During active labour in a hospital setting throughout Australia, The United Kingdom (UK) and The United States of America (USA) it is standard practice to fast women of food and fluid (Hunt, 2013). Hospital guidelines vary from the practice of nil by mouth to allowing sips of water or isotonic drinks. Hospitals may prefer women not eat whilst others may allow a small intake of light foods, usually with a recommendation for no food once in established labour (Mayer, Hong, & Bernstein, 2015). This practice came into effect during the 1940’s with Mendelson’s research associating the risk of pulmonary aspiration during general anaesthesia amongst patients who had not been fasted (Mendelson, 1946). Maternal morbidity in women undergoing …show more content…
In Australia, the 3centres Collaboration guidelines that benchmark midwifery care in Victoria recommend women eat a light diet and drink as desired (3centres Collaboration, 2014). The presence of ketonuria indicates the importance of using isotonic drinks to prevent the development of ketosis, with ketosis reducing the efficacy of uterine activity, possibly contributing to prolonged labours (Hunt, 2013; Toohill, Soong, & Flenady, 2008). Moreover, evidence points to the opinions, experience, practice and policies of clinicians and their associated hospital, impacting on women’s access to food and fluids and the ability to make informed choices (King, Glover, Byrt, & Porter-Nocella, 2011; 3centres Collaboration, 2014). King’s (2011) research found little evidence to support restriction of oral nutrition in labour and recommends hospitals review policies to align with current evidence. Overall, 3centres Collaboration (2014) guidelines advocate for the labouring woman have access to adequate nutrition and hydration, whilst acknowledging the role of midwife to intervene should the labour degenerate or opioid pain management be utilised. Using evidence to guide and principle the care a Midwife provides to the labouring woman is an important aspect of safe and competent midwifery care (Nursing and Midwifery Board of Australia, 2006). When considering the risks associated with the intake of food and fluid hospital
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 does not only defined by assisting women in childbirth. The general dictionary definition are the misconception of how people view midwives. Being a midwife means to be ‘with women’ and this leads the construction of the midwifery philosophy, Page (2006) 5 steps and Nursing and Midwifery Board of Australia (NMBA) competency standards, in order to provide the best women centred care (Australia Collage of Midwives, 2017). This essay will cover a constructive overview of what Page (2006) 5 steps of being a midwife means, it will also defined what women centred care is and emphasis on the importance it has for the woman. Understanding Page (2006) 5 steps and women centred care helped build the pathway for midwifery philosophy to correlate with NMBA competency standard in order to support midwifery practice. For
©Copyright 2010 This work is copyright February 2010. Copyright is held jointly by the Australian Nursing and Midwifery Council and the Nursing Council of New Zealand. ISBN 978-0-9807515-7-4 This work is copyright. It may be reproduced in whole or in part for study or training purposes subject to an inclusion of an acknowledgement of the source and is available electronically at www.anmc.org.au. It may not be reproduced for commercial use or sale. Reproduction for purposes other than those indicated above requires a licence or written permission, which may be obtained from the Australian
The Australian College of Midwives believes that it is the right of every pregnant woman to have access to continuity of care by a known midwife for her pregnancy, labour and early postnatal period. Midwives are the most appropriate primary care providers for healthy mothers and newborn babies and are able to refer to specialist medical care if the need arises (Hicks, Spurgeon & Barwell, 2003). Midwives must work within the competency standards enforced by The ANMC Australian Nursing & Midwifery Council (2006) in order to obtain and practice as a registered midwife in Australia. Competency 4 states Midwives should “promote safe and effective practice” (ANMC, 2006), this is achievable by providing Midwifery continuity of care to women and
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 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.
Providing an effective care and support to the patient and for their babies during labour
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).
The assignment will be written in the style of the British Journal of Midwifery (BJM), the abstract is incorporated into this introduction and Harvard 2014 will be used for the referencing style.
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
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.
Bernadette Ward RN, Midwife, Grad Cert Ed, MPHandTM, MHlth Sci Lecturer, Faculty of Health Sciences, La Trobe University, Bendigo, Australia. B.Ward@latrobe.edu.au Glenda Verrinder RN, Midwife, Grad Cert Higher Ed, Grad Dip Pub and Com Health, MHlth Sci Senior Lecturer, Faculty of Health Sciences, La Trobe University, Bendigo, Australia.
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.
Victoria’s midwife processed the referral in an untimely manner therefore delaying her treatment. It was not sent until Victoria was 31 weeks, as a result she was not seen until 31 weeks and three days. She had a little over two weeks where she was left confused about what her management should be and worried for the well being of her unborn child. Realistically the referral should have been done immediately. She saw a physician, obsetrician, dietitian and diabetic midwives during this appointment. In her appointment with the dietitian Victoria voiced her concerns regarding her traditional Indian diet while she was being educated about meal preparation and healthy food choices. She worked full time and lived with her mother who did all the cooking so feared she would struggle to stick to the strict new eating regime. Many women attempt to adhere to the recommendations and lifestyle modifications, but find this incredibly challenging (Nielsen et al., 2014). It is understood that women struggle with the enormous dietary changes due to food preferences and cravings, and women are often confused with lack of sufficient advice (Neufeld, 2011; Hirst et al., 2012). From the clinics point of view they understood the barriers in Victorias life and tried to work with her to reduce her anxiety, and provide food choices that worked with her diet such as consuming less rice so that she could have better outcomes and possibly avoid treatment. Additional to the advice Victoria received
The aim of this research assignment is to demonstrate the ability to critically appraise two pieces of research evidence which relates to midwifery and use the evidence to make recommendations for change to improve the quality of care.