SECTION 4 Labour 15 Care of the perineum, repair and female genital mutilation........................311 16 Physiology and care during the first stage of labour........................................327 17 Physiology and care during the transition and second stage phases of labour..................................................367 18 Physiology and care during the third stage of labour........................................395 19 Prolonged pregnancy and disorders of uterine action..................................... 417 20 Malpositions of the occiput and malpresentations....................................435 21 Operative births......................................455 22 Midwifery and obstetric emergencies.............................................475 IV Curriculum 1. The philosophy of the midwifery education programme is consistent with the ICM philosophy and model of care. 2. The purpose of the midwifery education is to produce a competent midwife who: a. has attained/demonstrated, at a minimum, the current ICM Essential Competencies for basic midwifery practice; b. meets the criteria of the ICM Definition of a Midwife and regulatory body standards leading to licensure or registration as a midwife; c. is eligible to apply for advanced education; and d. is a knowledgeable, autonomous practitioner who adheres to the ICM International Code of Ethics for Midwives, standards of the profession and established scope of practice within the jurisdiction where legally recognized. 3. The sequence and content of the midwifery curriculum enables the student to acquire essential competencies for midwifery practice in accord with ICM core documents. 4. The midwifery curriculum includes both theory and practice elements with a minimum of 40% theory and a minimum of 50% practice. a. Minimum length of a direct-entry midwifery education programme is 3 years; b. Minimum length of a post-nursing/health care provider (post-registration) midwifery education programme is 18 months. 5. The midwifery programme uses evidence-based approaches to teaching and learning that promote adult learning and competency based education. 6. The midwifery programme offers opportunities for multidisciplinary content and learning experiences that complement the midwifery content. SECTION 1 The midwife in context 1 The midwife in contemporary midwifery practice...................................... 3 2 Professional issues concerning the midwife and midwifery practice..............25 Cecily Begley, MSc MA PhD RGN RM RNT FFNRCSI FTCD Professor of Nursing and Midwifery, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland Chapter 18 Physiology and care during the third stage of labour

Box 1.1 An International definition of the midwife A midwife is a person who has successfully completed a midwifery education programme that is duly recognized in the country where it is located and that is based on the ICM Essential Competencies for Basic Midwifery Practice and the framework of the ICM Global Standards for Midwifery Education; who has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery and use the title ‘midwife’; and who demonstrates competency in the practice of midwifery. INTERNATIONALIZATION/ GLOBALIZATION Globalization and internationalization against the background of midwifery practice are difficult terms to define, compounded by the fact that the terms are often used interchangeably and synonymously, even though they are construed as distinctly separate entities. Globalization is not a new phenomenon (Baumann and Blythe 2008) with a number of varying definitions evident in the literature. The definition with the greatest resonance for midwives is that provided by the World Health Organization (2013), who states that globalization is: Senior Lecturer – Midwifery, School of Nursing and Midwifery, University of Brighton, Eastbourne, UK Chapter 19 Prolonged pregnancy and disorders of uterine action

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Foreword are not being provided with sufficient opportunity to attend, yet classes can make a big difference to women’s experiences of birth and parenting. In addition she draws attention to the value they have in giving women social networks. This has been evident in my daughter’s experience of classes in Germany. Whilst she was critical of some of the content of the classes, she and four other women who birthed one to 10 days apart, have supported each other in parenting. Two years on they remain good friends. Chapter 13 skilfully draws together the most significant medical conditions a midwife is likely to encounter in her practice. Much attention is given to obesity. The authors qualify that although obesity is not in itself a disease it is considered abnormal in western cultures and is now a key health concern affecting society. They discuss the additional risks to pregnant women who are obese and the association of obesity with poor socioeconomic status. Midwives have a key role in educating these women and their families to develop healthier life styles, but the women will only be receptive if they do not experience judgemental attitudes. Myles advice to midwives in the 1960s that, ‘nature is capable of performing her function without aid in most instances; meddlesome midwifery increases the hazards of birth’, is still as relevant today. In this edition, given all the technological advances in the maternity services, Section 4 on labour begins by reminding students that: ‘birth is a physiological process characterized by non-intervention, a supportive environment and empowerment of the woman’. However, an appropriate reflection of multi-cultural changes in UK society is the inclusion of female genital mutilation in chapter 15. Whilst many students will not be involved in the care of women who have undergone such a procedure, it is essential that all midwives understand the mutilation some young women have undergone and the special care they will need in childbirth. The inclusion of Kinsi’s poignant and brave story of her own experiences should help midwives develop the empathy they will need when caring for women who have been subject to similar mutilation. Perinatal mental health has figured since the early days of the textbook but only in recent editions have students been provided with the necessary information to understand the complexity of the psychology of childbearing and psychiatric disorders. A useful inclusion in this edition is tocophobia, fear of giving birth. Students need to take this fear seriously in supporting women and they cannot afford to trivialize these very real phobias. As ever this textbook includes a comprehensive section on the newborn baby, often neglected in other general texts for midwives. This is so important when parents turn to midwives for advice and reassurance or explanations. With many midwifery curricula including a module on the specialist education for the Newborn and Infant Physical Examination, chapter 28 clearly differentiates between the midwife’s and the doctor’s responsibilities when undertaking this examination. The publishers have brought about major improvements also, through locating the colour photographs in these newborn baby chapters close to where they are described in the text rather than as a separate colour plate section. Midwifery is the best career you can have. It is a privilege to work with women and their families as they experience pregnancy, birth and parenting. The knowledge, skills and attitudes that students need to be competent midwives and professional friends to women have been skilfully interwoven in this sixteenth edition. The chapter authors and editors have summarized where appropriate, elaborated when needed, referenced liberally and used illustrations effectively to enhance understanding. Given the infinite depth and breadth of information available in written and electronic forms, they have succeeded in producing a textbook that remains invaluable for the next generation of midwives. In the United Kingdom (UK) midwives are encouraged to broaden their toolkit of skills and knowledge in an effort to strengthen their public health remit and leadership potential in order to work collaboratively with women as equal partners in their care. Midwifery 2020 (Department of Health [DH] 2010a) outlines the future vision for midwifery. This initiative is a unique UK-wide collaborative programme where the four countries of Great Britain share a common purpose and ideology that can benchmark their midwifery planning and provision. It is envisaged that each country will be able to identify their own priorities to deliver care that is woman-centred, safe and fulfilling within existing resources. There are parallels here to be drawn with wider global initiatives such as the United Nations [UN] (2010, 2013) Millennium Development Goals (MDGs) and the International Confederation of Midwives (ICM 2011) international definition of the midwife. THE CHAPTER AIMS TO:

Access-restricted-item true Addeddate 2020-12-09 12:06:01 Associated-names Myles, Margaret F; Bennett, V. Ruth; Brown, Linda K Boxid IA40009003 Camera Sony Alpha-A6300 (Control) Collection_set printdisabled External-identifier Physiology and care during the puerperium..............................................499 24 Physical health problems and complications in the puerperium.......... 515 25 Perinatal mental health.......................... 531 26 Bereavement and loss in maternity care...........................................................555 27 Contraception and sexual health in a global society.......................................569 SECTION 2 Human anatomy and reproduction 3 The female pelvis and the reproductive organs..................................55 4 The female urinary tract........................... 81 5 Hormonal cycles: fertilization and early development.................................... 91 6 The placenta............................................ 101 7 The fetus...................................................111

The V Resources, facilities and services 1. The midwifery programme implements written policies that address student and teacher safety and wellbeing in teaching and learning environments. 2. The midwifery programme has sufficient teaching and learning resources to meet programme needs. 3. The midwifery programme has adequate human resources to support both classroom/theoretical and practical learning. 4. The midwifery programme has access to sufficient midwifery practical experiences in a variety of settings to meet the learning needs of each student. 5. Selection criteria for appropriate midwifery practical learning sites are clearly written and implemented. Specialist Midwife (FGM), Nottingham University Hospitals NHS Trust (City Campus), Hucknall Road, Nottingham, UK Chapter 15 Care of the perineum, repair and female genital mutilation Individuals from other disciplines who teach in the midwifery programme are competent in the content they teach. 5. Midwife teachers provide education, support and supervision of individuals who teach students in practical learning sites. 6. Midwife teachers and midwife clinical preceptors/ clinical teachers work together to support (facilitate), directly observe and evaluate students’ practical learning. 7. The ratio of students to teachers and clinical preceptors/clinical teachers in classroom and practical sites is determined by the midwifery programme and the requirements of regulatory authorities. 8. The effectiveness of midwifery faculty members is assessed on a regular basis following an established process.

Jayne E Marshall, PhD MA PGCEA ADM RM RGN Head of School of Midwifery and Child Health, Faculty of Health, Social Care and Education, St Georges, University of London/Kingston University, UK Chapter 1 The midwife in contemporary midwifery practice Chapter 2 Professional issues concerning the midwife and midwifery practice Chapter 13 Medical conditions of significance to midwifery practice Chapter 16 Physiology and care during the first stage of labour Chapter 17 Physiology and care during the transition and second stage phases of labour Rosemary Mander, MSc PhD MTD RGN SCM Emeritus Professor of Midwifery, School of Health in Social Science, University of Edinburgh, Edinburgh, UK Chapter 1 The midwife in contemporary midwifery practice Chapter 26 Bereavement and loss in maternity care Change and adaptation in pregnancy................................................143 10 Antenatal care.........................................179 11 Antenatal screening of the mother and fetus..................................................203 12 Common problems associated with early and advanced pregnancy............... 221 13 Medical conditions of significance to midwifery practice..............................243 14 Multiple pregnancy.................................287 assessment, planning, implementation, evaluation and documentation of care are all crucial for midwifery practice, human factors also matter. In England, the Francis Report (Mid Staffordshire NHS Foundation Trust Public Inquiry 2013) was the outcome of a public inquiry into failings at Mid Staffordshire and relevant regulatory bodies. It represents a watershed moment in the history of the UK National Health Service (NHS). The scale of the problems highlighted by the report relates to the unusually high death rates amongst the sick and vulnerable at Mid Staffordshire in the late 2000s. The key lessons learnt convey the importance of transparent, compassionate, committed, competent and confident caring premised on strong leadership. It can be argued therefore that common standards and a shared vision established through global initiatives such as the MDGs and the ICM definition of a midwife are essential for midwives working within a global community. Not least because there is a strong correlation between outcomes for mothers and babies and the specific professional competencies the midwife possesses. Helen Baston, BA(Hons) MMEdSci PhD ADM RN RM Consultant Midwife, Public Health, Supervisor of Midwives, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK Chapter 10 Antenatal care

Ninth edition 1981 Tenth edition 1985 Eleventh edition 1989 Twelfth edition 1993 Thirteenth edition 1999 Fourteenth edition 2003 Fifteenth edition 2009 Sixteenth edition 2014