InhaltsangabePreface xiii Contributors xv 1 Labour and normal birth - Cathy Charles 1 Introduction 1 The birth environment 3 Signs that precede labour 5 First stage of labour 6 Second stage of labour 18 Pushing 20 The birth 22 Third stage of labour 25 After the birth 30 Summary 31 Useful contacts and information 32 References 32 2 Vaginal examinations and artificial rupture of the membranes - Vicky Chapman 39 Vaginal examinations 39 Accuracy and timing of VEs 40 Consent or compliance? 41 Performing a VE 42 Some common problems 45 Artificial rupture of the membranes 47 Summary 49 References 49 3 Fetal heart rate monitoring in labour - Bryony Read 52 Introduction 52 Intermittent auscultation 52 Electronic fetal monitoring 54 Fetal scalp electrode 56 Classification of fetal heart rate features 56 Positive and negative aspects of EFM 59 Summary 60 References 61 Appendix: Continuous EFM algorithm (NICE, 2007) 63 4 Perineal trauma and suturing - Vicky Chapman 64 Introduction 64 Reducing perineal trauma 65 Assessment of perineal trauma 66 First and second degree tears: to suture or not to suture? 67 Suturing procedure 69 Summary 82 Recommended reading 82 References 82 5 Examination of the newborn baby at birth - Caroline Rutter 86 Introduction 86 The midwife's assessment of the baby at birth 87 Measurements of the newborn 89 Vitamin K prophylaxis 90 Toptotoe check 91 Neonatal infection 96 Giving upsetting news to parents 98 Useful contacts 99 References 99 6 Home birth - Janet Gwillim and Cathy Charles 102 Introduction 102 Benefits of home birth 103 Issues to consider before choosing home birth 104 Preparing for a home birth 106 Care in labour 108 Possible transfer to hospital 112 Summary 115 Useful contacts 115 References 115 7 Water for labour and birth - Cathy Charles 117 Introduction 117 Benefits of warm water immersion 118 Possible risks of warm water immersion 119 Criteria for labouring in water 120 Relative contraindications 120 Preparation 121 Labour care 123 Possible problems 125 Summary 127 Useful contacts 128 Recommended reading 128 References 128 8 Malpositions and malpresentations in labour - Vicky Chapman 130 Introduction 130 Definitions 130 Occipitoposterior position 133 Face presentation 140 Brow presentation 141 Transverse lie (shoulder presentation) 142 Summary 143 References 144 9 Slow progress in labour - Vicky Chapman 146 Introduction 146 Prolonged labour 147 Causes of a prolonged labour 148 Prolonged latent phase 149 Prolonged active first stage 150 Prolonged second stage 153 Summary 155 Recommended reading 156 References 156 10 Assisted birth: ventouse and forceps - Cathy Charles 160 Introduction 160 Avoiding an instrumental delivery 161 Indications for an instrumental delivery 161 Types of instrument 162 Choice of instrument 162 Care of a woman undergoing instrumental delivery 163 Assisting at an instrumental delivery 166 Midwife instrumental delivery 167 Postbirth discussion and care 172 Summary 174 References 174 Appendix 10.1 Midwife ventouse practitioner log book record 177 Appendix 10.2 Decision to decline midwife ventouse delivery 178 11 Caesarean section - Cathy Charles 179 Introduction 179 Risks and benefits of CS 180 Stemming the flow 182 Indications for elective CS 183 The experience of CS 183 Elective CS birth plan 184 Midwifery care for CS 184 Summary 189 Support groups for women following CS 190 Further reading 190 References 190 12 Vaginal birth after caesarean section - Vicky Chapman 193 Introduction 193 The influence and opinions of professionals 194 VBAC or elective CS 194 What improves the success rate in VBAC? 196 Induction of

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