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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