The Current Model Of Postnatal Care Provision

* Pre - birth conference was held to establish the issues surrounding the mother, her pregnancy and her parenting skills. Mother did not attend. The pre – birth conference attended by the CDAT key worker, safeguarding midwife, health visitor, GP, social worker. The pre – birth conference took place as mum was concealing her pregnancy and that she was heavily

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).

Being a midwife refers to a profession where the midwife would work in partnership with the women throughout her pregnancy, labour and the postpartum period. Not only is being a midwife women-centred, however, their role also includes ensuring the partner and family members are prepared and aware of the process. Within a women’s health, the midwife should focus on health, family planning, nutrition, domestic and other health issues as the main priority is the

This report will evaluate the roles and responsibilities of a midwife. “Midwifery encompasses care of women during pregnancy, labour, and the postpartum period, as well as care of the new-born.”(WHO, 2015) This is a recent definition and clearly points out that a midwife has many roles and responsibilities. The NMC Codes of Conduct will be evaluated with specific emphasis on recent changes within healthcare. These changes took place as a result of the tragedies at Mid-Staffordshire Hospital in 2005-2009 and are the outcome of the Francis report in order to improve care given to patients.

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).

(2012) and Swain and Dahlen (2013) Australian studies used a quantitative methodology to obtain data. Each paper evidences the raw data, improving the transparency of the research (Department for International Development, 2014), allowing the reader to make comparisons between the data enabling the findings to be critiqued in terms of relevance and reliability (Wicherts, Bakker and Molenaar, 2011; Critical Appraisal Skills Program, 2013). As each of the studies are Australian the generalizability of the findings should be applied with caution to the UK population (Papaioannou, 2013). However, as Australian midwifery practice is similar to the UK's with midwives being the primary care providers for normal pregnancies (Nursing and Midwifery Board of Australia, 2015), and as pain is endured by the majority of women regardless of demographic location (Declercq et al, 2008), the findings are increasingly

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.

Evidence-based standards have been developed for maternity, neonatal, health visiting/ public health nursing and children’s centre services. Implementation of these standards will improve the care and support that pregnant women, new mothers and their families receive to build a strong relationship with, and feed and care for, their baby.

The midwife as distinguished by the Australian College of Midwives (ACM) (2016a) role is centred in a therapeutic relationship defined by “each woman’s social, emotional, physical, spiritual and cultural needs, expectations and context as defined by the woman herself” (para. 7). ACM position the midwife as the primary profession for quality maternity care founded during training, through the direction of the Nursing and Midwifery Board of Australia (NMBA) “Code of Professional Conduct For Midwives In Australia” (CPC) and reinforced by the “Code of Ethics For Midwives In Australia” (ACM, 2015; NMBA, 2008a; 2008b). It is the boundaries in the NMBA “CPC” along with meeting the educational requirements of the “National Competency Standards For The Midwife” that direct the midwife to work in accordance with legislations and standards set by the Australian Health Practitioner Regulation Agency (AHPRA) to provide safe midwifery care for the community (AHPRA, 2015a, para. 4; NMBA, 2006). The principles of sound midwifery care are working with a woman-centred focus, whilst practicing reflectively and ethically ensuring women during the perinatal period are supported, guided, the newborn and infant cared for and the birth is conducted in a manner that accesses the safest environment (ACM, 2016b, para. 1-3; International Confederation of Midwives, 2011).

Adequate and effective management of perineal pain begins with a comprehensive assessment (Marcus et al, 2009; Breivikl et al, 2008; Dalton et al, 1999). However, Andrews et al, (2008) UK-based study concluded that there is no pain scale to date that has been developed to appropriately and accurately assess the perineal pain that women experience during the postnatal period. This begins to offer explanation as why up to 92% of new mothers endure perineal pain in the early postpartum period (Macarthur and Macarthur, 2004).To further support these findings Way (2012) discovered that women expect perineal pain following vaginal birth but under estimate the severity of the pain. Women will experience high levels of pain before requesting analgesia as they attempt to normalise the pain as a consequence of vaginal delivery (Swain and Dahlen, 2013). Macarthur and Macarthur (2004) conclude that the current management of perineal pain is inadequate as the use of analgesia is not standardised.

As a midwifery student, the author has worked with two women, within the Continuity of Care Experience, who have been induced for post-term pregnancy. Reflections have been written about the care these women received and are located in the authors Continuity of Care Experience reflective journals under the pseudonyms RO’B and EE. The purpose of this portfolio is to explore current midwifery practice in relation to this event which can turn an uncomplicated pregnancy into a complex labour and birth. Current literature will be reviewed to determine best practice in care provision for woman who are post-term and a recommendation will be made on how midwifery practice can improve outcomes for women whose pregnancies progress past term. For

During the course of this placement I have focused my learnings on ‘true’ midwifery whilst beginning a journey to find deeper meaning and understanding in my pratice. I have tried to advance my abilities to manage more challenging situations. I have developed my competence and practice reasoning to be able to critically anaylse and respond but also focused on the main basis that governs my interctions with families– partnership. I have had goals in regards to developing my interdisciplinary communication skills and focusing on the multidisciplinary interface that as a future midwife I will be involved heavily in when planning and negotiating care with women. Throughout my entire development the underpinning threads of midwifery have helped guide and shape me but I’ve found during this placement continuity has weaved all these threads together. Continuity has enabled me to establish deeper partnerships than I have been able to in the past and connect with clients on higher levels transcribing to a more intense sense of accountability and responsibility as I am able to see the results of my decisions and care provided. Continuity is a concept that is integral to midwifery and is the backbone to holistic women-centred care. Continuity of care has been showen in samples of low risk women to reduce the likelyhood of epidurals, episiotomies and instrumental deliveries in conjunction with increasing the chances of a spontaneous vaginal birth (Sandall, Soltani, Gates & Shennan,

The Aim of this assignment is to discuss the principles on which the role of a clinical Midwife is based and explore the legislation which regulates Midwifery practice. The assignment will underpin key sections of the NMC Code as well as aspects from the Midwives rules and standards.

Meeting a newborn baby for the first time is magical for a mother. The first hour after birth is important to keep the mother and baby together for physiological needs (Crenshaw, 2007, p. 211). According to Crenshaw (2007), mothers and babies who were kept together the moments after delivery significantly improves maternal and newborn outcomes. Infants skin-to skin contact with their mother after delivery promotes healthy breastfeeding, better sleep for infant, and increased self-esteem and confidence for new mothers. Being a new mother is sometimes overwhelming. The transition to motherhood brings many hormonal changes and needs psychological acceptance of self as a mother figure. As nurses, supporting

The study used an experimental, cross over design. This specific study explores a cause about whether or not hydrocortisone cream reduces perineal pain after vaginal birth. Considering it was a therapy question, the crossover design was the most thorough possible design because they usually provide the most convincing evidence about the outcomes of an intervention. In this particular study, the type of comparison used was not to gather data over a prolonged period of time, but to gather it at one point in time, as it is beneficial in illustrating key relationships. Interventions used in this study included three consecutive pain management treatments after birth. Sufficiently described, the intervention included two topical creams, one