Praise for previous editions:
An excellent resource for both student midwives and qualified staff alike. (Alison James, Midwifery Lecturer, Plymouth University)
"A lovely book with a lot of practical advice and easy to navigate. (Jayne Samples, Midwifery Lecturer, University of Huddersfield)
This fully revised and updated third edition ofThe Midwifes Labour and Birth Handbook is a practical and accessible guide to midwifery care.
It addresses important questions such as:
Why are women being pressured into caesarean section for breech presentation when the evidence is equivocal?If a baby needs assisted ventilation breaths at birth, why not bring the ambubag to the baby and leave the cord intact so the baby can benefit from the extra maternal oxygen supply?Why is skin-to-skin contact at birth so rarely offered to preterm babies when there is evidence of benefit?
This well-regarded text promotes normality and woman-centred care, using research, evidence-based guidelines and anecdotal accounts from women. It challenges practice and guidelines which are biased or based on poor evidence. Guidance is offered on how to deal with difficult, sometimes controversial, situations.
The Midwife's Labour and Birth Handbook 3rd edition is an essential guide for both student midwives and experienced practising midwives.
New to this edition:
Full colour photographs including a kneeling breech birthSuturing diagrams to assist left-handed midwives.Expanded chapters on slow progress in labour and malposition/malpresentations, including a rare photograph of a face presentation birth.
Preface 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 midwifes assessment of the baby at birth 87
Measurements of the newborn 89
Vitamin K prophylaxis 90
Top-to-toe 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
Post-birth 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 labour for VBAC 196
Midwifery care for VBAC labour 197
Summary 201
References 201
13 Preterm birth Charlise Adams 204
Introduction 204
Incidence and facts 205
Causes and associated factors of preterm birth 206
Place of delivery 206
Preterm prelabour rupture of membranes (PPROM) 206
Corticosteroids for threatened preterm birth 208
Tocolysis in threatened preterm labour 208
Monitoring the fetal heart in preterm labour 209
Midwifery care 209
Mode of delivery 210
Care immediately after birth 211
Skin-to-skin contact 212
Resuscitation 213
Care related to specific types of preterm labour 214
Postnatal care 215
Summary 216
Useful contacts 217
References 217
14 Breech birth Lesley Shuttler 220
Introduction 220
Types of breech presentation 221
Womens options and the provision of care 223
Concerns and possible complications with a breech birth 225
Labour and birth 226
Summary 236
Useful contacts 236
Recommended reading 236
References 236
15 Twins and higher-order births Jo Coggins 240
Introduction 240
Place of delivery 241
Mode of delivery 241
Care in labour 243
Third stage of labour 246
Care after the birth 248
Summary 249
Useful contacts 249
References 249
16 Haemorrhage Sheila Miskelly 252
Introduction 252
Placenta praevia 253
Vasa praevia 255
Placental abruption 255
Postpartum haemorrhage 260
The 4Ts: Tone, Tissue, Trauma, Thrombophilias 261
Retained placenta 265
Summary 267
References 268
17 Emergencies in labour and birth Sheila Miskelly 271
Introduction 271
Snapped cord 272
Cord prolapse and cord presentation 272
Amniotic fluid embolism 274
Uterine rupture 276
Shoulder dystocia 278
Inverted uterus 284
Maternal collapse/shock 286
Summary 287
References 288
18 Neonatal and maternal resuscitation Nick Castle 292
Introduction 292
Risk management: anticipation 293
Basic neonatal resuscitation 293
Ongoing neonatal resuscitation/complications 297
Maternal resuscitation 301
Summary 304
References 304
19 Induction of labour Mary-Lou Elliott 306
Introduction 306
Risks and side effects 307
Information giving and informed consent 308
Determining expected date of delivery (EDD) 308
IOL for social reasons 309
Induction for post-term pregnancy 309
IOL versus expectant management for PROM at term 309
Assessing the cervix 310
Methods of induction 310
Care of a woman during IOL 313
Summary 315
Recommended reading 316
References 316
20 Pre-eclampsia Annette Briley 318
Introduction 318
Signs and symptoms 321
Care during labour 323
Monitoring the maternal and fetal condition in moderate/severe pre-eclampsia 324
Drugs used in the treatment of severe hypertension 326
Management of eclampsia 327
Care during/following an eclamptic fit 328
HELLP syndrome 330
Summary 332
Useful resources 333
References 333
21 Stillbirth and neonatal death Barbara Kavanagh and Cathy Charles 336
Introduction 336
Definition 337
Incidence and facts 337
Causes and predisposing factors for perinatal death 337
Diagnosing fetal death and decision making 338
Midwifery care in labour following intrauterine death 341
Neonatal death and unexpected death at/after birth 342
Immediate care following stillbirth/NND: precious moments with the baby 343
Ongoing postnatal care 345
Supporting staff 349
Summary 350
Useful contacts 350
References 350
Appendix: Checklist following a pregnancy loss after 24 weeks 353
22 Risk management, litigation and complaints Cathy Charles 355
Introduction 355
Clinical risk management: learning from adverse events 356
Litigation 357
Vicarious liability of employer 358
Clinical risk management organisations 359
Records 359
Complaints 360
Writing a statement 360
Caring for the mother or father following an adverse event 361
Conclusion 361
Summary 362
Useful contacts 362
References 362
23 Intrapartum blood tests Vicky Chapman and Julie Davis 364
Blood tests 364
Haematology and coagulopathy 370
Blood bank (immunohaematology) 373
Blood tests for specific conditions and blood pictures 374
Fetal blood tests 376
References 379
24 Medicines and the midwife Vicky Chapman 381
Introduction 381
Midwife exemption orders 382
Standing orders 385
Patient group directions (PGDs) 385
Documentation and drug errors 385
Common abbreviations 387
Useful contacts 388
References 388
Index 389
