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Background: Uninformed adoption of simulation technology such as high-fidelity simulators may result in ineffective learning and teaching. However, in the literature little is known about specific developmental approaches to prepare midwifery educators for using this pedagogy. Aims: The overall aim of this research was to describe the experiences of midwifery educators following a 2-day high-fidelity workshop and the impact on their perceived preparedness to teach using a high-fidelity simulator. Methods: Qualitative data were gathered from one semi-structured focus group 2 weeks following the workshop. Thematic analysis identified emergent themes pertaining to the research objectives. Findings: Four main themes emerged from the data: fears regarding complex technology, time for scenario-building, opportunity for team-building, and enhancement of the curriculum. Conclusions: Initial face-to-face high-fidelity workshops are recommended to achieve successful integration of high-fidelity simulators into midwifery education, with supportive materials to promote continued accessibility and learning. Support from technical staff is essential. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical topics which include postpartum depression, fear of childbirth, and hypertension in pregnancy.

A systematic review of the literature was undertaken to explore fathers' opinions and views on antenatal education and its effectiveness in preparing them for their role as birth partners and for parenthood. The findings are categorised under four key themes: outnumbered, excluded, anxious and uncertain, and preparedness. While research suggests that most fathers want to support their partners and be involved in the pregnancy, labour and birth of their baby, they are less likely to attend antenatal classes than women. While fathers who attend antenatal education classes value them, their experiences are not always as positive or helpful in preparing them for their role as birth partners or in parenthood. It was highlighted that men are more likely to feel unprepared when complications at birth arise. A common finding was that men would welcome the opportunity to focus on their individual needs. [ABSTRACT FROM AUTHOR]

It is evident from a review of the literature that looking after the psychological and emotional needs of women who have their baby removed at birth is a vital part of midwifery care in the childbirth continuum. This review reports on the experiences of midwives who have provided care and emotional support to mothers who have had their baby removed at birth and the challenges they have encountered from doing so. BNI, CINAHL, EMBASE, Google Scholar, Maternity and Infant Care and PsycInfo were searched for articles published until January 2014 and findings suggest that providing care and emotional support to women who have had their babies removed at birth remains one of the most challenging aspects of contemporary midwifery practice. It is anticipated that this study will raise awareness of the challenges associated with providing care and emotional support for women whose babies have been removed at birth and contribute to the evidence base for best practice. [ABSTRACT FROM AUTHOR]

The importance of good clinical communication to women during pregnancy and birth is clear. Poor communication in labour is associated with general dissatisfaction, more complaints and a range of perinatal mental health problems including post-traumatic stress disorder (PTSD) and postnatal depression. To communicate effectively, maternity staff need information about which women are vulnerable and require extra support. To address this, a pink sticker communication system to alert midwifery and obstetric staff to potential psychological difficulties experienced by some women was implemented and evaluated. Evaluation showed this system was viewed positively by women and midwifery staff. Audit of referrals to the perinatal psychology service during this period suggests no woman with a pink sticker developed birth trauma as a direct result of perceived poor care. In addition, the proportion of referrals to perinatal psychology for birth trauma significantly reduced during this period. [ABSTRACT FROM AUTHOR]

The death of a baby, whether before, during or after birth is extremely sad. Mothers who were expecting a new life find themselves dealing with death. Midwives are one of a few people to share the important memory of the birth and death of a baby; therefore, the quality of care offered during this period is crucial to support mothers and limit the distress experienced at this difficult time. Emotionally, mothers require compassionate and sensitive care from midwives and health professionals, while physically the bereaved mother will require support and advice with her postnatal needs, as her body recovers from childbirth. The importance of knowledge and understanding of grief theory and the grieving process will guide midwives as they support the bereaved postnatal mother. [ABSTRACT FROM AUTHOR]

New models of maternity service provision are currently emerging across the NHS. One to One (North West) Limited was the first Any Qualified Provider (AQP) of midwifery care throughout the maternity continuum, with midwives providing community-based care for women across the risk spectrum. It was also the first non-NHS maternity organisation to gain independent insurance for intrapartum care. One to One commenced a 3-year contract with NHS Wirral in November 2011. This article discusses the care the organisation's midwives offer, and presents routinely collected clinical outcome data and women's testimonies from One to One's first full year of operation. Between 1 November 2011 and 31 October 2012, 711 women were booked, 414 of whom gave birth with One to One. The spontaneous vaginal birth rate was 76% for all births, while the home birth rate was 31%. The article highlights the successes, challenges and opportunities a reconfigured NHS offers for those receiving and providing midwifery care. [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]

The risk of perineal injury during childbirth continues to affect the majority of women. Morbidity associated with perineal injury and repair is a major health problem for women. Therefore, it is vitally important that midwives are educated and trained to recognise risk factors and the extent of perineal injury. Education and training has been shown to assist midwives to gain confidence and clinical skills to suture competently and keep themselves up-to-date with the best available evidence on which to base their care. This article provides an overview of the literature relating to risk, recognition and repair of the perineum during the childbirth continuum. [ABSTRACT FROM AUTHOR]

Obstetric anal sphincter injury (OASIS) and the long-term morbidity associated with it can have a devastating impact on the lives of women and their families. Although the majority of women will not sustain a third or fourth degree tear there is the risk of long-term morbidity if these more severe injuries go unrecognised or mismanaged. With the aid of current guidelines every attempt is made to maintain normal function after birth. However, current research suggests that deficiencies in training for the recognition and management of OASIS are resulting in preventable sequelae. Skills and training are highly variable both trust- and nationwide and recommendations to improve practice include standardised evidence-based perineal assessment and management training. [ABSTRACT FROM AUTHOR]

This article will describe and discuss the anatomy and physiology of the pelvic floor and the important role it plays during childbirth. It will also consider damage that can be caused to the pelvic floor and in the genital/rectal region. Urinary and faecal incontinence, perineal injury (naturally occurring or surgically induced) and haemorrhoids can cause a lot of distress and pain for many women following childbirth. Alleviating the distress and pain associated with these problems is vitally important and will be explored. [ABSTRACT FROM AUTHOR]

Objective: To gain insight into how continuity of care can increase student midwives' understanding of midwifery, with emphasis on the promotion of normal pregnancy, childbirth and postnatal period. Design/setting: A pilot project at Sør-Trøndelag University College. Six student midwives provided continuity of care to 58 women throughout their pregnancy, childbirth and postnatal period. The students, under the supervision of a clinical midwife, worked in pairs during the antenatal care, in groups during antenatal classes and individually during childbirth and the home visit. A group interview with the six student midwives, based on a focus group technique, was conducted at the end of the project. Qualitative data were analysed through systematic text condensation. Findings: The findings include three main themes: relational continuity, personal development and health-promoting perspective. By offering relational continuity, the students experienced interdependent trust and partnership. This resulted in personal development based on mastering skills and relational learning. The students became aware of the importance of individual care, holistic care and empowerment and understood midwifery through a health-promoting perspective. Conclusions: To achieve high quality midwifery skills, student midwiveswould benefit from experiencing relational continuity in their practical studies. This continuity promotes interdependent trust and partnership with the women in their care. Follow up through continuity of caregives the students more meaningful practice and results in personal development for the students and health promotion in midwifery. [ABSTRACT FROM AUTHOR]

The purpose of this qualitative study was to explore women's experiences of giving birth with their husband's support in urban Nepal. The study was conducted in July 2009 at a midwife-led birthing centre in the capital of Nepal. In-depth, semi-structured interviews were conducted among twelve first-time expectant mothers who gave birth with the support of their husband. Each interview was audio-taped. The recorded data was analysed using thematic analysis. Three themes were identified: (1) feeling in control of the labour process, (2) concern for their husband and (3) emotional discomfort. Most of the time, the women, with support from their husband, felt in control of the childbirth process, but they were also periodically in discomfort. Moreover, they were concerned that their husband had to witness their labour pain. Educational and birth preparation classes for expectant couples would help to reduce women's emotional discomfort and alleviate their concern for their husband. [ABSTRACT FROM AUTHOR]

This article is a report of a grounded theory study of pregnancy and childbirth experiences of women in rural Cambodia. Antenatal anxiety and depression have been linked to adverse outcomes of preterm delivery and low birth weight in the baby. Recent study findings from Cambodia reveal high levels of clinically significant antenatal anxiety and depression with consequent links to low birth weight in the infant. Thirteen in-depth interviews with rural pregnant women were conducted in December 2008 over 3 days during the midwifery outreach service to the villages. The research process followed the principles of grounded theory methodology. Four core categories were identified during the interview analysis: fear of childbirth, lack of information, traditional versus allopathic practice, and access to the government midwife. Childbirth causes fear, largely owing to a lack of knowledge about the normal physiological process and fear of death in the case of complications due to poor access to health services. Traditional and allopathic practice largely ran in parallel or in contradiction to each other but there were some examples of successful integration. Most of the interviewees wanted more contact with the government midwife. This could be an opportunity to share information in a confidential, non-threatening but informative relationship while reducing anxiety and consequences for the mother and her child. These categories can be extrapolated to the wider context highlighting complex barriers to women accessing midwifery care, while emphasizing the negative impact of anxiety on fetal wellbeing and the role of accurate information and professional support. [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]

The needs of women giving birth from prison were highlighted in 1995. A group of antenatal teachers and midwives in London met and decided to offer birth support to women in Holloway prison. Birth Companions has been working with pregnant women and mothers and babies in Holloway for 14 years and has expanded the birth support service to include breastfeeding and working with women post release. The aim of the project is to improve the experience of this vulnerable group of women and babies. Studies show that birth support can improve outcomes for mothers and babies and the feedback from women in Holloway is very encouraging. However, there is a need for more research into the needs and experiences of women and babies who are in prison during the perinatal period. [ABSTRACT FROM AUTHOR]

Growing numbers of openly gay women choose to have children, but there have been few studies on the topic. The aim of this study was to describe the co-mother's experiences of care provided during their partner's pregnancy, childbirth and the postnatal period. Six co-mothers were interviewed between six weeks and three years after the birth of their child. The open interviews were analysed using content analysis. The overall theme of the findings was 'like everyone else, but not quite'. The following main categories were identified: need for acknowledgement, need for care designed to suit same-sex couples, and in the hands of nursing staff. Co-mothers felt themselves to be 'like everyone else but not quite'. In order to support the relationship of same-sex parents in parenthood it is important for midwifery staff to recognize comothers as an equal parent of the child. [ABSTRACT FROM AUTHOR]

Presents three web sites which share a common theme of encouraging women and their care providers to respect and facilitate the normal, natural physiological process of birth through education and advocacy. Web site of the Lamaze Institute for Normal Birth; Web site of the National Childbirth Trust; Web site for Birth International.

Since 1997 women in a consultant-led unit in Inverness have had access to a purpose-designed pool for labour and birth. The number of women using the pool over the last 11 years has steadily increased and midwives have gained more experience and confidence in the use of the pool for labour and birth. This article describes the ongoing evaluation of the pool from September 1997 to December 2008 and identifies how the experience in Inverness varies from other units in the UK. [ABSTRACT FROM AUTHOR]

Nepal has one of the highest infant and maternal mortality rates in the world, second only to parts of Africa. Using in-depth interviews, fifteen postpartum mothers and eight mothers-in-law were interviewed to examine current cultural, social and contextual birthing process in Nepal. Analysis of this qualitative data through a grounded theory approach identified the dichotomy between 'traditional birthing' and modern medical obstetric care. This dichotomy limits technical, social and cultural collaborative birthing practices between the many traditional birthing attendants and medical staff. The emerging themes suggest other approaches for childbirth care; bringing harmony to traditional as well as modern clinical approaches. The outcomes of this study hope to enfranchise women with safer and more acceptable birthing experiences and outcomes not only in Nepal but also in other developing countries. [ABSTRACT FROM AUTHOR]

The Cochrane Collaboration is internationally renowned as the leading organization for the production of systematic reviews of healthcare interventions. Since the mid-1990s, Cochrane reviews have become synonymous with randomized controlled trials (RCT5), contributing to the elevation of RCTs as the gold standard for research in healthcare. However, this article demonstrates how the inclusion of non-randomized data in Cochrane Reviews is now up for debate. The Cochrane Review of ‘Caesarean section for non-medical reasons at term’ is the first from the Cochrane Pregnancy and Childbirth Group (PCG) to strongly recommend research methods, other than an RCT, to gather future data. Here, two of the review authors assert that Cochrane reviews with no trials may have their place in the work of the PCG. [ABSTRACT FROM AUTHOR]

To evaluate first time fathers' experiences during pregnancy and to compare labour experiences between three different modes of delivery. Fathers whose partners delivered at Aberdeen Maternity Hospital were given a questionnaire postnatally before their partners' discharge from hospital. Fathers rated their experiences of pregnancy and labour on a visual analogue scale. 142 fathers completed the questionnaire. Fathers became progressively more connected to the pregnancy feeling most connected to it during the scans and when feeling fetal movements. Throughout labour fathers in emergency deliveries felt more anxious, helpless and frustrated compared to fathers in spontaneous vaginal deliveries (SVD) and elective/semi-elective caesarean sections (CS). Fathers in emergency deliveries felt labour did not match their expectations more so than those fathers in SVDs. Health professionals should be sensitive to fathers' needs during their transition towards fatherhood and their role during labour should be assessed regularly. [ABSTRACT FROM AUTHOR]

Literature on birth trauma has focused on women's experiences and the evidence of post-traumatic stress disorder (PTSD) following childbirth. For some fathers witnessing a traumatic birth involving their partner and/or baby, symptoms of post- traumatic stress disorder may also be apparent. In this New Zealand study descriptive phenomenology was used to explore the phenomenon of post-traumatic stress following childbirth as twenty-one fathers narrated their experiences of witnessing a traumatic birth. Four themes encapsulated their experiences: it's not a spectator sport; it's about being included; it's sexual scarring; it's toughing it out. These results demonstrate that some men are left with a negative emotional experience that has serious consequences for their relationships and families. Midwives should be aware that many men have ambiguous expectations about being at the birth. If fathers are witness to a traumatic birth, as they perceive it, they need resolution. [ABSTRACT FROM AUTHOR]

Mood disorders are common in pregnancy and the postpartum period and there is little doubt of the clinical and public health importance of affective illness occurring at this time. However, over recent years the scientific concept of postnatal depression has been challenged by studies suggesting no increased risk of depression at this time and little difference in the clinical presentation, response to treatment or prognosis of depression presenting in the postpartum and non-postpartum period. In the case of bipolar disorder (manic depression), however, there is compelling evidence that the postpartum is a period of very high risk and evidence is emerging to suggest that, for at least a proportion of women with major depression, there is a specific relationship to a childbirth related trigger. The author will consider some of the lines of evidence pointing to a specific relationship between childbirth and mood disorders and argue that this link is an important clue that can inform understanding, not only of postpartum mood disorders, but of affective disorders in general. [ABSTRACT FROM AUTHOR]

This article uses story-telling techniques to describe and then reflectively analyse the practice of directed pushing in the second stage of labour. The practice is endemic despite evidence from formal research that it does not benefit women and babies, and, indeed, that it may be harmful. The lessons from the narrative account are discussed alongside the formal evidence base. The article is based on a student midwife's story of observing a midwife who used directed pushing to ‘manage’ the expulsive phase of labour in one case. Three specific aspects are discussed, namely the paradox of research-based evidence, trust policies, and professional skills and beliefs; technocratic monitoring and mechanical theories of childbirth; and issues of power and resistance. The intention is to highlight the potentially dramatic impact that story telling could have in the shaping of maternity services when constructively used as a tool to inform practice. This is the first of a two-part series of articles that explore the issues around normality and the expulsive phase of labour. The second article will address the phenomenon of so-called ‘premature’, or ‘early’ pushing. INSET: Case Report: Rachel's story. [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]

In recent years it became increasingly apparent that women accessing services at Corbar Birth Centre in the High Peak wanted the choice of using water for labour and birth. The Birth Centre responded by undertaking a large project, which resulted in practice development and the introduction of a permanent birthing pool. Clinical audit was implemented to evaluate the new service and assess the perceived risks and benefits of immersion in water during labour and birth on specific outcomes. This article describes how the project evolved and aims to share the findings from the March 2001 to April 2004 audits comparing 'pool users' with 'pool births' and reflects on the experience of the midwives. [ABSTRACT FROM AUTHOR]

The amount of pain a woman experiences is influenced by many individual, physical, emotional and environmental factors. Some of these factors can be anticipated and controlled. It is important that, before the birth, a woman is aware of relaxation techniques and of all the forms of pain relief which are available before and during the birth. The midwife has an important role to play in informing the woman of the options available and devising a birth plan to suit the woman's needs. This article focuses on transcutaneous electrical nerve stimulation (TENS), where electrodes paced on the woman's back send out electrical signals, blocking pain and stimulating the production of endorphins. There are no known harmful side effects and studies have shown that it greatly reduces the need for pharmacological analgesia. Women should be made aware of ail methods of pain relief available so they can make an informed choice on what they believe will suit them. [ABSTRACT FROM AUTHOR]

This study addresses the balance by providing an illuminating picture of women's experiences of these traumatic events during childbirth. This qualitative study followed a phenomenological approach to highlight women s experiences of obstetric emergencies. Selection criteria was specifically aimed at women who had experienced one or more of the following types of emergencies during childbirth - cord prolapse, placental abruption, shoulder dystocia, uterine scar rupture, severe pre-eclampsia and major postpartum haemorrhage. Ten women were interviewed. They described their 'lived experiences' of the emergencies. Significant themes included issues around communication both verbal and non-verbal and the need to make sense of what had happened to them. The interviews provide a valuable insight into obstetric emergencies highlighting areas for improvement and also the positive aspects to care that women received during these events. [ABSTRACT FROM AUTHOR]

Eight women's experiences of home birth were explored using tape recorded semi-structured interviews. The main themes were identified and presented in the form of dialogue and quotes. This article explores the available literature, describes the methodology and reports the results from the first two themes of the study. The decision to have a home birth was based on previous birth experience, the desire for a familiar environment and concerns over childcare. Expectations centered on maintaining normality, a calm atmosphere and having more control. [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.

Shows how the social model of birth may be understood as beliefs and values and as an applied midwifery model. Models of health; Beliefs about women users; Relationship between women and midwives. INSET: KEY POINTS.

The author comments on whether midwives should give care to family and close friends. She says that midwives often do this without prior consultation with their named supervisor of midwives (SOM). She shares her experience of giving care in labour to a friend. She notes the stress involved in undertaking intrapartum care to a friend or relative. Also discussed is the guidance offered by the Local Supervising Authorities (LSA) in Great Britain for midwives who are in this situation.

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 reflects on a parenthood case in which a child was born to a transgender woman in Great Britain who has secured a Gender Recognition Certificate (GRC) before becoming pregnant and its possible impact/s to the midwifery profession. Topics include the provision of the 2008 Human Fertilisation and Embryology Act stating that the person who gave birth to a child is the mother and whether one should stop claiming that a 'midwife' is 'with woman.'