Fundamentals of Midwifery: A Textbook for Students (88 page)

Although it would seem midwives are ideally placed to undertake this role, many midwives once qualified to perform this examination do not continue to practise this extended role (Steele 2007). Midwives have expressed a great deal of satisfaction in being able to deliver a complete package of care to their women (Mitchell 2003a) but a number of reasons why they did not perform this task were highlighted in a study by Steele (2007) and included a lack of support from peers and managers, work pressures and staffing levels. Interestingly, the pre- sumed fear of litigation if an abnormality is not detected (Baston and Durward 2010) was not put forward as a reason, but is a point worth clarifying as all professionals undertaking this role must be aware of their responsibility. The EMREN study (Townsend et al. 2004) which evaluated this extension to the midwives’ role concluded that there was no statistical difference between SHO paediatricians and midwives, either in appropriate or inappropriate referrals, or in prob- lems identified or not identified. So if mothers are expressing more satisfaction with the mid- wives, this is a valuable role for midwives to undertake, and they should endeavour to liaise with medical colleagues and midwifery management to provide opportunities to keep up their skills (Mitchell 2003b).

205

Key points

Care of the newborn baby requires knowledge of normal physiology during the neonatal period
in order to recognise any deviation from the normal.

Midwives should provide parents with appropriate, evidence-based information in order for the them to make informed choices and provide safe care for their baby.

Care needs to be individualised and take into account maternal history, needs and

understanding.

Care of the newborn baby is an essential element of the midwives’ role and includes both

monitoring the health and wellbeing of the baby and educating and supporting parents in caring for their new baby. Understanding normal physiology, particularly in relation to the transition from intrauterine to extrauterine life, is vital in recognising deviations from the normal. A good knowledge of the evidence supporting care of the newborn is also essential to effective midwifery care. Care needs to take into account antenatal and intrapartum issues that may affect the neonate and the individual needs of the parents and family. Good communication and record keeping are as ever central to good midwifery practice.

206

1 2

3

4

5

6

7

8

9

10

The ductus which shunts blood away. from the liver in utero.

Jaundice is caused by this substance.

This action should be the first element of immediate care of the newborn baby.

A cold baby will use this to try and keep warm.

Screening test offered to all newborns since 2005.

Scoring method used for infant’s condition at birth.

Ideal colour for a newborn.
Down

Overriding of the skull bones is known as
7.
One of the measurements taken following this. delivery.

One of the diseases the blood spot screen- ing test detects.
Find out more
Below is a list of things you can find out about to enhance your knowledge of the issues and topics covered in this chapter. Make notes using the chapter content, the references and further reading identified, local policies and guidelines, and discussions with colleagues.
207
1.
Familiarise yourself with the neonatal resuscitation equipment in your placement delivery suite.
2.
Reflect on the determination of Apgar scores for births you have attended particularly in relation to timing and accuracy.
3.
Find out what advice is given to mothers regarding skin care products for babies in your placement area.
4.
Find out about your local guideline for the management of neonatal jaundice.
5.
Find out more about local practices for screening of the newborn.
Glossary of terms
Apgar score
An internationally recognised scoring system for the condition of the baby at birth which scores heart rate, respirations, muscular tone, colour and response to stimulus.
Caput succedaneum
Oedematous swelling of the scalp due to pressure during delivery.
Cephalhaematoma
Bleeding under the periosteum (outer layer) of a skull bone.
Conduction
Heat loss to cold surfaces.
Convection
Heat loss due to cold draughts.
Evaporation
Heat loss due to wet skin.
Grunting
The sound of expiration when the glottis is partially closed which is associated with respiratory distress.