A Local Trusts Policy For Induction Of Labour

The writer explained there could be no concern for fetal or maternal health during the delivery although some obstetricians tended to induce labor in all diabetic mothers to protect babies and mothers. Moreover, labor progress was supposedly assessed by old-fashioned methods, which resulted in performing unnecessary obstetrical practices. Intervention was imposed in cases of inaccurately labeled slow or abnormal labors and failures to progress. It is common practice that a primary cesarean generally produces subsequent surgical deliveries. The author realized that cesareans were performed because of insufficient data on laboring women’s

Providing an effective care and support to the patient and for their babies during labour

For almost all of the previous 25 years roughly, the knowledge of pregnancy, labor, and delivery has changed little for some women. But change is arriving to the most traditional establishing, the hospital.

In many cases, a patient increases their odds of a cesarean section if they chose to be induced without causation. A study was conducted between the years of 1999 to 2000 with 3215 nulliparous women. The findings of this study showed that nulliparous women are at a significantly higher risk of needing a cesarean section if they were electively induced (Luthy et al., 2004). Multiple studies have looked at nulliparous versus multiparous women and have found that elective inductions do not look to increase the odds of a woman needing a cesarean section in multiparous women. Researchers have begun to look at other possible relationships between patients who undergo an elective induction that results in a caesarean section and they have found

The conclusion was ultimately reached that medical or elective induction of term women was associated with an increased risk of cesarean delivery and that estimate was determined heavily based on the Bishop Scores attained The study closes by advising that induction of labor, whether it is medical or electively induced, should be avoided because a low Bishop score means that the cervix is unripe and even with cervical ripening agents, the study showed that the risk of cesarean delivery for nulliparous women remained unchanged. Their advice is to allow the mothers to spontaneously go into labor if they have an unfavorable Bishop score because it will lower cesarean delivery rates (Vrouenraets et al. 2005). This rationale directly correlates

This essay demonstrates significant factors, a midwife and the women may face within Australian public hospitals. As a midwife the key skills are understanding of what supports and impacts the normal physiological process of labour and birth. This essay will discuss two influencing factors that have a negative effect on the normal progress of labour and birth. This will be seen, firstly by discussing the cultural and environmental impacts of labour and birth. Then, examining how the midwife may best support and facilitate the adverse effects of normal physiological process. This essay also discusses a positive labour and birth environment within the Australian standard model of care.

As well as being notated as ‘eligible’, to work as a eligible midwife in private practice an eligible midwife must work in collaboration with a medical practitioner (Queensland Nurses Union, 2010). The Queensland Nurses Union (2010) explains that legislation specifies that eligible midwives working in private practice must operate under one of four collaborate models of care. These four collaborative models are as follows: Eligible midwives may be employed by an obstetric practitioner or an entity that employs an obstetric practitioner; eligible midwives may accept a written referral from a specified medical practitioner; eligible midwives may obtain a written agreement with a specified medical practitioner; or eligible midwives may have an arrangement with a specified medical practitioner (Queensland Nurses Union, 2010). The Queensland Nurses Union (2010) is concerned that this legislation will limit the ability for eligible midwives to work in private practice as unless eligible midwives are employed by medical practitioners, have women referred to them by a medical practitioner, or have an agreement with a medical practitioner, they will unable to work in private practice. Newnham (2010, p. 245) describes this as ‘creating a maternity service that is entirely within medical parameters, while seeming to advance midwifery models of care’

It relies on persuasive tactics to ensure compliance. Being medical-based, it aims to reduce morbidity and reduce premature mortality and is conceptualised around the absence of disease. As midwives do not regard pregnancy and child-birth as states of ill-health, its validity in midwifery care must be questioned (Dunkley, 2000a). The benefits of breastfeeding are well-documented (Appendix Two), however difficulties arise in making this information relevant and personal to each woman. Often, simply giving women ‘information’ makes little difference to them (Dunkley, 2000b).

Within Victoria there are multiple models of maternity care available to women. An initial discussion with the woman’s treating GP during the early stages of her pregnancy is critical in her decision-making about which model of care she will choose and this key discussion is essential in allowing a woman to make the first of many informed decisions throughout her pregnancy. According to a survey conducted by Stevens et al. (2010) only 43% of women felt ‘they were not supported to maintain up-to-date knowledge on models of care, and most reported that model of care referrals were influenced by whether women had private health insurance coverage.’ Many elements of these models of care differ: from location of care, degree of caregiver continuity, rates of intervention and maternal and infant health, outcomes access to medical procedure, and philosophical orientation such as natural or medical (Stevens, Thompson, Kruske, Watson, & Miller, 2014). According to the World Health Organization (1985) and Commonwealth of Australia (2008) there is a recognition that ‘85% of pregnant women are capable of giving birth safely with minimal intervention with the remaining 15% at potential risk of medical complications’ (McIntyre & Francis, 2012).

In 1993 continuity of care was recognised by the government and was outlined in the department of health policy paper ‘Changing childbirth’ (DH, 1993). The document focused on choice and continuity of the care a woman should receive. Subsequently, a greater shift towards Midwifery Led Care developed. It has been suggested that a midwife should be the first point of contact for women accessing maternity services (Department of Health 2007, Welsh Assembly Government 2002, Scottish Executive 2001). Nevertheless, statics show that this was the case for only 24 percent of women in 2010, with some improvement by 2013 at 32 percent. Conversely, in 2013 63 percent of women first made contact with their family doctor (The Care Quality Commission, 2013). However 98% percent of women had their the remaining antenatal care provided by a midwife, 40% exclusively and with 60% having shared care with a GP or consultant led care (The Care Quality Commission, 2013).

This essay will explore the care received by a woman during her pregnancy, with particular reference to the application of Lesley Page’s (2000) five steps (Appendix I). In accordance with the Nursing and Midwifery Council (NMC), 2004 guidelines on confidentiality, the woman’s name has been changed.

This essay will be relating to an episode of care that was provided to a woman, her partner and their baby on day five during the postnatal period. It will examine the role of the midwife in relation to breastfeeding and how this was not achieved in the case study which is shown in the appendix. Throughout the essay it will look at the following outcomes: the role and responsibility of the midwife within current maternity care provision, the importance of sensitive midwifery, key legal and ethical dimensions of the midwife's role and key sociological and psychological agendas impacting on current maternity care.

Vaginal birth after caesarean (VBAC) is the name used for identifying the method of giving birth vaginally after previously delivering at least one baby through a caesarean section (CS). A trial of labour (TOL) is the term used to describe the process of attempting a VBAC. An elected repeat caesarean (ERC) is the other option for women who have had a caesarean in the past. The rates of women choosing to deliver by means of an ERC has been increasing in many countries, this is typically due to the common assumption that there are too many risks for the baby and mother (Knight, Gurol-Urganci, Van Der Meulen, Mahmood, Richmond, Dougall, & Cromwell, 2013). The success rate of VBAC lies in the range of 56 - 80%, a reasonably high success rate, however, the repeat caesarean birth rate has increased to 83% in Australia (Knight et al., 2013). It is essential to inform women of the contraindications, success criteria, risks, benefits, information on uterine rupture and the role of the midwife in relation to considering attempting a VBAC (Hayman, 2014). This information forms the basis of an antenatal class (Appendix 1) that provides the necessary information to women who are considering attempting a VBAC and can therefore enable them to make their own decision regarding the mode of birth.

Over the years birthing methods have changed a great deal. When technology wasn’t so advanced there was only one method of giving birth, vaginally non-medicated. However, in today’s society there are now more than one method of giving birth. In fact, there are three methods: Non-medicated vaginal delivery, medicated vaginal delivery and cesarean delivery, also known as c-section. In the cesarean delivery there is not much to prepare for before the operation, except maybe the procedure of the operation. A few things that will be discussed are: the process of cesarean delivery, reasons for this birthing method and a few reasons for why this birthing method is used. Also a question that many women have is whether or not they can vaginally

monitor fetal heartbeat. In the first stage of labor , the neck of the uterus,