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The paper outlines the current global situation in respect of making childbirth safer through the promotion of skilled care during this critical life event. The implications of the fifth Millennium Development Goal (MDG5) are discussed and a hypothesis offered that has been derived from an analysis and synthesis of a vast quantity of literature. Examples of policy and practice from numerous countries are shared and the possible implications for midwifery practice in the UK contemplated. [ABSTRACT FROM AUTHOR]

Caesarean section by maternal request (CSMR) is the provision of a caesarean section when requested by the mother, with no medical indication. This paper aims to provide a narrative overview of CSMR to inform clinicians about the pertinent issues. It will examine current provision of CSMR in the UK and contextualise it among prevailing social and societal factors. It will explore in detail the reasons why women may choose caesarean section, and provide arguments for and against the provision of CSMR on the NHS. [ABSTRACT FROM AUTHOR]

Objective: This service evaluation aimed to collect data on clinical handover on labour ward and compare them with the local guideline. Design and methods: This service evaluation was structured in four stages, each using a different design and research methods. Setting: The study was undertaken between September 2013 and August 2014 in a maternity unit in a large NHS teaching hospital in London, UK. Findings and conclusion: Communication breakdown is widely considered to be a significant factor contributing to poor patient outcomes, with handover being a major risk point. The discrepancy between the local guideline and current clinical practice reinforces the belief that urgent action is needed to improve clinical handover on labour ward. The results of this service evaluation suggest that a drastic overhaul of the communication model during handover should be considered, ie from handover to takeover, and that the mnemonic SBAR may not be fit-for-purpose in maternity care and should be replaced with a different format that reflects the chronological flow of clinical events. [ABSTRACT FROM AUTHOR]

Background An interprofessional education initiative was developed and piloted in 2014 at Queen’s University Belfast, within the School of Nursing and Midwifery and the School of Medicine. Aims The aim of the collaboration was to introduce concepts of normal labour and birth to fourth-year medical students, led by final-year midwifery students. Methods A variety of birthing resources were available to the midwifery students to promote interactivity with the medical students, including birthing balls and birth manikins. Artistic licence in relation to planning the activities was encouraged. Significant emphasis was placed on the importance of relationship-building with women in labour, and the concept of being ‘with woman’ was core to all elements of teaching. Midwifery students undertook acting roles such as the labouring woman, partner or midwife role and acted out mini scenarios such as contacting for advice about early labour, positions for labour or positions for birth. Medical students were encouraged to participate in the role play, and the interactive workshop culminated with a hands-on simulation of childbirth. Findings Evaluation of the workshops has been extremely positive. The midwifery students reported a perceived benefit of teamwork in preparing for the workshop and also a perceived increased level of confidence. Conclusion Both schools have recognised the benefits of this form of inter-professional education and have subsequently made a commitment to embed it within their respective curricula. [ABSTRACT FROM AUTHOR]

This literature review was carried out in the UK to explore the cultural practices of Nigerian women during pregnancy and childbirth both within and outside their indigenous community, in order to highlight aspects of birth practices that may serve to enhance their health and wellbeing or to constrain these. Literature was sourced from journals of related disciplines. To encapsulate current knowledge and broaden the scope of the literature review, only articles published within the last 2 decades were selected for this review. Themes drawn from the literature review sum up core beliefs and practices of Nigerian women in childbirth and uncover existing knowledge on the topic in relation to: beliefs and traditions through the birth continuum, the influence of culture on birth practices and beliefs within and outside their indigenous community, challenges of culture to maternal adaptation and/or transition to motherhood in terms of migration and acculturation, the value of motherhood and children in Nigerian culture, social support or the lack of it, religion and spirituality and the interplay of these in their birth experiences. These themes bear relevance to Nigerian women's experience of pregnancy, birth and maternity care experience both in their home country and in the UK. [ABSTRACT FROM AUTHOR]

Research indicates that midwives are equally effective as senior house officers, if not more so, in performing the routine examination of the newborn. When midwives performed this examination their level of job satisfaction was increased and the mother's satisfaction with the examination was also increased. However, studies have also highlighted that midwives are concerned that they might be pressurized into taking on new roles as well as being worried that they may have no control over their workload. Furthermore, it has also been shown that the majority of maternity units do not have enough staff to cope with the rising birth rate and that midwives already have to deal with an increasing workload, resulting in them struggling to provide a safe, quality service to women and babies without taking on new roles. By delegating some of a midwife's workload to another category of skilled worker may enable midwives to re-evaluate their existing role, and take on new roles that support the midwifery philosophy of care. This philosophy of care views pregnancy, childbirth and the postnatal period as a continuum, with the woman and baby being the primary focus of the midwives' practice, stresses the importance of the midwife working in partnership with the woman and her family. Such a philosophy enables the woman to make informed decisions about her care. The pregnancy continuum is also viewed as a normal life event, which is supported by midwives. If research indicates that midwives are better at performing the examination of the newborn, then why is it that more maternity units do not have midwives who are able to carry out this skill, since midwives in the UK have been able to undertake this examination for more than 10 years? In addition, in units which do have midwives who can perform the examination, why are these midwives not using their skills? [ABSTRACT FROM AUTHOR]

Postnatal care has for too long been the Cinderella of the childbirth continuum and marginalized within maternity care services. Most women in the UK are hospitalized after giving birth and spend time on a postnatal ward. Women tend to view this aspect of their childbirth journey as the least satisfying, and in-depth analysis as to the reasons for this perspective is limited. This article presents a thought-provoking debate on postnatal hospital care and is underpinned by data that have emerged from observing postnatal wards as part of a larger research study. Two main points are pursued: reflections on carrying out 'fieldwork' and the notion that postnatal care is becoming deficient in purpose. Questions are raised as to the intention of hospitalization after birth, given the culture and context of a busy ward. Many factors impinge upon the woman's experience of the postnatal ward: the availability of midwives, the status/value of postnatal work and having enough time to spend with women on a busy ward. However, the essence of midwifery and intention of postnatal care must not be lost. Evidence to support postnatal care by midwives needs to be visible. [ABSTRACT FROM AUTHOR]

Focuses on the community maternity unit (CMU) in Great Britain. Adoption of birth center principles; Objectives and standards of the unit; Promotion of water birth and hydrotherapy; Rate for women transferred to the central delivery suite for epidural; Accessibility of CMU; Low-risk audit performed by the unit.

Waterbirth has been practised safely and to enormous benefit in the UK for decades (Miller, 2006). In 2006 the RCM/RCOG reported that 64% of UK hospitals had a birth pool installed, though usage varied from only 15-60% (RCM, 2000). This article will look at the benefits of water during labour and birth, and discuss the types of pool that are available for hire and purchase. There will also be a short discussion of birth balls and TENS machines for use in both the hospital and home setting. [ABSTRACT FROM AUTHOR]

The author discusses the controversy surrounding his comments on labour pain and epidurals in an interview he gave to the "Observer" newspaper. He cites issues that emerged during a lecture for the Royal College of Midwives in Great Britain on June 20, 2009 which, in his view, was the original source for controversy, such as the serious side effects of epidurals on normal labour and birth. He asserts that discussing childbirth pain internationally has been positive and may have the impact of critically assessing the existing maternity service provision.

The article discusses the appropriateness of midwifery duties in Great Britain. The education of student midwives always needs delegation, however it does not equate to substitution. Under the rules and standards of the Nursing and Midwifery Council, a midwife cannot arrange for anyone to act as a substitute, other than another practicing midwife or a registered medical practitioner. Only midwives and registered medical practitioners are permitted to attend a woman in childbirth.

Focuses on the parallels between fast and slow food and childbirth in Great Britain. Resonance of free-standing birth centers with the Slow Food Movement; Observation on maternity care in a free-standing birth center and a large consultant unit; Effectiveness of birth center birth in enabling midwives and women to reconnect with meaning and significance in a non-medical, non-technological environment that enables the social and cultural domains to resurface.