Looking back – a midwife’s reflection of her career

By Angela McBennett   A note to start…. It seems that in the ‘blink of an eye’, 27 years have flown by as I retire from general midwifery. My memories of midwifery will always be forever in my heart. Pregnancy and birth is a unique time in a family’s life and, as a midwife, we […]

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Birth Undisturbed – a guest post by Natalie Lennard

I am a fine-art and commercial photographer of 11 years. Having long created surreal and elaborate fantasy scenes, always with a singularly conventional femininity, I’ve been increasingly hungry to showcase a more raw, powerful beauty in the most surreal yet commonplace event in a woman’s life: childbirth. Evan Gabriel I have long been fascinated by […]

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Relationship-based continuity of carer: informed choice for mothers AND midwives

There can be no doubt that we should be implementing relationship-based continuity of carer for most women and their babies. The evidence has been mounting over years and is compelling: there are few developments that offer so much benefit, with fewer risks (See http://www.gtc.ox.ac.uk/images/stories/academic/skp_report.pdf). It is difficult to understand why this evidence is still seen […]

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navigating spaces:


fetal navigation techniques “I turned my OP baby and regulated my own contractions in an hour, directly avoiding induction and possibly other interventions. This was my second labour, which from this point on flowed smoothly to a physiological birth in just a few hours. My first baby had also started labour in a less than […]

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Birth Outside the Box – #TheatreChallenge!

By midwife Katherine Mabey   What is Birth Outside the Box? Derby Birth Outside the Box team is an informal forum at Royal Derby Hospital which aims to bring midwives, doctors and other team members together, with the common goal of increasing rates of physiological birth and improving women’s experience for all births regardless of […]

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Thinking Outside The Box: Untangling Tocophobia

THINKING OUTSIDE THE BOX Untangling tocophobia After a pregnant woman asked about fear-related terminology, Sara began to question what we mean by the term ‘tocophobia’ and whether this term takes account of the complexity of people’s fears and the fact that, for some, their concerns are more about fear of the maternity system than fear […]

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Best practice in fetal monitoring and neonatal care crucial to improve birth outcomes

Best practice in fetal monitoring and neonatal care crucial to improve birth outcomes Three quarters of babies who die or are brain injured during birth might have had a different outcome with different care, says national investigation. For the first time, the RCOG “Each Baby Counts” initiative has been able to pinpoint and share the […]

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Advancing Practice: The Midwifery Unit Network – Creating A Community Of Practice To Enhance Maternity Services

ADVANCING PRACTICE The Midwifery Unit Network: creating a community of practice to enhance maternity services The Midwifery Unit Network (MUNet) is a community of practice which aims to promote and support the implementation and improvement of midwifery units (MUs) in the UK and internationally. It was launched in April 2016 and has been growing fast […]

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Midwifery management of face presentation

Midwifery management of face presentation The 1980 edition of Oxorn and Foote (1980) urges the midwife not to be hasty in employing cæsarean (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 […]

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Water as non-pharmacological pain management in labour

Water as non-pharmacological pain management in labour The use of Complementary and Alternative Medicine (CAM) in maternity care has risen over the past two decades. An increasing number of women seek non-pharmacological pain management during labour and birth. The use of hydrotherapy – or water immersion – during labour offers women a naturalistic approach to […]

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Physiological breech birth: Evaluation of a training programme for birth professionals

Physiological breech birth Evaluation of a training programme for birth professionals This paper reports an evaluation of the Breech Birth Network (BBN) physiological breech birth (PBB) training programme, which has been developed out of consensus research with highly experienced health professionals. The training was delivered in four National Health Service trust hospitals in the north […]

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Hypnosis and hypnobirthing for labour – a critical selective narrative review

Hypnosis and hypnobirthing for labour – a critical selective narrative review The provision of woman-centred care is at the heart of midwifery practice, and there appear to be increasing numbers of women choosing alternative forms of support for their childbearing journey. Women are often fearful of the experience of labour and birth, and in particular […]

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Promoting normality and choice by creating a home-from-home birthing room

Promoting normality and choice by creating a home-from-home birthing room Promoting normality within the birth environment has been a key policy driver for a number of years. The National Institute for Health and Care Excellence (NICE) (2014) recommends that low-risk women birth either at home or in a midwife-led unit, but not all maternity services […]

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Articles - Advancing Practice

Reducing maternal sepsis

ADVANCING PRACTICE Intrapartum Care / Mortality Reducing maternal sepsis Despite significant advances in the diagnosis and management of sepsis, sepsis in the puerperium remains an important cause of maternal death (Royal College of Obstetricians and Gynaecologists (RCOG) 2012). To ensure the best outcome for women who are septic, timely diagnosis and treatment is required, together […]

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Articles - Advancing Practice

Detecting fetal compromise during active labour and managing neonatal after-effects

ADVANCING PRACTICE Intrapartum Care Detecting fetal compromise during active labour and managing neonatal after-effects Evaluating fetal wellbeing during the intrapartum period to detect fetal compromise and hypoxia is a topic of considerable importance to midwives. In part this is because the events during this time can have profound significance for the physical and emotional wellbeing […]

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Articles - Basics

Catherisation: best practice in bladder care

MIDWIFERY BASICS Preceptorship Catherisation: best practice in bladder care Bladder care is an integral part of caring for a woman in labour and the immediate postpartum period (National Institute for Health and Care Excellence (NICE) 2014a). To ensure effective bladder care, the skill of urinary catheterisation is often undertaken by a midwife and can be […]

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Articles - Advancing Practice

Dancing in the grey zone between normality and risk

ADVANCING PRACTICE Intrapartum Care Dancing in the grey zone between normality and risk Childbirth is mainly grey. The most straightforward of births can lead to unexpected, heart-stopping moments – and the highest risk woman can, despite our fears, birth without any of the imagined horrors being realised. As midwives we can choose to be paralysed […]

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Articles - Advancing Practice

Perineal protection

ADVANCING PRACTICE Intrapartum Care Perineal protection Perineal tearing in childbirth is common and can have a considerable impact on women. There are various hands-on techniques that midwives use routinely to protect the perineum but not all of them are evidence based. Despite this, midwives often feel that they are the determining factor in whether a […]

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Articles - Advancing Practice

Supporting women’s instinctive pushing behaviour during birth

ADVANCING PRACTICE Intrapartum Care Supporting women’s instinctive pushing behaviour during birth During birth women instinctively push in the most effective and safe way for themselves and their babies. However, midwives continue to direct women’s pushing behaviours. The assumptions underpinning this practice must be examined and challenged. Midwives need to develop an evidence-based approach that acknowledges […]

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Articles - Basics

Preceptorship: 7. Perineal suturing

MIDWIFERY BASICS Preceptorship 7. Perineal suturing During the transition from student midwife, the newly qualified practitioner (NQM) is required to obtain experience of perineal suturing. With exposure varying from student to student and inconsistency in teaching methods between hospital trusts, the NQM can be left feeling apprehensive and unsupported to learn this skill. Suturing is […]

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Articles - Advancing Practice

Effective non-pharmacological birth interventions

ADVANCING PRACTICE Intrapartum Care Effective non-pharmacological birth interventions Midwifery expertise is in ‘normal’ birth. What constitutes ‘normal’ is debatable, but well embedded within ‘normal’ are the birth plans of women who aspire to give birth without using drugs. To give birth without drugs for many may seem undesirable or intolerable, especially to those whose cultural […]

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Umbilical cord prolapse in primary midwifery care in the netherlands; a case series – Part 1

We aimed to gain insight into umbilical cord prolapse (UCP) reported by primary care midwives in the Netherlands. Cases of UCP were reported by midwives who participated in a postgraduate training programme developed for community-based midwives. Cases were analysed using midwifery charts, ambulance report forms and discharge letters. Procedures to alleviate cord pressure, ambulance timing, […]

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Articles - Evidence

Research Unwrapped – Continuity of care: what matters to women when they are referred from primary to secondary care during labour?

EVIDENCE Research Unwrapped Continuity of care: what matters to women when they are referred from primary to secondary care during labour? A qualitative interview study in the Netherlands – Ank de Jonge, Rosan Stuijt, Iva Eijke, and Marjan J Westerman (2014). BMC Pregnancy and Childbirth, 14: 103 Research unwrapped is a popular series to help […]

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Use of acupuncture during labour

Acupuncture is becoming widely recognised as an effective method of pain relief and is being increasingly integrated within the NHS, particularly for the treatment of tension-type headache, migraine and low back pain. Acupuncture during labour has been shown by a Cochrane review to reduce labour pain intensity, increase patient satisfaction and limit the use of […]

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Hypnotherapy for birth

There are many misunderstandings about hypnotherapy for birth and how best to support a woman who has chosen to use it. This article brings together experiences of midwives who have attended women in labour using hypnotherapy, and aims to help birth professionals understand a bit more about hypnotherapy and how they can best support women […]

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Mobility and upright positioning in labour

A study by the Royal College of Midwives (RCM) (2010) concluded that 49 per cent of women gave birth in the supine position. The RCM advocates getting women ‘off the bed’ in its campaign for normal birth (RCM 2005a). There has been much speculation as to why women labour on the bed, with some suggesting […]

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Too afraid to push: dealing with fear of childbirth

Maternal request for caesarean section in the absence of medical need is an ethical and moral dilemma for the NHS. When a woman makes such a request it requires careful exploration of the underlying motivation. Many of these women will be anxious or fearful of giving birth and require tailored support. The provision of an […]

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Not my choice: results of an online survey

FEATURE The Practising Midwife – February 2014 Not my choice: results of an online survey A survey into women’s experiences of giving birth in the UK, published in October 2013, provides a useful insight (Birthrights UK 2013). It is the first of its kind to capture women’s views on dignity in childbirth. The survey reflects […]

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