Fundamentals of Midwifery: A Textbook for Students (50 page)

The Teenage Pregnancy Myth
, BBC Radio 4 Broadcast, [Online]. Available: http:// www.bbc.co.uk/radio/player/b01dhhpq [12 Feb 2013].Shaw, R.L., Giles, D.C. (2009) Motherhood on ice? A media framing analysis of older mothers in the UK news.
Psychology and Health
24 (2), pp. 221–236.Sloggett, A., Joshi, H. (1998) Deprivation indicators as predictors of life events 1981–1992 based on the UK ONS longitudinal study.
Journal of Epidemiology and Community Health
52, pp. 228–233.Smith, M. (2010) Good parenting: Making a difference.
Early Human Development
86, pp. 689–693. Soanes, C., Hawker, S., Elliott, J. (2005)
Pocket Oxford English Dictionary
, 10th edn, Oxford: Oxford UniversityPress.Social Exclusion Unit (1999)
Teenage Pregnancy: Report by the Social Exclusion Unit
. London: The Stationary Office.Society of Obstetricians and Gynaecologists of Canada Genetics Committee (2012) Delayed Child-Bearing.
Journal of Obstetrics and Gynaecology Canada
34 (1), pp. 80–93.
Surrogacy Arrangements Act 1985, Ch 49
. London: HMSO.Sutcliffe, A.G., Barnes, J., Belsky, J., Gardiner, J., Melhuish, E. (2012) The health and development of children born to older mothers in the United Kingdom: observational study using longitudinal cohort data.
British Medical Journal
, [Online]. Available. doi: http://dx.doi.org/10.1136/bmj.e5116 [24 January 2014].Teenage Pregnancy Independent Advisory Group (2010)
Past successes – future challenges
. [Online], Available: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/181078/ TPIAG-FINAL-REPORT.pdf [11 Nov 2013].The Boulevard Centre (n.d)
About Us
, [Online]. Available: http://www.boulevardcentre.co.uk//files/15/55/f1555/public/ mums004.html.nc [10 October 2013].Thain, M. (ed.) (2009)
Penguin Dictionary of Human Biology
. London: Penguin.Tiran, D. (2008)
Baillière’s Midwives’ Dictionary
, 11th edn. Edinburgh: Baillière Tindall,The UK Collaborative Group for HIV and STI Surveillance (2006)
A Complex Picture: HIV, other Sexually Trans- mitted Infections in the United Kingdom
, [Online], Available: http://www.hpa.org.uk/webc/HPAwebFile/ HPAweb_C/1194947365435 [19 June 2013].UNICEF UK (2013) UNICEF UK Baby Friendly Initiative statement on Bed-sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case-control studies, [Online], Available: http://www.unicef.org.uk/BabyFriendly/News-and-Research/News/UNICEF-UK-Baby-Friendly-Initiative-statement-on-new-bed-sharing-research/ [28 January 2013].Velde, E., Pearson, P.L. (2002) The variability of female reproductive ageing.
Human Reproduction Update
8 (2), pp. 141–154.Walsh-Gallagher, D., McConkey, R., Sinclair, M., Clark, R. (2013) Normalising birth for women with a disabil- ity: The challenges facing practitioners.
Midwifery
29 (4), pp. 294–299.World Health Organization (WHO) (2004)
Adolescent Pregnancy: Issues in Adolescent Health and Develop- ment
. Geneva: WHO.World Health Organization (2013)
Disabilities
. [Online], Available: http://www.who.int/topics/disabilities/ en/ [9 November 2013].Winnicott, D. (1953) The theory of the parent–infant relationship.
International Journal of Psychoanalysis
41, pp. 585–595. Available: http://nonoedipal.files.wordpress.com/2009/09/transitional-objects-and-transitional-phenomenae28094a-study-of-the-first-not-me-possession.pdf. Wyatt, J. (2009)
Matters of Life and Death
, 2nd edn. Nottingham: Intervarsity Press.
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Chapter 6‌
Antenatal midwifery careJulie Flint
University of Hull, Hull, UK
Carol Lambert
City University, London, UK
Learning outcomesBy the end of this chapter the reader will be able to:

explain service provision for childbearing women experiencing normal pregnancy

discuss choices open to women in relation to planning and preparing for the birth

monitor the wellbeing of the woman and fetus throughout pregnancy

determine when deviations in normal pregnancy may occur requiring support of theinterprofessional team

provide evidence based care in pregnancy.

For the majority of women the childbirth journey should be a normal process that can be

enjoyed and celebrated. Midwifery care is at the heart, supporting and educating a woman throughout the antenatal period. This ensures the woman is both physically and psychologically ready for giving birth and becoming a mother. Some women may begin with a normal preg- nancy then develop complications along the way and some women begin with complicating factors, meaning they require medical care in addition to that fundamental midwifery care. This chapter will explore the provision and content of antenatal care for normal pregnancies, apply- ing knowledge of anatomy and physiology of pregnancy, including maternal screening and examining the potential influence of birth preparation education. It will examine influences on women’s decision-making and outcomes of birth, as well as highlighting some of the profes- sional, legal and ethical responsibilities of the midwife and interprofessional team.

, First Edition. Edited by Louise Lewis.

© 2015 John Wiley & Sons, Ltd. Published 2015 by John Wiley & Sons, Ltd. Companion website: www.wileyfundamentalseries.com/midwifery

Activity 6.1

A woman has just taken a pregnancy test and it is positive; what thoughts and emotions do you think different women have?

The National Health Service (NHS) is available in the United Kingdom for all childbearing women to improve health and wellbeing of mothers and their infants. Through this statutory mecha- nism, NHS hospital Trusts are most commonly the providers of maternity services, although some independent and third sector providers are emerging. Clinical Commissioning Groups (CCGs) currently are tasked by Government to commission maternity services to provide mater- nity care. This procurement part of the commissioning system is undertaken through a tender- ing process determining who would be the best provider of a particular service. In effect a CCG receives a budget from the Government to advertise a required service for service users and invites businesses, from both the public (government financed) and private sectors, to apply to deliver that service for the NHS. The CCG will then‘buy in’, procure those services from whichever they consider to be the most appropriate bidder in the process. The quality of the service pro- vided should remain uppermost to any service provision regardless of provider. Quality of the service provision is monitored by the CCG alongside with other bodies such as Healthwatch England, Care Quality Commission (CQC) and The Kings Fund (Care Quality Commission 2014; Healthwatch 2014; The King’s Fund 2014).

Some independent midwives (IMs) have historically provided care for individuals and groups of women, however, since October 2013 they are legally obliged to only practise midwifery with indemnity insurance. The cost of this is prohibitive for individual midwives or small group prac- tices. Nonetheless, midwifery initiatives are emerging in cooperation with insurance underwrit- ers to develop indemnity insurance for IMs work collectively, separate from NHS Trusts. One such scheme‘One to One’(no date) was developed in the Wirral; another is the‘Neighbourhood Midwives’ in London (Neighbourhood Midwives 2013). They focus on women-centred care from a caseload holding operation, rather than a hospital set up, and it is organised to be economi- cally efficient. The traditional NHS Trust way of working navigates women around different departments and professionals, referring them for consultations.

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Although Department of Health policy determines provision of care, the woman’s pregnancy and birth experience can be highly influenced by the support, care and education she and her birth partner receives. There is potential for individuals and cultural aspects to influence and alter birth outcomes, to both positive and negative degrees. For example, a woman may feel emanci- pated and in control at any given point and enjoy her experience, or she may be passive or fearful, possibly giving rise to an increased risk of potential intervention. Providing maternity care through an evidence-based approach ensures guidance and recommendations on clinical care which are developed from research, and have the woman at the centre of that care.