Advancing Skills in Midwifery Practice (eBook)

Front Cover 1
Advancing Skills in Midwifery Practice 4
Copyright Page 5
Contents 6
Contributors 8
Foreword 10
Preface 12
Reference 12
Chapter One: Introduction 14
Contents 14
Introduction 14
Advanced practice or advancing skills? 15
How to use the book 15
References 17
Chapter Two: The midwife's professional responsibilities in developing competence in new skills 20
Contents 20
Introduction 20
A framework of responsibility 21
Professional responsibility 22
Legal responsibility 24
Ethical responsibility 25
Employer responsibility 27
Conclusion 29
References 30
Useful websites 31
Chapter Three: Complementary therapies in midwifery: a focus on moxibustion for breech presentation 32
Contents 32
Introduction and rationale 32
Professional responsibilities of the midwife 33
Mechanism of action 34
Outline of the 'skill' 36
Contraindications and precautions 36
Evidence-based practice 38
Conclusion 39
References 39
Further reading 40
Resources 41
Chapter Four: Ultrasonography in midwifery practice 42
Contents 42
Introduction 42
Safety of ultrasound 43
Self-regulation 43
Basic ultrasound technology 44
Early pregnancy ultrasound 45
Multiple pregnancies in the first trimester 46
First trimester screening for chromosome abnormalities 47
Second trimester ultrasound 48
Fetal measurements used in the second trimester 48
The second trimester fetal anomaly ultrasound scan 49
Normal head shape and internal structures 50
Abdominal shape and content 52
Examination of the fetal heart 53
Fetal limbs 53
Placental location 54
Monitoring for twin-to-twin transfusion syndrome 54
Cervical length 55
Third trimester ultrasound 55
References 57
Further reading 58
Chapter Five: Reducing unnecessary caesarean section by external cephalic version 60
Contents 60
Introduction 60
The significance of breech presentation 61
Rationale for trying to avoid breech presentation 61
Who should be offered an external cephalic version? 62
What is the optimal gestation? 62
What influences the success of external cephalic version? 62
Complications associated with external cephalic version 63
The procedure 63
Is external cephalic version cost effective? 64
Professional issues and challenges when educating and training midwives to perform external cephalic version 64
Information for women 65
Some alternatives to external cephalic version 65
Acknowledgement (Carol McCormick) 66
External cephalic version: a mother's perspective (Abigail Cairns) 66
References 68
Further reading 68
Useful websites 68
Chapter Six: Peripheral intravenous cannulation 70
Contents 70
Introduction 70
Peripheral intravenous cannulation: redefining the role of the midwife 71
Legal and professional responsibilities of the midwife 71
Conclusion 77
References 78
Further reading 79
Useful Website 79
Chapter Seven: Midwives undertaking ventouse births 80
Contents 80
Introduction 80
Background: why some midwives undertake ventouse births 81
The midwife ventouse practitioner: barriers and opportunities 82
Ventouse extraction: the practicalities 82
Training and practice procedures 83
Recruitment of midwife ventouse practitioners 83
The benefits of midwives undertaking ventouse births 84
The procedure 84
Women's responses 84
Training 85
Accountability 85
Personal reflections 85
Conclusion 87
References 87
Further reading 88
Chapter Eight: Forceps-assisted birth 90
Contents 90
Introduction 90
Rationale 91
Sharing best practice 92
Clinical practice rationale 92
Educational rationale 93
Implementation 94
Management rationale 94
Procedure for undertaking forceps birth 95
Instrument choice and basic procedure 96
Potential complications from forceps-assisted births 96
Challenges 96
Establishing links 98
Reflections on a birth story 98
Record keeping 98
Conclusion 98
References 99
Further reading 100
Chapter Nine: Facilitating vaginal breech birth at term 102
Contents 102
Introduction 103
Incidence of breech presentation 103
The evidence 103
Indications and contraindications of vaginal breech birth 104
Potential complications of breech birth 105
Place of birth 105
Position for birth 106
Facilitating a breech labour and birth 106
Manoeuvres to assist the birth of the breech 107
Professional responsibilities of the midwife 110
Conclusion 113
References 114
Further reading 115
Useful websites 115
Chapter Ten: Perineal management and repair 116
Contents 116
Introduction 117
Background 117
Education/training 117
Classification of spontaneous perineal tears 118
Assessment of perineal trauma 118
Current evidence 119
Suture techniques 121
Suture materials 121
Management of complex perineal trauma 123
Risk factors 123
Repair of sphincter trauma 123
Principles and technique of repair 123
Who should carry out primary repair of obstetric anal injuries? 124
Management of other types of complex trauma 125
Female genital mutilation 127
Assessment and care planning for labour 129
Immediate postnatal care 130
Perineal care postpartum: practice implications 130
Perineal care clinic 130
Medico-legal implications 131
References 132
Further reading 133
Chapter Eleven: Haemodynamic assessment and monitoring in maternity care 134
Contents 134
Skill outline 134
Rationale and background 134
Procedure 135
Professional responsibilities 144
References 145
Further reading 146
Chapter Twelve: Physiological examination of the neonate 148
Contents 148
Introduction 148
Examination of the heart 149
Examination of the eye 154
Examination of the hip for developmental dysplasia of the hip 155
Conclusion 158
References 158
Further reading 159
Chapter Thirteen: Infant massage 160
Contents 160
Introduction 160
The geography and history of infant massage 161
Scientific claims and evidence 162
Demonstrable benefits of infant massage 162
Type of massage 163
Areas for further testing of claimed benefits 163
Comment on the Cochrane reviews 164
Professional issues 164
Practical infant massage 167
Establishing classes for parents and carers 170
Conclusion 171
References 171
Further reading 172
Professional bodies 172
Chapter Fourteen: Postnatal physiological examination of the mother 174
Contents 174
Introduction 174
Framework for postnatal care 175
The context of care 176
Maternal morbidity 176
Physiological examination to detect major maternal morbidity 177
Physiological examination to identify common maternal health problems 179
Other postnatal health needs 182
References 183
Further reading 185
Chapter Fifteen: Working in new ways to advance midwifery skills in practice 186
Contents 186
Introduction 186
Advancing skills versus 'extended' role 186
Continuity of care: opportunities and challenges 189
Meeting the education needs of midwives 189
Role changes and leadership: midwives as change agents 190
The future 192
References 193
Further reading 193
Index 194