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Asthma in pregnancy is a common respiratory co-morbidity, but if this serious condition is not addressed appropriately, acute exacerbations may contribute to maternal mortality and morbidity. Indeed, any acute episode of asthma can quickly become life-threatening, and midwives should be aware of the need for urgent referral. The importance of effectively managing asthma in pregnancy includes the immediate detection of a worsening condition, along with immediate referral to a physician in order to minimise the complications associated with acute exacerbations. In order to minimise poor outcomes for women, midwives should be aware of evidence-based practice guidelines for managing asthma and to avoid complacency, midwives must be aware of the most recent report, Why Asthma Still Kills. Furthermore, as part of their scope of practice, midwives should ensure that all women have access to personalised asthma action plans, and should work across the multidisciplinary team to promote smoking cessation, infection control and vaccination against influenza. Importantly, midwives should assess compliance with women's prescribed short- and long-acting asthma medication.

Antimicrobial resistance is one of the greatest challenges to health care. With a reduced number of effective antibiotics, treatable conditions, such as ear, tooth and urine infections, may therefore become life-threatening. In order to minimise antimicrobial resistance, midwives should use clinical strategies that facilitate antibiotic stewardship, such as promoting healthy lifestyles, infection control and compliance with prescribed antibiotic treatment, and should endeavour to share knowledge and expertise with members of the wider multidisciplinary team, such as pharmacists. In addition, midwifery curricula should ensure that midwives have a knowledge of the dynamics of antimicrobial resistance and principles of antibiotic stewardship so that health professionals may share their expertise in order to combat this significant challenge, which poses the threat of a post-antibiotic era.

This article highlights principles for the safe administration of blood transfusion in maternity care. The aim is to increase awareness of the context for blood transfusion in midwifery, the components most frequently used and the process for safe blood transfusion, including clinical observations. There are serious hazards associated with this procedure so there should be a clear indication for transfusion. Midwives must not engage in the administration of blood unless they have received appropriate training, have been assessed as clinically competent and meet the requirements for periodic review or assessment in administering blood transfusion.

Aim To investigate the degree of choice pregnant women at low obstetric risk had in making informed decisions on the use of intrapartum fetal monitoring techniques. Methods An exploratory descriptive design was used as part of a larger, multi-method study. A total of 63 pregnant women at low obstetric risk were approached to complete antepartum and postpartum questionnaires. Sixty-three women completed antepartum questionnaires, 38 of these 63 women also completed postpartum questionnaires. The data were analyzed using descriptive statistics. Results More than half of the sample wanted electronic fetal monitoring (EFM) in labor despite being classified at low risk for obstetric complications. Having choices and being in control was important to all respondents whilst in labor. Despite this, almost all respondents stated that midwives had not given them a choice of monitoring method. More than a half of the sample received some form of EFM. Conclusions Intrapartum fetal monitoring practices for women with normal pregnancies do not reflect current evidence. Women still expect EFM in labor. Choice and control are very complex issues and as such are difficult to measure.

This article discusses the perceived clinical credibility of midwifery lectures. Are midwife teachers practical teachers with academic expertise or pure theorists? Research findings will highlight the opinions of clinicians, student midwives and lecturers with respect to the nature of clinical credibility.