 Bereavement and loss 373
Liz Smith and Brenda Waite

Introduction 373

Terminology 373

Theories 374

Communication 376

Culture and religion 377

Care around the time of death 378

Care following loss 379

Midwifery care 380

Maternal death 382

Peer support for midwives 383

Support groups 383

Conclusion 384

Glossary of terms 385

End of chapter activities 386

References 386

Answers 387

Index 402

Chapter 1
To Be a Midwife


Nicky Clark

University of Hull, Hull, UK

Carol Paeglis

Former Supervisor of Midwives and Local Supervising Authority Midwifery Officer, Yorkshire and the Humber, UK

Learning Outcomes


By the end of this chapter the reader will be able to:

  • understand how midwifery has evolved as a profession
  • examine how midwifery as a profession is regulated in the united kingdom
  • identify the support processes available to student midwives undertaking a pre-registration midwifery programme
  • be cognisant of the demands working within the midwifery profession
  • identify factors that can facilitate successful course completion.

Introduction


Midwifery is a dynamic profession that is responsive to change. In recent years, the social, economic and technological forces have altered the context of midwifery significantly. The scale of healthcare provision has changed greatly; philosophies and values have been adjusted and the restructuring of healthcare provision has been dramatic. Public expectation regarding involvement in care and opportunities for informed choice has increased; consequently women and their babies expect more than ever before to be partners in the care process.

Midwives provide high-quality professional care to women and their families, acting autonomously, accountably and responsibly within their sphere of practice. This chapter aims to explore the development of midwifery and its professional regulation with the subsequent evolution of the role and responsibilities of a midwife. The quality of midwifery education and the supervision of midwifery will also be examined.

Activity 1.1


Ask yourself why you wanted to become a midwife. It will be useful to revisit this as you progress on your programme. At difficult times within your programme these statements can be very helpful.

To be a midwife is to understand the role and responsibilities of being a midwife. The midwifery profession is recognised globally and is defined by the International Confederation of Midwives (ICM) (2011) as:

…A midwife is a person who has successfully completed a midwifery education programme that is duly recognized in the country where it is located and that is based on the ICM Essential Competencies for Basic Midwifery Practice and the framework of the ICM Global Standards for Midwifery Education; who has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery and use the title ‘midwife’; and who demonstrates competency in the practice of midwifery…

This definition is complex; therefore the professional status and regulation of midwifery nationally and internationally will now be clarified.

The Professional Status and Regulation of Midwifery


Historically the professional status of midwifery in England and Wales began with The Midwives Act 1902. This enabled the state enrolment of midwives and established the Central Midwives Board (CMB) for England and Wales. The Midwives Institute was established in the 1880s and was instrumental in the application of the Midwives Act. The Midwives Institute became known as the Royal College of Midwives (RCM) in 1941. All practising midwives were enrolled with the CMB by 1910. A Midwives Act was not passed in Scotland until 1915, which built on the experience of the CMB for England and Wales when setting up the CMB for Scotland.

The CMB produced an annual Roll of Midwives, which was a list of qualified midwives, indicating which were practising. The CMB was independent from nursing, although many midwives were nurses. In 1983 the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) replaced the General Nursing Council (Nursing) and the CMB (Midwifery), which brought the nursing, and midwifery records together for the first time. The Nursing Midwifery Council (NMC) was established under the Nursing and Midwifery Order 2001 (‘the order’) (SI:2002/253) and came into being on 1 April 2002, abolishing the UKCC and its four National Boards.

Midwifery, as a profession is recognised globally, although there are wide variations in education and scope of practice between the different continents. Currently, in the United Kingdom, the NMC is the nursing and midwifery regulator for England, Wales, Scotland, Northern Ireland and the Islands. The aims of the NMC are outlined in Box 1.1.

Box 1.1    Aims of the NMC

  • Exist to safeguard the health and wellbeing of the public.
  • Set standards of education, training, conduct and performance so that nurses and midwives can deliver high quality healthcare consistently throughout their careers.
  • Ensure that nurses and midwives keep their skills and knowledge up to date and uphold the professional standards.
  • Have clear and transparent processes to investigate nurses and midwives who fall short of the standards.

The NMC


The NMC are governed by legislation approved by the Houses of Parliament and this is detailed in what is known as the Statutory Instruments (SIs). SIs allow an Act of Parliament to be brought into force or altered. The Statutory Instrument 2002 No. 253 is The Nursing and Midwifery Order 2001, and replaced the Nurses, Midwives and Health Visitors Act 1997.

The main objective of the NMC in exercising its functions under The Order is to safeguard the health and wellbeing of persons using or needing the services of registrants. The principal functions of the Council are to establish from time to time standards of education, training, conduct and performance for nurses and midwives and to ensure the maintenance of those standards.

Part VIII of the Nursing and Midwifery Order is specific to Midwifery and is concerned with:

  • The Midwifery Committee.
  • Rules as to midwifery practice.
  • Local supervision of midwives.

Since 1 December 2012, following the Health and Social Care Act (2012) the NMC has been regulated by the Professional Standards Authority for Health and Social Care (PSA). The PSA replaced the Council for Healthcare Regulatory Excellence (CHRE). The PSA's function is to ensure that the NMC and other healthcare regulators promote the best interests of patients and the public and ensure consistency across the professions (Yearley and Dawson-Goodey 2014).

European Union


The UK became part of the European community in 1973, and after the Maastricht Treaty was signed in 1992, the European Union (EU) was formed. As a member state of the EU, all EU legislation must be enforced and UK law must adhere to the EU framework and refer to the European Court of Justice. The NMC maintains close partnerships with colleagues and decision makers in Europe to ensure they can influence EU legislation in the interests of patients and the public in the UK.

There are three main institutions involved in EU legislation:

  • The European Parliament, which represents the EU's citizens and is directly elected by them.
  • The Council of the European Union, which represents the governments of the individual member countries. The Presidency of the Council is shared by the member states on a rotating basis.
  • The European Commission, which represents the interests of the Union as a whole.

Together, these three institutions produce the new policies and laws that apply throughout the EU. In principle, the Commission proposes new laws, and the Parliament and Council adopt them. The Commission and the member countries then implement them, and the Commission ensures that the laws are properly applied and implemented.

EU Directives


The purpose of the EU is to facilitate the freedom of movement of people, goods and services. In the case of seven professions who have to be registered to practice (doctors, nurses, dentists, midwives, veterinarians, opticians and architects); specific sectarian directives were developed as the EU recognised that the purpose of the registration is first and foremost the protection of the public. To ensure the protection of the public throughout the EU, directives were developed so that a minimum standard of education and practice could be identified. Midwifery education and practice are determined by the Directive 2005/36/EC of the European Parliament and of the Council (2005). This Directive has just been amended on 20 November 2013 to ensure greater efficiency and transparency with the recognition of professional qualifications and has placed value on the use of a European Professional Card (Directive 2013/55/EU, 2013).

The NMC set standards for education and practice and give guidance to professionals. The latest standards for pre-registration midwifery education (NMC 2009) are guided by the international definition of a midwife and the requirements of the European Union Directive Recognition of Professional Qualifications 2005/36/EC Article 40 (training of midwives) and amendments to the EU Directive as stated above. These directives stipulate the experience that students must demonstrate before registering as a qualified midwife and are listed in Box 1.2.

Box 1.2    The European Union Article 40 (Training of Midwives) of Directive 2005/36/EU

  • Advising of pregnant women, involving at least 100 antenatal examinations.
  • Supervision and care of at least 40 women in labour. (The student should personally carry out at least 40 deliveries; where this number cannot be reached owing to the lack of available women in...

Erscheint lt. Verlag 8.12.2014
Reihe/Serie Fundamentals
Fundamentals
Fundamentals
Sprache englisch
Themenwelt Medizin / Pharmazie Gesundheitsfachberufe Hebamme / Entbindungspfleger
Medizin / Pharmazie Pflege
Schlagworte Antenatal • Bereavement • complimentary therapies • Contraception • Emergencies in Midwifery • Family planning • Geburtshilfe • Gynäkologie u. Geburtshilfe • Gynäkologie u. Geburtshilfe • Health Promotion • Hebamme • Hebammenpraxis • Infant feeding • Intranatal • Krankenpflege • Krankenpflege i. d. Frauenheilkunde • Loss • Medical Science • medicines management • Medizin • Midwifery • midwifery care • newborn • nursing • Obstetrics & Gynecology • parenthood • Perinatal Mental Health • pharmacology • Psychology • Public Health • Sociology • Student • Team working • Women's Health Nursing
ISBN-10 1-118-52807-7 / 1118528077
ISBN-13 978-1-118-52807-5 / 9781118528075
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