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Book Details
Abstract
Joints and Connective Tissues - General Practice: The Integrative Approach Series. In order to diagnose and manage the patient presenting with musculoskeletal symptoms, it is important to distinguish whether the pathology is arising primarily in the so-called hard tissues (such as bone) or the soft tissues (such as cartilage, disc, synovium, capsule, muscle, tendon, tendon sheath). It is also important to distinguish between the two most common causes of musculoskeletal symptoms, namely inflammatory and degenerative.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Half title page | i | ||
| Evolve splash page | ii | ||
| Midwifery, 3/e | iii | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Preface | vii | ||
| Philosophical framework | vii | ||
| Structure of the textbook | vii | ||
| Aim | vii | ||
| Structuring concepts | viii | ||
| Sections of the textbook | viii | ||
| About the editors | ix | ||
| Foreword | xi | ||
| Foreword | xii | ||
| Contributors | xiv | ||
| Reviewers | xvii | ||
| Acknowledgements | xviii | ||
| A Partners | 1 | ||
| one Context | 1 | ||
| 1 Australian and New Zealand midwifery and maternity services | 3 | ||
| Learning outcomes | 3 | ||
| Key Terms | 3 | ||
| Introduction | 4 | ||
| Historical Overview | 4 | ||
| Contemporary Maternity Services in New Zealand | 6 | ||
| The New Zealand health system | 6 | ||
| The maternity service | 6 | ||
| Vision for the maternity service | 6 | ||
| Place of birth | 7 | ||
| Section 88, Public Health and Disability Act 2000 | 8 | ||
| New Zealand midwifery workforce | 9 | ||
| Outcomes of midwifery care in New Zealand | 10 | ||
| Health Funding: Australia and New Zealand | 13 | ||
| Health Funding in Australia | 14 | ||
| Current Australian health system reform | 15 | ||
| The split between Commonwealth and state and territory health funding | 16 | ||
| Funding midwifery | 16 | ||
| The impact of funding on maternal and infant outcomes | 18 | ||
| Recent history | 21 | ||
| The effect of fee-for-service | 21 | ||
| Options for change to general funding mechanisms | 22 | ||
| Cost of continuity | 22 | ||
| Data Retrieval | 22 | ||
| Perinatal Statistics for Australia and New Zealand | 23 | ||
| review questions | 26 | ||
| online resources | 27 | ||
| references | 28 | ||
| further reading | 32 | ||
| 2 The Australian and New Zealand context | 39 | ||
| Learning outcomes | 39 | ||
| Key Terms | 39 | ||
| Introduction | 40 | ||
| Australia | 40 | ||
| Early Australia | 40 | ||
| Federation of the colonies into a nation: a Commonwealth of Australia | 42 | ||
| The First World War | 42 | ||
| Wars waged between Indigenous peoples and the colonial invaders | 43 | ||
| Australian identity | 43 | ||
| Modern Aboriginal society | 45 | ||
| New Zealand | 47 | ||
| Early New Zealand | 47 | ||
| The Treaty of Waitangi and British ‘annexation’ in 1840 | 49 | ||
| War and beyond | 50 | ||
| Contemporary New Zealand society | 50 | ||
| Modern M¯aori society | 51 | ||
| Pacific Islands people in New Zealand | 51 | ||
| review questions | 52 | ||
| online resources | 53 | ||
| references | 53 | ||
| further reading / viewing | 54 | ||
| Films and television | 54 | ||
| Novels | 54 | ||
| Poets | 55 | ||
| 3 Models of health | 56 | ||
| Learning outcomes | 56 | ||
| Key Terms | 56 | ||
| Introduction | 57 | ||
| Changing Concepts of Health, Wellness and Disease | 57 | ||
| The biomedical model of health and the ‘scientific’ method | 57 | ||
| Medicalisation of health and illness | 58 | ||
| Summary | 59 | ||
| The biopsychological, biopsychosocial and social models of health | 59 | ||
| Biopsychosocial model | 59 | ||
| The social model of health | 59 | ||
| Primary Healthcare (PHC) | 60 | ||
| The Ottawa Charter (WHO, 1986) | 60 | ||
| Levels of Primary Healthcare Services | 60 | ||
| Comparison between primary care and primary healthcare | 61 | ||
| Social Determinants of Health | 62 | ||
| Summary | 63 | ||
| Social Capital | 63 | ||
| Millennium Health Goals | 64 | ||
| The Third Millennium Development Goal | 65 | ||
| MDG Goal 3 Promotion of gender equality and empowement of women | 65 | ||
| The Fifth Millennium Development Goal | 65 | ||
| MDG Goal 5: Improve maternal health | 65 | ||
| Target 5.A—Reduce the maternal mortality ratio by three-quarters, between 1990 and 2015 | 66 | ||
| Target 5.B Achieve, by 2015, universal access to reproductive health | 66 | ||
| Midwifery and Primary Healthcare | 66 | ||
| Summary | 67 | ||
| Midwifery as a Primary Healthcare Workforce | 67 | ||
| review questions | 68 | ||
| online resources | 69 | ||
| references | 69 | ||
| further reading | 71 | ||
| 4 Midwifery and maternity in a global context | 72 | ||
| Learning outcomes | 72 | ||
| Key Terms | 72 | ||
| Introduction | 73 | ||
| Part 1: Human Rights in Childbirth | 73 | ||
| Human Rights | 73 | ||
| Relevance to Women’s Rights and Reproductive Rights | 75 | ||
| The right to choose | 76 | ||
| Women’s rights versus fetal rights | 77 | ||
| What Can Midwives Do to Maintain Human Rights for Both Women and Midwives? | 78 | ||
| Part 2: Sustainability and Midwifery | 78 | ||
| Sustainability | 78 | ||
| Midwifery and Sustainability | 79 | ||
| Part 3: Women and the Refugee Experience | 80 | ||
| Refugees | 80 | ||
| Communication and Interpreters | 81 | ||
| Imparting information | 81 | ||
| Screening and Ongoing Care | 81 | ||
| Culturally sensitive approaches are essential when working with refugees | 81 | ||
| Reproductive health concerns | 81 | ||
| Gender-based violence | 82 | ||
| Ongoing concerns | 82 | ||
| Maternity care | 82 | ||
| History taking and assessment | 82 | ||
| Strategies | 83 | ||
| review questions | 83 | ||
| online resources | 84 | ||
| references | 84 | ||
| further reading | 86 | ||
| 5 Risk, fear and safety | 87 | ||
| Learning outcomes | 87 | ||
| Key Terms | 87 | ||
| Introduction | 88 | ||
| What is Risk and How Do We Work with It? | 88 | ||
| How Does Fear Influence Midwifery and Obstetric Practice? | 91 | ||
| What do Australian and New Zealand midwives fear? | 92 | ||
| Is fear all bad? | 93 | ||
| The 0.1% doctrine or the 99.9% response | 93 | ||
| Working with Risk and Fear: a Birth Stool for the Midwife | 94 | ||
| Being ‘with women’ | 94 | ||
| Being a professional | 95 | ||
| Working the system | 95 | ||
| Working with complexity | 96 | ||
| Storytelling | 97 | ||
| review questions | 98 | ||
| online resources | 98 | ||
| references | 99 | ||
| 6 Ways of looking at evidence and measurement | 103 | ||
| Learning outcomes | 103 | ||
| Key Terms | 103 | ||
| Introduction | 104 | ||
| Seeking truth | 104 | ||
| Qualitative Research Methods | 105 | ||
| Overview of qualitative methods | 106 | ||
| Phenomenology | 106 | ||
| Ethnography | 106 | ||
| Narrative | 106 | ||
| Historical research | 106 | ||
| Grounded theory | 107 | ||
| Other methods | 107 | ||
| Reading and critiquing qualitative research: questions to ask | 107 | ||
| Evidence-based practice | 107 | ||
| Evidence-based everything | 109 | ||
| The Randomised Controlled Trial | 112 | ||
| The Systematic Review | 113 | ||
| Meta-Analysis | 114 | ||
| Synthesising Research | 115 | ||
| Practice Development | 117 | ||
| Complex Interventions, Healthcare Policy and Realist Review | 117 | ||
| The Hierarchy of Evidence | 118 | ||
| Intervention Studies | 120 | ||
| Cohort studies | 120 | ||
| Case–control studies | 121 | ||
| Cross-sectional studies | 121 | ||
| Ecological studies | 121 | ||
| Bias in Research Studies | 121 | ||
| Confidence Interval | 122 | ||
| Odds Ratio | 123 | ||
| Likelihood Ratio | 125 | ||
| review questions | 126 | ||
| online resources | 127 | ||
| references | 127 | ||
| further reading | 130 | ||
| 7 The place of birth | 132 | ||
| Learning outcomes | 132 | ||
| Key Terms | 132 | ||
| Introduction | 133 | ||
| Birth Moves From Home to Hospital | 133 | ||
| What Was Lost in the Move? | 133 | ||
| Birth at home or in hospital: which is safer? | 134 | ||
| The birth centre: a halfway house? | 135 | ||
| The return of a familiar caregiver | 137 | ||
| What is a ‘Normal Birth’? | 138 | ||
| ‘Continuity of care’ versus ‘continuous labour support’ | 138 | ||
| The New Zealand Experience | 138 | ||
| What Do We Know About Birth Physiology? | 140 | ||
| Labouring undisturbed | 140 | ||
| The birth environment | 141 | ||
| Belief in Birth as a Normal Physiological Process | 142 | ||
| Being confident to provide intrapartum care in a low-technology setting | 143 | ||
| Being comfortable to use embodied knowledge and skills to assess a woman and her baby, as opposed to using technology | 143 | ||
| Being able to let labour ‘be’ and not interfere unnecessarily | 144 | ||
| Being confident to trust the process of labour and be flexible with respect to time | 144 | ||
| Being willing to employ other options to manage pain without access to epidurals | 145 | ||
| Being confident to avert or manage problems that might arise, and being solely responsible for outcomes without access to on-site specialist assistance | 146 | ||
| Are Midwives Able to Promote Physiological Birth in Any Setting? | 147 | ||
| review questions | 148 | ||
| online resources | 148 | ||
| references | 148 | ||
| further reading | 151 | ||
| two The woman | 155 | ||
| 8 Challenges to women’s health | 157 | ||
| Learning outcomes | 158 | ||
| Key Terms | 157 | ||
| Introduction | 159 | ||
| Sexual Health and Sexual Identity | 159 | ||
| Women, Health and Illness | 160 | ||
| What does women’s health encompass? | 160 | ||
| Do we still need a women’s health movement? | 160 | ||
| Women’s health and the asylum seeker and refugee experience | 161 | ||
| Refugee settlement in New Zealand | 162 | ||
| Refugee and asylum settlement in Australia (see also Ch 4) | 162 | ||
| Health services for women interred in Australia’s Mandatory Detention Centres | 162 | ||
| Health services for women seeking refugee status resident in Australia | 163 | ||
| Health effects of TPVs and bridging visas | 163 | ||
| Differences between migrants and refugees | 163 | ||
| Arrival in the host country—screening and ongoing care | 164 | ||
| Midwives working with refugee women | 164 | ||
| Maternity care | 165 | ||
| Communication and interpreters | 165 | ||
| Imparting information | 165 | ||
| Strategies | 166 | ||
| Summary | 166 | ||
| Family Violence | 166 | ||
| Impact of violence on health of mother and baby | 168 | ||
| Working with women at risk of or experiencing family violence | 168 | ||
| Screening for family violence | 169 | ||
| Screening tools for family violence | 169 | ||
| The importance of building a trusting relationship | 169 | ||
| NZ Resources and national agency contact details | 170 | ||
| Australian resources for family violence | 170 | ||
| Female Genital Mutilation | 170 | ||
| Complications associated with FGM | 172 | ||
| Resources for midwifery students (a self-directed resource package) | 172 | ||
| Women’s Health Assessment Skills | 173 | ||
| Cardiorespiratory assessment | 173 | ||
| Conditions that may be detected during cardiorespiratory assessment | 173 | ||
| Rheumatic fever and heart disease in pregnancy | 173 | ||
| Risks for RHD among Ma¯ori and Australian Aboriginals and Torres Strait Islander women | 173 | ||
| Respiratory health | 174 | ||
| Tuberculosis (TB) | 174 | ||
| Cardiac health assessment | 174 | ||
| Breast Health, Awareness and Examination | 176 | ||
| Breast cancer | 176 | ||
| Treatment and prognosis | 177 | ||
| Overview of breast assessment | 177 | ||
| Visualisation | 177 | ||
| Palpation | 177 | ||
| Women’s Emotional and Physical Wellbeing | 177 | ||
| Healthy lifestyles | 178 | ||
| Exercise in pregnancy | 178 | ||
| Exercise programs for pregnant women | 179 | ||
| Summary | 179 | ||
| Healthy weight gain | 179 | ||
| Eating disorders | 180 | ||
| Obesity | 180 | ||
| Factors contributing to the development of overweight and obesity | 181 | ||
| Obesity—what are the risks? | 181 | ||
| Pregnancy related-complications | 181 | ||
| During labour and birth (see also Ch 39) | 181 | ||
| After the birth | 182 | ||
| Obesity and caesarean section | 182 | ||
| Working with the obese woman | 182 | ||
| Risk behaviours | 182 | ||
| Emotional wellbeing | 183 | ||
| The factors that cause or modify pregnancy-related emotions | 183 | ||
| Tocophobia | 183 | ||
| Perinatal depression in pregnancy | 184 | ||
| Antenatal risk reduction of postnatal depression and psychosis | 185 | ||
| Treatment of perinatal depression | 185 | ||
| Tobacco smoking | 185 | ||
| Pharmacotherapy | 186 | ||
| Nicotine replacement therapy | 186 | ||
| Bupropion | 186 | ||
| Advice | 186 | ||
| Other strategies | 186 | ||
| Promotional campaigns | 186 | ||
| Environmental and regulatory interventions | 186 | ||
| Health financing | 187 | ||
| Alcohol | 187 | ||
| Alcohol consumption during pregnancy | 187 | ||
| Safe alcohol intake | 187 | ||
| Screening for alcohol abuse | 188 | ||
| Screening for alcohol abuse: AUDIT-C | 188 | ||
| Marijuana use in pregnancy | 188 | ||
| Drugs of addiction in pregnancy | 188 | ||
| Cocaine | 188 | ||
| Opioids | 190 | ||
| Aims of a multidisciplinary approach to working with opioid-dependent women | 190 | ||
| Pregnancy and opiate substitution therapy (OST) | 190 | ||
| Sexually Transmitted Infections and Blood-Borne Viruses | 191 | ||
| Notification of STIs | 191 | ||
| High-risk groups for STIs | 191 | ||
| Young Indigenous people | 192 | ||
| Chlamydia | 192 | ||
| Clinical signs of infection | 192 | ||
| Screening | 192 | ||
| Opportunity testing | 192 | ||
| Routine testing | 192 | ||
| Speculum examination and swab examination | 193 | ||
| Key barriers to young people’s access to sexual health services | 193 | ||
| Human papillomavirus | 196 | ||
| Treponema pallidum (syphilis) | 196 | ||
| Screening, treatment and outcomes | 196 | ||
| Gonococcal infection | 196 | ||
| Hepatitis | 197 | ||
| Hepatitis B surface antigen | 197 | ||
| Hepatitis C | 197 | ||
| Breastfeeding | 197 | ||
| Herpes simplex virus | 197 | ||
| Care after birth | 198 | ||
| review questions | 199 | ||
| online and other resources | 199 | ||
| Alcohol and drug use in pregnancy | 199 | ||
| Blood-borne viruses in pregnancy | 199 | ||
| Diet and exercise | 200 | ||
| Family violence | 200 | ||
| Female genital mutilation (FGM) | 200 | ||
| Mental health | 200 | ||
| Refugees | 200 | ||
| Sexually transmitted infections | 200 | ||
| Smoking in pregnancy | 200 | ||
| references | 201 | ||
| further reading | 206 | ||
| 9 Midwives working with Aboriginal and Torres Strait Islander women | 207 | ||
| Learning outcomes | 207 | ||
| Key Terms | 207 | ||
| Introduction | 208 | ||
| Aboriginal and Torres Strait Islander Health in Australia | 208 | ||
| Closing the gap | 208 | ||
| Maternal and infant health | 209 | ||
| Rural and remote areas | 209 | ||
| Why the Difference in Health Outcomes? | 210 | ||
| Colonisation | 210 | ||
| Connection to country | 212 | ||
| Social determinants of health | 213 | ||
| The Aboriginal and Torres Strait Islander Definition of Health | 214 | ||
| Equity | 214 | ||
| Access | 214 | ||
| Birthing on Country | 215 | ||
| Making a Difference | 216 | ||
| Working in partnership | 216 | ||
| Barriers to working in partnership | 217 | ||
| Being ethnocentric | 218 | ||
| White privilege | 218 | ||
| The Way Forwards | 219 | ||
| ‘Working with’ versus ‘doing to’ | 219 | ||
| The organisational level | 220 | ||
| Closing the gap | 220 | ||
| Summary of Important Points | 221 | ||
| Successful services | 221 | ||
| Relationship is everything | 221 | ||
| Culturally safe childbirth | 221 | ||
| Key principles | 221 | ||
| review questions | 222 | ||
| online resources | 222 | ||
| references | 222 | ||
| further reading | 225 | ||
| 10 Midwives and Ma¯ori women: | 227 | ||
| Learning outcomes | 227 | ||
| Key Terms | 227 | ||
| Introduction | 228 | ||
| Indigenous peoples | 228 | ||
| Determinants of health and wellbeing | 228 | ||
| Māori Health and New Zealand’s Colonial History | 228 | ||
| An Overview of Māori Health | 229 | ||
| The Development of Pregnancy and Childbirth Services for Māori Women | 230 | ||
| Recruitment and retention of Ma¯ori women into midwifery | 231 | ||
| Preparation for all midwives | 232 | ||
| Māori childbirth discourse—philosophy and theory | 232 | ||
| Māori Health Strategy | 233 | ||
| review questions | 234 | ||
| online resources | 235 | ||
| references | 235 | ||
| further reading | 238 | ||
| 11 Options for women around fertility and reproduction | 243 | ||
| Learning outcomes | 243 | ||
| Key Terms | 243 | ||
| Introduction | 244 | ||
| World Population Trends | 244 | ||
| United Nations population policy | 245 | ||
| Fertility | 245 | ||
| Demographics of New Zealand women | 246 | ||
| Demographics of Australian women | 246 | ||
| Delayed pregnancy | 247 | ||
| Physiological factors affecting fertility | 248 | ||
| The body fat connection | 249 | ||
| Older Women and Childbirth | 250 | ||
| Teenage Pregnancies | 251 | ||
| Assisted Reproductive Technology (ART) or Assisted Human Reproduction (Ahr) | 252 | ||
| Methods of Assisted Reproduction | 253 | ||
| In-vitro fertilisation | 253 | ||
| Ovarian stimulation | 253 | ||
| Egg collection | 253 | ||
| Insemination and fertilisation | 254 | ||
| Embryo transfer | 254 | ||
| Luteal support | 254 | ||
| Embryo freezing | 254 | ||
| Abandoned cycles | 254 | ||
| Support when undergoing treatment | 254 | ||
| Gamete intrafallopian transfer | 254 | ||
| Intracytoplasmic sperm injection | 255 | ||
| What does ICSI involve? | 255 | ||
| When is ICSI used? | 255 | ||
| The ICSI procedure | 255 | ||
| Laws About Donation | 256 | ||
| Demographics of Assisted Reproduction | 256 | ||
| Data on ART in Australia and New Zealand | 257 | ||
| Birth outcomes following ART | 257 | ||
| Complication rates for women | 257 | ||
| Cost associated with ART | 258 | ||
| Surrogacy | 258 | ||
| The legality of surrogacy | 259 | ||
| Australia | 259 | ||
| Canada and New Zealand | 260 | ||
| Midwifery Care for Women Who Have Pregnancies Following ART | 260 | ||
| review questions | 261 | ||
| online resources | 261 | ||
| references | 261 | ||
| three The midwife | 265 | ||
| 12 Professional frameworks for practice in Australia and New Zealand | 267 | ||
| Learning outcomes | 267 | ||
| Key Terms | 267 | ||
| Introduction | 268 | ||
| Professions and Professionalism: What Do They Mean? | 268 | ||
| Gendered professions | 269 | ||
| ‘Old’ and ‘new’ styles of professionalism | 269 | ||
| Midwifery as a profession in Australia | 270 | ||
| Influences of competing discourses of childbearing | 270 | ||
| Professional status | 271 | ||
| Educational process | 271 | ||
| Body of knowledge | 272 | ||
| Discretionary authority and judgment | 272 | ||
| Cohesive professional organisation | 272 | ||
| Birth culture and institutionalisation | 273 | ||
| ‘Eligible’ midwives | 274 | ||
| Redefining professionalism in New Zealand | 274 | ||
| Development of the Midwifery Profession in New Zealand | 277 | ||
| Structure and functions of the New Zealand College of Midwives | 277 | ||
| The Midwifery and Maternity Providers Organisation | 277 | ||
| The Rural Midwifery Recruitment and Retention Service (RMRRS) | 279 | ||
| Midwifery Employee Representation and Advisory Service | 280 | ||
| The Joan Donley Midwifery Research Collaboration (JDMRC) | 280 | ||
| Professional activities | 280 | ||
| Midwifery Standards Review | 280 | ||
| Resolution committees | 281 | ||
| Midwifery Education in New Zealand | 281 | ||
| Preregistration midwifery education | 281 | ||
| Midwifery first year of practice | 281 | ||
| Postgraduate midwifery education | 281 | ||
| Midwifery as a profession in New Zealand | 281 | ||
| Development of the Midwifery Profession in Australia | 282 | ||
| Challenges to a professional framework for midwifery practice | 282 | ||
| Structure of the ACM | 282 | ||
| Role and functions | 283 | ||
| Australian College of Midwives Framework for Midwifery | 285 | ||
| Australian National Standards for Midwifery Practice | 285 | ||
| Preregistration midwifery education | 285 | ||
| Midwifery Regulation in New Zealand | 286 | ||
| Midwifery scope of practice | 286 | ||
| Competencies for entry to the Register of Midwives | 287 | ||
| Cultural competence | 287 | ||
| Code of Conduct | 287 | ||
| Registration as a midwife in New Zealand | 287 | ||
| Continuing competence as a midwife | 288 | ||
| Competence review | 289 | ||
| Disciplinary functions | 289 | ||
| Other functions | 289 | ||
| Changes to the HPCAA and the Midwifery Council | 289 | ||
| Relationship between the New Zealand College of Midwives and the Midwifery Council of New Zealand | 289 | ||
| Midwifery Regulation in Australia | 289 | ||
| National Registration and Accreditation Scheme | 290 | ||
| Midwifery Scope of Practice | 291 | ||
| National midwifery competencies | 291 | ||
| Registration standards, continuing competence and disciplinary functions | 291 | ||
| Maternity reform and regulation—considerations for midwives and women | 293 | ||
| Relationship between Professional and Regulatory Frameworks in Australia | 293 | ||
| review questions | 294 | ||
| online resources | 294 | ||
| references | 295 | ||
| further reading | 302 | ||
| 13 Legal frameworks for practice in Australia and New Zealand | 304 | ||
| Learning objectives | 304 | ||
| Key Terms | 304 | ||
| Introduction: the Law | 305 | ||
| Why is the law important to midwives? | 305 | ||
| The Regulation of Midwifery Practice | 305 | ||
| Midwifery regulation in Australia overview | 305 | ||
| Background | 305 | ||
| Relevant legislation and structure of the scheme | 305 | ||
| Registration standard for eligible midwives under section 38(2) | 306 | ||
| Registration standard for endorsement for scheduled medicines for midwives under section 94 | 307 | ||
| The PII requirements for privately practising midwives (PPMs) | 308 | ||
| Notifications and complaints about midwives | 309 | ||
| The NSW complaints system | 309 | ||
| Midwifery regulation in New Zealand overview | 311 | ||
| Nurses Act 1977 and Nurses Amendment Act 1990 | 311 | ||
| The Health Practitioners Competence Assurance Act 2003 | 312 | ||
| Professional Regulatory Authorities | 312 | ||
| Impairment | 312 | ||
| Competence | 313 | ||
| Conduct / discipline | 314 | ||
| Other Statutes That Protect Public Safety | 315 | ||
| Complaint procedures and professional negligence in Australia | 315 | ||
| Health complaints authorities in Australia | 315 | ||
| Professional negligence | 315 | ||
| Consumer complaint procedures and professional accountability in New Zealand | 316 | ||
| Health and Disability Commissioner Act 1994 | 317 | ||
| Responding to a complaint | 321 | ||
| Legal standards of care for civil cases | 321 | ||
| Legal standards of care for manslaughter cases | 322 | ||
| Human Rights Act 1993 / Human Rights Amendment Act 2001 | 322 | ||
| Accident Compensation Act 2001 (ACC) | 322 | ||
| Assault | 323 | ||
| Obligation towards vulnerable patients | 324 | ||
| Privacy, Confidentiality and Access to Personal Information | 324 | ||
| Australia | 324 | ||
| Australian privacy legislation | 325 | ||
| New Zealand statutes on privacy and information | 325 | ||
| Health (Retention of Health Information) Regulations 1996 | 325 | ||
| Health Information Privacy Code 1994 / Privacy Act 1993 | 325 | ||
| Legislation on Midwifery Practice | 327 | ||
| Australian legislation | 327 | ||
| Notification of birth | 327 | ||
| Abortion laws in Australia | 328 | ||
| Adoption laws in Australia | 328 | ||
| New Zealand legislation | 328 | ||
| New Zealand Public Health and Disability Act 2000 | 328 | ||
| Births, Deaths, Marriages, and Relationships Registration Act 1995 | 329 | ||
| Adoption Act 1955 | 329 | ||
| Contraception, Sterilisation and Abortion Act 1977 | 329 | ||
| Legislation on Drug Administration and Prescribing | 330 | ||
| Australia | 330 | ||
| New Zealand | 330 | ||
| Medicines Acts and Regulations | 330 | ||
| Urgent prescriptions | 330 | ||
| Controlled drugs | 330 | ||
| Coroner’s Court Legislation and Process | 331 | ||
| review questions | 333 | ||
| Australia | 333 | ||
| New Zealand | 334 | ||
| online resources | 334 | ||
| references | 334 | ||
| Statutes and case law | 336 | ||
| further reading | 338 | ||
| 14 Ethical frameworks for practice | 339 | ||
| Learning outcomes | 339 | ||
| Key Terms | 339 | ||
| Introduction | 340 | ||
| Moral ideas from everyday life | 340 | ||
| Law and ethics | 341 | ||
| The history and development of bioethics | 341 | ||
| Thalidomide | 342 | ||
| The unfortunate experiment | 342 | ||
| Approaches to Ethics | 343 | ||
| The four-principle approach to healthcare ethics | 343 | ||
| Autonomy | 343 | ||
| Informed consent | 343 | ||
| Informed choice | 343 | ||
| Beneficence | 344 | ||
| Non-maleficence | 344 | ||
| Justice | 345 | ||
| Some criticisms of a principles approach | 345 | ||
| Feminist approaches to ethics in healthcare | 346 | ||
| Objections to a feminist approach | 346 | ||
| Ethic of care | 346 | ||
| Some problems with an ethic of care | 347 | ||
| Summary | 347 | ||
| Midwifery Codes of Ethics | 347 | ||
| International Confederation of Midwives Code of Ethics | 348 | ||
| Australian Nursing and Midwifery Council Code of Ethics | 348 | ||
| New Zealand College of Midwives Philosophy and Code of Ethics | 350 | ||
| The Midwifery Council of New Zealand Code of Conduct | 350 | ||
| Ethics in Practice | 354 | ||
| Research Ethics and Midwifery | 357 | ||
| Involving pregnant women in research | 357 | ||
| Ethical review of research involving human participants | 357 | ||
| Ensuring the wellbeing of research participants | 358 | ||
| Consent for participation in research | 358 | ||
| Calculating harms and benefits | 358 | ||
| Confidentiality in research | 358 | ||
| Innovative practice | 358 | ||
| acknowledgements | 359 | ||
| review questions | 359 | ||
| online resources | 360 | ||
| references | 360 | ||
| further reading | 361 | ||
| 15 Sustaining midwifery practice | 362 | ||
| Learning objectives | 362 | ||
| Key Terms | 362 | ||
| Part One: The Nature of Midwifery and the Role of the Midwife | 363 | ||
| Introduction | 363 | ||
| Developing the Role of the Midwife | 363 | ||
| Qualities for Midwives | 364 | ||
| Empathy | 364 | ||
| Companionship | 364 | ||
| Honesty | 364 | ||
| Commitment | 364 | ||
| Integrity | 365 | ||
| Robustness and resilience | 365 | ||
| Decisiveness | 365 | ||
| Curiosity | 365 | ||
| Practicality | 365 | ||
| Boldness | 365 | ||
| Reflectiveness | 366 | ||
| Friendliness | 366 | ||
| Generosity | 366 | ||
| Positivity | 366 | ||
| Self-knowledge | 366 | ||
| Autonomy | 367 | ||
| Self-responsibility | 367 | ||
| Developing and Negotiating Relationships | 367 | ||
| Organisational skills | 368 | ||
| In Summary | 368 | ||
| Part Two: Sustainable Midwifery Practice | 369 | ||
| Introduction | 369 | ||
| Sustaining Midwifery as a Profession, and Belief in Women’s Ability to Give Birth | 370 | ||
| Sustaining the Midwifery Profession Into the Future | 370 | ||
| Midwifery as an Environmentally Sustainable Profession | 371 | ||
| Midwifery as an Economically Sustainable Profession | 372 | ||
| Midwifery as a Socially Sustainable Profession | 373 | ||
| Midwifery as a Culturally and Spiritually Sustainable Profession | 373 | ||
| Midwives Sustaining Themselves in Practice—Self-Care | 373 | ||
| Support | 374 | ||
| Relationships | 374 | ||
| Horizontal violence or workplace bullying | 374 | ||
| Boundaries | 374 | ||
| ‘Burnout’ | 375 | ||
| Work–life balance | 375 | ||
| Sense of purpose and enjoyment | 376 | ||
| review questions | 376 | ||
| online resources | 377 | ||
| references | 377 | ||
| further reading | 379 | ||
| B Practice | 381 | ||
| One Partnership | 381 | ||
| 16 Theoretical frameworks for midwifery practice | 383 | ||
| Learning outcomes | 384 | ||
| Key Terms | 383 | ||
| Introduction | 385 | ||
| Midwifery and relationships | 385 | ||
| Theoretical frameworks for practice | 385 | ||
| What is a theoretical framework? | 385 | ||
| The Origins of Cultural Safety and Midwifery Partnership | 386 | ||
| Cultural Safety and Midwifery Partnership in Other Contexts | 387 | ||
| Cultural Safety | 387 | ||
| What is meant by ‘culture’? | 388 | ||
| The development of cultural safety | 389 | ||
| Principles of cultural safety | 391 | ||
| Implications for midwifery practice | 391 | ||
| Midwifery Partnership | 392 | ||
| Evolving understandings of midwifery partnership | 393 | ||
| Overview of midwifery partnership: a model for practice | 393 | ||
| The partners | 394 | ||
| Philosophical underpinnings | 396 | ||
| Pregnancy and childbirth are normal life events | 397 | ||
| Midwifery is an independent profession | 398 | ||
| Midwifery provides continuity of caregiver | 398 | ||
| Midwifery is woman centred | 398 | ||
| Theoretical concepts | 399 | ||
| Equality and reciprocity | 399 | ||
| Negotiation | 400 | ||
| Trust and time | 400 | ||
| Sharing power and responsibility | 401 | ||
| Empowerment and emancipation | 402 | ||
| Professional friendship | 402 | ||
| Potentials and possibilities for partnership | 403 | ||
| TŪRANGA KAUPAPA | 404 | ||
| Cultural Competence | 404 | ||
| review questions | 407 | ||
| online resources | 407 | ||
| references | 408 | ||
| 17 Working in partnership | 412 | ||
| Learning outcomes | 412 | ||
| Key Terms | 412 | ||
| Introduction | 413 | ||
| The Relationship | 413 | ||
| Partnering women throughout the pregnancy: the first phone call to the discharge visit at 4–6 weeks | 413 | ||
| What do women want from their midwife? | 415 | ||
| Partnering women in decision making: informed choice and consent | 415 | ||
| Partnering women in communication—written and verbal | 416 | ||
| The Role of the Midwife | 418 | ||
| The changing landscape of midwifery practice in Australia | 418 | ||
| Aotearoa New Zealand—LMC and core midwifery roles | 418 | ||
| Provision of continuity of care—outcomes of one-to-one care | 418 | ||
| Structures That Support Midwives to Work in Partnership with Women: Midwifery Frameworks | 419 | ||
| Australia | 419 | ||
| Aotearoa New Zealand | 420 | ||
| Partnerships with consumer organisations | 420 | ||
| Partnerships with other midwives—group practice | 420 | ||
| Student midwives—partnering midwives and women | 422 | ||
| Other partnerships—the midwife and her community | 422 | ||
| review questions | 423 | ||
| online resources | 423 | ||
| references | 424 | ||
| further reading | 427 | ||
| 18 Working in collaboration | 428 | ||
| Learning outcomes | 428 | ||
| Key Terms | 428 | ||
| Introduction | 429 | ||
| The Nature of Collaboration | 429 | ||
| Collaboration in the Context of the Australian Maternity Reforms 2010 | 432 | ||
| Professional Collaborations | 433 | ||
| The New Zealand Referral Guidelines | 434 | ||
| The Process of Referral | 435 | ||
| The Australian National Midwifery Guidelines for Consultation and Referral | 435 | ||
| The collaborative process | 435 | ||
| The Guidelines | 436 | ||
| Three main steps in consultation and referral | 436 | ||
| A. Discuss the situation with a colleague–midwife and / or with a medical practitioner or other healthcare provider | 436 | ||
| B. Consultation with a medical or other healthcare provider | 436 | ||
| C. Referral of a woman or her infant to secondary or tertiary care | 437 | ||
| Appendix A: When a woman chooses care outside the guidelines | 438 | ||
| review questions | 440 | ||
| online resources | 441 | ||
| references | 441 | ||
| 19 Promoting physiological birth | 443 | ||
| Learning outcomes | 443 | ||
| Key Terms | 443 | ||
| Introduction | 444 | ||
| The Midwife as ‘Guardian of the Normal’ | 444 | ||
| The Rationale for Promoting Physiological Birth | 444 | ||
| Promoting Physiological Birth | 446 | ||
| Access to midwifery care | 446 | ||
| Midwifery continuity of care | 447 | ||
| Midwifery caseload practice | 447 | ||
| Offering home birth and birth centre / primary unit care | 447 | ||
| Reconstructing the story of the birth of Jack Taylor | 448 | ||
| Antenatal groups | 448 | ||
| Building confidence throughout pregnancy | 449 | ||
| Late pregnancy | 449 | ||
| The 36-week home visit or ‘birth talk’ | 449 | ||
| Evidence about strategies to promote physiological birth during pregnancy | 450 | ||
| Promoting physiology during labour | 451 | ||
| Building a Culture in Which Physiological Birth Can Flourish | 452 | ||
| review questions | 454 | ||
| online resources | 454 | ||
| references | 454 | ||
| further reading | 457 | ||
| Two Autonomous practice | 459 | ||
| 20 The physiology of conception and pregnancy | 461 | ||
| Learning outcomes | 462 | ||
| Key Terms | 461 | ||
| Introduction | 463 | ||
| Female and Male Reproductive Systems | 463 | ||
| Anatomy of the female reproductive system | 463 | ||
| Female internal genitalia | 463 | ||
| Female external genitalia | 464 | ||
| Mammary glands | 464 | ||
| The female pelvis | 464 | ||
| The pelvic (hip) girdle | 464 | ||
| Joints of the pelvic girdle | 464 | ||
| Ligaments associated with the pelvic girdle | 465 | ||
| Bones of the pelvic girdle | 466 | ||
| Ilium | 466 | ||
| Ischium | 466 | ||
| Pubic bones | 466 | ||
| Sacrum | 466 | ||
| Sacral promontory | 466 | ||
| Coccyx | 466 | ||
| Pelvis, true or false | 466 | ||
| Anatomy of the male reproductive system | 468 | ||
| Accessory sex glands and semen | 468 | ||
| Gametogenesis | 469 | ||
| Oogenesis | 469 | ||
| Spermatogenesis | 469 | ||
| Female reproductive cycles | 470 | ||
| Ovarian cycle | 470 | ||
| Follicular phase | 470 | ||
| Ovulation | 471 | ||
| Luteal phase | 471 | ||
| Uterine cycle | 471 | ||
| Menstrual phase | 472 | ||
| Proliferative phase | 472 | ||
| Secretory phase | 472 | ||
| Hypothalamic–pituitary–ovarian (HPO) axis | 472 | ||
| Hypothalamus | 472 | ||
| Pituitary gland | 472 | ||
| Ovaries | 473 | ||
| Summary: homeostatic control of the reproductive cycle | 474 | ||
| Hypothalamic–pituitary–testicular control in the male | 474 | ||
| Summary points | 474 | ||
| Embryology | 474 | ||
| Fertilisation | 474 | ||
| Sperm transport | 475 | ||
| Capacitation and acrosomal reaction | 475 | ||
| Factors that facilitate fertilisation | 476 | ||
| Cleavage and formation of blastomeres | 476 | ||
| Steps of implantation | 476 | ||
| Changes in the endometrium | 477 | ||
| Development of the embryo | 478 | ||
| The embryo in week 3 | 479 | ||
| Gastrulation | 479 | ||
| Notochord and somite formation | 479 | ||
| Neurulation | 479 | ||
| Cellular processes that control embryological development | 479 | ||
| Cell differentiation | 480 | ||
| Induction | 480 | ||
| Differential cell proliferation | 480 | ||
| Programmed cell death | 480 | ||
| Cell size and shape change | 480 | ||
| Cell migration | 481 | ||
| Cell recognition and adhesion | 481 | ||
| Folding of the embryo | 481 | ||
| Differential maturity | 481 | ||
| Organogenesis: highlights of weeks 4 to 8 | 481 | ||
| The fetus: from nine weeks to birth | 482 | ||
| Development of the placenta and fetal membranes | 483 | ||
| Uteroplacental and fetoplacental circulation | 483 | ||
| Maternal lacunae | 483 | ||
| Chorionic villi | 483 | ||
| Formation of the smooth chorion and amnion | 483 | ||
| Amniotic fluid | 484 | ||
| Formation of the yolk sac (umbilical vesicle) | 485 | ||
| Placental circulation in the mature placenta | 485 | ||
| Maternal placental circulation | 485 | ||
| Fetal placental circulation | 485 | ||
| Placental function | 485 | ||
| Transport role | 485 | ||
| Immunological role | 486 | ||
| Endocrine role | 487 | ||
| Metabolic role | 487 | ||
| Summary of placental and fetal membrane development | 487 | ||
| Fetal Circulation | 487 | ||
| Characteristics | 487 | ||
| Structures | 487 | ||
| Oxygen saturation of fetal blood | 488 | ||
| Development of fetal circulation and lungs | 488 | ||
| Fetal breathing movements | 489 | ||
| Composition and function of surfactant | 489 | ||
| Clinical applications | 490 | ||
| Summary of fetal circulation | 490 | ||
| Maternal Changes Associated with Pregnancy | 490 | ||
| Hormones of pregnancy | 490 | ||
| Human chorionic gonadotrophin | 490 | ||
| Human placental lactogen | 491 | ||
| Steroid hormones | 491 | ||
| Oestrogens | 491 | ||
| Progesterone | 492 | ||
| Changes to maternal physiology | 492 | ||
| Endocrine glands | 492 | ||
| Changes to the reproductive system | 493 | ||
| Uterus | 493 | ||
| Cervix | 493 | ||
| Vagina | 493 | ||
| Haematological changes | 494 | ||
| Haemodilution | 494 | ||
| Changes to blood coagulability | 494 | ||
| Cardiovascular system | 494 | ||
| Blood flow distribution | 495 | ||
| Respiratory system | 495 | ||
| Renal system | 495 | ||
| Musculoskeletal system | 496 | ||
| Integumentary system | 496 | ||
| Gastrointestinal system | 496 | ||
| Effect of progesterone on smooth muscle | 496 | ||
| Gums | 497 | ||
| Summary of maternal changes in pregnancy | 497 | ||
| review questions | 497 | ||
| online resources | 498 | ||
| references | 498 | ||
| further reading | 500 | ||
| 21 Nutrition and physical activity foundations for pregnancy, childbirth and lactation | 501 | ||
| Learning outcomes | 502 | ||
| Key Terms | 501 | ||
| Introduction: Nutrition in Pregnancy | 503 | ||
| Macronutrients | 503 | ||
| Fats | 503 | ||
| Carbohydrates | 504 | ||
| Protein | 504 | ||
| Micronutrients | 505 | ||
| Minerals | 505 | ||
| Iron | 505 | ||
| Calcium | 506 | ||
| Zinc | 506 | ||
| Iodine | 506 | ||
| Vitamins | 507 | ||
| Folate | 507 | ||
| Vitamin B12 | 508 | ||
| Vitamin A | 508 | ||
| Vitamin D | 508 | ||
| Gestational Weight Gain | 509 | ||
| Multiple pregnancies | 510 | ||
| Obesity | 510 | ||
| The Use of Diet to Aid in Common Pregnancy Ailments | 511 | ||
| Nausea and vomiting | 511 | ||
| Constipation | 512 | ||
| Gastro-oesophageal reflux | 512 | ||
| Pica | 512 | ||
| Anaemia | 512 | ||
| Listeria | 513 | ||
| Nutrition in Labour | 514 | ||
| Nutritional Foundation for Lactation | 514 | ||
| Physical Activity during Pregnancy | 515 | ||
| Recommendations for physical activity during pregnancy | 515 | ||
| Benefits of physical activity during pregnancy | 515 | ||
| Risks of physical activity during pregnancy | 516 | ||
| Postpartum Physical Activity | 516 | ||
| Pelvic floor exercises | 516 | ||
| review questions | 517 | ||
| online resources | 517 | ||
| references | 518 | ||
| further reading | 522 | ||
| 22 Screening and assessment | 523 | ||
| Learning outcomes | 523 | ||
| Key terms | 523 | ||
| Introduction: Screening Guidelines | 524 | ||
| NICE guidelines | 524 | ||
| Midwives Handbook for Practice | 524 | ||
| Information Shared | 524 | ||
| Review of current and past maternity history | 524 | ||
| Definition of terms | 524 | ||
| Screening Tests | 525 | ||
| Assessing the effectiveness of a test | 525 | ||
| Sensitivity | 525 | ||
| Specificity | 525 | ||
| Appointment Times for Screening | 526 | ||
| First appointment | 526 | ||
| 16 weeks | 527 | ||
| 18–20 weeks | 527 | ||
| 24 weeks | 527 | ||
| 28 weeks | 527 | ||
| 31 weeks | 527 | ||
| 34 weeks | 527 | ||
| 36 weeks | 527 | ||
| Gestational Age Assessment | 527 | ||
| Ultrasound scans | 527 | ||
| Side effects of ultrasound | 528 | ||
| Intrauterine Growth Restriction (IUGR) | 530 | ||
| Screening for Chromosomal Anomalies Including Down Syndrome | 530 | ||
| Screening in Australia and New Zealand | 530 | ||
| Development of diagnostic testing methods | 531 | ||
| Current practice | 532 | ||
| Australia | 532 | ||
| New Zealand | 533 | ||
| Summary: screening for Down syndrome | 533 | ||
| What to tell women | 533 | ||
| Screening in the future | 535 | ||
| Neural tube defects | 535 | ||
| Indications for genetic counselling | 536 | ||
| Future fetal diagnosis | 537 | ||
| Screening for Infections | 537 | ||
| Bacterial | 537 | ||
| Asymptomatic bacteriuria | 537 | ||
| What to tell women | 537 | ||
| Asymptomatic bacterial vaginosis | 537 | ||
| Chlamydia trachomatis | 538 | ||
| Syphilis | 539 | ||
| What to tell women | 539 | ||
| Group B Streptococcus | 540 | ||
| Incidence | 540 | ||
| Screening options | 540 | ||
| Identification of GBS colonisation in pregnant women | 541 | ||
| Risk factors for EOGBS infection | 542 | ||
| GBS colonisation (Box 22.7)— | 542 | ||
| GBS bacteriuria in pregnancy— | 542 | ||
| Previous child with GBS infection— | 542 | ||
| Chorioamnionitis— | 542 | ||
| Intrapartum fever— | 542 | ||
| Ruptured membranes: prolonged or prelabour— | 543 | ||
| Preterm birth— | 543 | ||
| Recommendations for midwifery practice (by Celia Grigg) | 543 | ||
| Viral infection | 544 | ||
| Cytomegalovirus (CMV) | 544 | ||
| Hepatitis B virus | 546 | ||
| What to tell women | 546 | ||
| Hepatitis C virus | 546 | ||
| Human immunodeficiency virus (HIV) | 546 | ||
| What to tell women | 547 | ||
| Rubella | 547 | ||
| What to tell women | 548 | ||
| Herpes simplex virus | 548 | ||
| Toxoplasmosis | 549 | ||
| Screening for Clinical Conditions | 549 | ||
| Blood group and Rhesus D status | 549 | ||
| Anti-D | 550 | ||
| Gestational diabetes mellitus | 550 | ||
| What is the evidence for screening? | 550 | ||
| In summary: guidelines for the testing and diagnosis of gestational diabetes mellitus in Australia and New Zealand | 551 | ||
| 1. Women not known to have pre-existing glucose abnormalities but who have risk factors for GDM | 552 | ||
| 2. Routine testing for GDM | 552 | ||
| Preeclampsia | 552 | ||
| Urine testing | 554 | ||
| review questions | 556 | ||
| acknowledgement | 556 | ||
| online resources | 556 | ||
| references | 556 | ||
| further reading | 563 | ||
| 23 Working with women in pregnancy | 564 | ||
| Learning outcomes | 565 | ||
| Key Terms | 564 | ||
| Introduction: What is Antenatal Care? | 566 | ||
| Organisation of Care | 566 | ||
| The antenatal visit | 567 | ||
| Summary points: the antenatal visit | 568 | ||
| Initial Contact | 568 | ||
| The interpersonal level | 568 | ||
| The professional level | 569 | ||
| The practical level | 569 | ||
| Summary points: initial contact | 570 | ||
| The Booking Visit | 570 | ||
| Reviewing the past | 571 | ||
| Identifying the present | 571 | ||
| Planning the future | 573 | ||
| Decision Points | 574 | ||
| Explanatory Sections | 575 | ||
| Estimated due date (EDD) | 575 | ||
| Dating in history and Naegele’s rule | 576 | ||
| Ultrasound scan dating | 579 | ||
| Practice guideline recommendations | 579 | ||
| Pregnancy calculators | 579 | ||
| Summary points: expected due date | 579 | ||
| Routine antenatal blood screening | 580 | ||
| Iron levels, measures and supplementation | 581 | ||
| Routine blood pressure screening | 581 | ||
| Preeclampsia | 582 | ||
| Routine urine screening | 583 | ||
| Screening for proteinuria as a marker for preeclampsia | 583 | ||
| Screening for asymptomatic bacteriuria | 583 | ||
| Screening for glycosuria as a marker for gestational diabetes mellitus | 584 | ||
| Summary: routine urine screening | 584 | ||
| Summary points | 585 | ||
| Palpation: hands-on learning, identification and assessment | 585 | ||
| Context and preparation | 585 | ||
| Equipment | 585 | ||
| Preparation | 585 | ||
| Techniques and methods | 586 | ||
| 1 Initial visual assessment | 586 | ||
| 2 Fundal assessment | 586 | ||
| 3 Lateral assessment | 589 | ||
| 4 Pelvic palpation | 590 | ||
| 5 Listening or auscultation | 591 | ||
| Summary points: palpation | 592 | ||
| Fetal movements | 592 | ||
| Antenatal education | 593 | ||
| What is antenatal education? | 593 | ||
| Who provides antenatal education and who uses it? | 593 | ||
| What are the objectives of antenatal education, and how is it evaluated? | 594 | ||
| What is the role of the LMC midwife in antenatal education? | 594 | ||
| Exercise in pregnancy | 595 | ||
| Physiological changes of pregnancy | 595 | ||
| Nausea and vomiting (morning sickness) | 597 | ||
| Constipation | 598 | ||
| Heartburn | 599 | ||
| review questions | 600 | ||
| online resources | 601 | ||
| references | 601 | ||
| further reading | 606 | ||
| 24 Physiological changes during labour | 607 | ||
| Learning outcomes | 607 | ||
| Key Terms | 607 | ||
| Introduction | 608 | ||
| Physiology of Labour | 608 | ||
| Uterine changes in preparation for labour | 608 | ||
| Cervical changes in preparation for labour | 608 | ||
| What Initiates Labour? | 609 | ||
| Corticotrophin-releasing hormone (CRH) | 609 | ||
| Prostaglandins | 610 | ||
| Oxytocin | 611 | ||
| Oestrogen (estrogen) | 611 | ||
| Progesterone | 611 | ||
| Relaxin | 611 | ||
| Nitric oxide | 611 | ||
| Summary: the hormonal contribution to labour | 612 | ||
| First Stage of Labour | 613 | ||
| Uterine contractions during the first stage | 613 | ||
| Uterine contractions and the fetus | 614 | ||
| The Second Stage of Labour | 614 | ||
| Pushing during the second stage of labour | 615 | ||
| Maternal position during the second stage of labour | 615 | ||
| Mechanism of labour | 615 | ||
| Descent | 616 | ||
| Flexion | 616 | ||
| Internal rotation of the head | 616 | ||
| Extension of the head | 617 | ||
| Restitution | 617 | ||
| Internal rotation of the shoulders and lateral flexion | 617 | ||
| Factors that influence the progress of the second stage | 617 | ||
| Bony pelvis | 617 | ||
| Fetus | 617 | ||
| Pelvic floor muscles | 617 | ||
| Position of the woman | 617 | ||
| Other | 617 | ||
| Third Stage of Labour | 618 | ||
| Mechanism of separation of the placenta | 618 | ||
| Cord clamping | 619 | ||
| Other Maternal Body Systems During Labour | 619 | ||
| Metabolism | 619 | ||
| Respiratory system | 620 | ||
| Cardiovascular system | 620 | ||
| Haematological changes | 620 | ||
| Renal function | 620 | ||
| Fourth Stage of Labour | 620 | ||
| Fetal Responses During Labour | 620 | ||
| Control of the fetal heart rate | 621 | ||
| Fetal responses to hypoxia | 621 | ||
| Summary | 621 | ||
| review questions | 623 | ||
| online resources | 623 | ||
| references | 623 | ||
| further reading | 625 | ||
| 25 Supporting women in labour and birth | 626 | ||
| Learning outcomes | 626 | ||
| Key Terms | 626 | ||
| Introduction | 627 | ||
| Developing the Woman–Midwife Relationship | 627 | ||
| Decision points for midwifery care in labour and birth | 627 | ||
| The Continuum of Labour and Birth | 627 | ||
| Recognising Labour | 627 | ||
| Labour: latent phase to onset of active phase | 628 | ||
| First Decision Point in Labour | 628 | ||
| When the woman or her support person first informs the midwife that she is in labour | 628 | ||
| Second Decision Point in Labour | 630 | ||
| When the woman wants intermittent support from the midwife | 630 | ||
| Labour: active phase to onset of transition | 630 | ||
| Third Decision Point in Labour | 631 | ||
| When the woman wants continuous support from a midwife | 631 | ||
| Facilitating a supportive labour environment | 632 | ||
| Eating and drinking in labour | 634 | ||
| Working with contractions | 634 | ||
| Physical assessment in active phase of labour | 634 | ||
| Contractions | 635 | ||
| Vaginal discharge | 635 | ||
| Abdominal palpation | 635 | ||
| Vaginal examinations | 635 | ||
| Artificial rupture of the membranes (amniotomy) | 636 | ||
| Listening to the baby’s heart rate | 638 | ||
| Maternal responses to physiological changes of labour | 640 | ||
| Ongoing Assessment of Progress in Labour | 640 | ||
| Documentation | 641 | ||
| Partograms | 641 | ||
| Woman-centred midwifery notes | 641 | ||
| Labour: Transition Phase to Birth | 641 | ||
| Fourth Decision Point in Labour | 642 | ||
| Second stage or birth to skin-to-skin | 642 | ||
| Facilitating a supportive birthing environment | 643 | ||
| Fifth Decision Point in Labour | 645 | ||
| The third stage | 645 | ||
| Supporting a physiological third stage of labour | 646 | ||
| Active management of third stage | 646 | ||
| Examination of the placenta and membranes | 647 | ||
| Placenta traditions | 647 | ||
| Assessing injury to the woman’s labial, vaginal and perineal area | 648 | ||
| Ongoing assessment | 648 | ||
| Examination of the Baby | 648 | ||
| Ongoing Care in the First Few Hours | 648 | ||
| Documentation | 649 | ||
| review questions | 650 | ||
| online resources | 650 | ||
| references | 651 | ||
| further reading | 655 | ||
| 26 Working with pain in labour | 656 | ||
| Learning outcomes | 656 | ||
| Key Terms | 656 | ||
| Introduction | 657 | ||
| Historical Perspectives on Pain in Labour | 657 | ||
| Women’s Perspectives on Pain in Labour | 658 | ||
| The particular quality of labour pain | 660 | ||
| Cultural Perspectives on Pain in Labour | 661 | ||
| Enabling a sense of control | 661 | ||
| The psychosocial dynamics of pain in labour | 661 | ||
| Feminist Perspectives on Pain in Labour | 662 | ||
| Pain in labour and the notion of empowerment | 662 | ||
| Pain in Labour and the Midwife–Woman Relationship | 663 | ||
| Engaging with women about labour during pregnancy | 663 | ||
| Labour and Birth Support | 664 | ||
| review questions | 665 | ||
| online resources | 666 | ||
| references | 666 | ||
| 27 Using water for labour and birth | 671 | ||
| Learning outcomes | 671 | ||
| Key Terms | 671 | ||
| Introduction | 672 | ||
| The Role of Water Birth in Supporting Physiological Birth | 672 | ||
| The History of Water Birth | 672 | ||
| The First Water Births in New Zealand and Australia | 673 | ||
| Using Water for Labour and Birth: The Evidence | 674 | ||
| Physiological effects | 675 | ||
| What women say about water immersion | 676 | ||
| Women feel more in control; water reduces their anxiety about pain and about the process of childbirth itself | 676 | ||
| Women use water to cope with pain, not necessarily to remove or diminish it | 676 | ||
| Women feel more relaxed and the water promotes their comfort | 676 | ||
| Women feel sheltered and protected in the water, which promotes privacy | 676 | ||
| Women are able to move around more easily and feel supported by the water | 677 | ||
| Anticipation of getting into the birth pool | 677 | ||
| Safety and Efficacy of Using Water | 677 | ||
| Water temperature | 677 | ||
| Immersion and duration of labour | 678 | ||
| Use of analgesia in labour | 678 | ||
| Perineal trauma | 679 | ||
| Risk of infection | 680 | ||
| Third stage and blood loss | 681 | ||
| Effects on the baby | 681 | ||
| Perinatal mortality and morbidity / adverse outcomes | 682 | ||
| Cord snapping | 682 | ||
| Neonatal resuscitation | 682 | ||
| Potential near-drowning | 683 | ||
| Using Water for Labour and Birth: The Practice | 684 | ||
| Skills and education of workforce | 684 | ||
| Principles for the use of water for labour and birth | 685 | ||
| Guidelines for the use of water for labour and birth | 685 | ||
| Who can use water for labour and birth? | 685 | ||
| Equipment | 685 | ||
| Occupational health and safety considerations | 686 | ||
| Care of woman and baby | 686 | ||
| During labour | 686 | ||
| During a birth in water | 686 | ||
| Complications | 687 | ||
| review questions | 688 | ||
| online resources | 688 | ||
| references | 688 | ||
| further reading | 692 | ||
| Video | 692 | ||
| 28 Perineal care and repair | 693 | ||
| Learning outcomes | 693 | ||
| Key Terms | 693 | ||
| Introduction | 694 | ||
| Historical Perspectives | 694 | ||
| Midwives and Perineal Repair | 695 | ||
| Risk factors for perineal trauma | 696 | ||
| Preventing perineal trauma and improving second-stage comfort | 697 | ||
| Anatomy and Physiology of the Pelvic Floor | 697 | ||
| Pelvic peritoneum | 697 | ||
| Pelvic fascia | 699 | ||
| Deep muscle layer | 699 | ||
| Superficial muscle layer | 700 | ||
| The perineal body | 700 | ||
| Nerve, lymph and blood supply | 701 | ||
| Other | 701 | ||
| Perineal Trauma and Repair | 701 | ||
| Degrees of perineal trauma | 701 | ||
| Other types of trauma | 701 | ||
| Episiotomy | 701 | ||
| Infiltration of the perineum | 702 | ||
| Pelvic organ prolapse | 703 | ||
| To suture or not to suture? | 703 | ||
| Midwifery responsibilities when repairing perineal trauma | 704 | ||
| Inspecting the perineum following the birth | 704 | ||
| Protection for the midwife | 704 | ||
| Infiltration of the perineum with local anaesthetic | 704 | ||
| Suture material | 704 | ||
| Technique of repair | 705 | ||
| Undertaking the repair | 705 | ||
| Severe perineal trauma | 707 | ||
| Summary | 707 | ||
| Care of Women With Perineal Trauma in the Postnatal Period | 707 | ||
| Postpartum care of the woman with perineal trauma | 708 | ||
| Other useful tips | 708 | ||
| HIPPS | 708 | ||
| Urinary and faecal incontinence | 709 | ||
| Urinary incontinence | 709 | ||
| Faecal incontinence | 709 | ||
| Caesarean section | 709 | ||
| Pelvic floor muscle exercises | 710 | ||
| review questions | 711 | ||
| acknowledgements | 711 | ||
| references | 711 | ||
| further reading | 715 | ||
| 29 Physiological changes during the postnatal period | 716 | ||
| Learning outcomes | 716 | ||
| Key Terms | 716 | ||
| Introduction | 717 | ||
| Hormonal Changes | 717 | ||
| Involution of the Uterus | 717 | ||
| Changes to the myometrium | 717 | ||
| Shedding of the decidua | 718 | ||
| Regeneration of the endometrium | 718 | ||
| Afterpains | 718 | ||
| Postpartum Vaginal Blood Loss (Lochia) | 718 | ||
| Soft Tissue Healing | 719 | ||
| Cervix | 719 | ||
| Vagina and vulva | 719 | ||
| Renal System | 720 | ||
| Urinary tract | 720 | ||
| Cardiovascular System | 720 | ||
| Respiratory System | 721 | ||
| Gastrointestinal System | 721 | ||
| Lactogenesis | 721 | ||
| Return of Menstruation and Ovulation | 724 | ||
| Summary of Key Learning Points | 724 | ||
| review questions | 725 | ||
| online resources | 725 | ||
| references | 726 | ||
| further reading | 727 | ||
| acknowledgement | 725 | ||
| 30 Supporting women becoming mothers | 728 | ||
| Learning outcomes | 728 | ||
| Key Terms | 728 | ||
| Introduction | 729 | ||
| The Midwife and Postnatal Care | 729 | ||
| Summary | 730 | ||
| Assessment of Women’s Health | 730 | ||
| Phases of the postnatal period | 730 | ||
| Frameworks for Midwifery Care | 731 | ||
| Postnatal care in hospital | 731 | ||
| Postnatal care at home | 735 | ||
| Emotional Responses to Change | 735 | ||
| Birth stories | 736 | ||
| Hormonal influences or ‘baby blues’ | 736 | ||
| Summary | 736 | ||
| Physical Assessment of Maternal Health | 736 | ||
| Breasts and feeding | 737 | ||
| The uterus, blood loss and afterpains | 737 | ||
| Involution of the uterus | 737 | ||
| Vaginal blood loss | 738 | ||
| Afterpains | 739 | ||
| Bladder, bowel and perineal health | 739 | ||
| Bladder function | 739 | ||
| Bowel function | 740 | ||
| Perineal care | 740 | ||
| Nutrition and weight loss following birth | 740 | ||
| Cardiovascular health | 741 | ||
| Assessment for anaemia | 741 | ||
| Provision of anti-D gammaglobulin for Rhesus-negative women | 741 | ||
| Administration of rubella | 741 | ||
| Assessment for deep vein thrombosis | 741 | ||
| Regular exercise following birth | 742 | ||
| Assessment of General Health and Common Issues | 742 | ||
| Fatigue | 742 | ||
| Backache | 743 | ||
| Headaches | 743 | ||
| Summary | 743 | ||
| The Importance of Support After the Birth | 743 | ||
| review questions | 746 | ||
| online resources | 746 | ||
| references | 746 | ||
| further reading | 750 | ||
| 31 Transitions to motherhood | 751 | ||
| Learning outcomes | 751 | ||
| Key Terms | 751 | ||
| Introduction | 752 | ||
| Biosocial Needs of Infants | 752 | ||
| Attachment and Bonding with the Baby | 753 | ||
| Infant Transition | 755 | ||
| Women’s Transition to Parenthood | 756 | ||
| Mother readiness and transition | 758 | ||
| Men’s Transition to Parenthood | 758 | ||
| Fathers’ attendance at their baby’s birth | 759 | ||
| Transition to Parenthood | 760 | ||
| Supporting fathers’ transition to parenthood | 760 | ||
| review questions | 761 | ||
| online resource | 761 | ||
| references | 761 | ||
| further reading | 763 | ||
| 32 Supporting the newborn | 764 | ||
| Learning outcomes | 764 | ||
| Key Terms | 764 | ||
| Introduction | 765 | ||
| Antenatal influences | 765 | ||
| The Transition to Extrauterine Life | 765 | ||
| Physiological Transition Following Birth | 766 | ||
| Respiratory function | 766 | ||
| Lung fluid | 766 | ||
| First active breath | 767 | ||
| Cardiovascular transition | 767 | ||
| Pulmonary oxygenation of blood | 767 | ||
| Closure of the foramen ovale and the ductus arteriosus | 767 | ||
| Temperature regulation | 767 | ||
| Thermoregulation following birth | 767 | ||
| Impaired thermoregulatory control | 769 | ||
| Neonatal hypothermia | 769 | ||
| Neonatal hyperthermia | 769 | ||
| Haemopoietic system | 770 | ||
| Haemoglobin concentration | 770 | ||
| Physiological jaundice | 770 | ||
| Pathological jaundice | 770 | ||
| Red blood cells, haematocrit and leucocytes | 771 | ||
| Clotting factors and vitamin K synthesis | 771 | ||
| Vitamin K deficiency bleeding | 771 | ||
| Routine vitamin K prophylaxis | 771 | ||
| Dosage | 771 | ||
| Immunological adaptations | 772 | ||
| Renal system | 773 | ||
| Gastrointestinal system | 773 | ||
| Stomach | 773 | ||
| Liver | 773 | ||
| Glucose regulation | 773 | ||
| Neurological system | 773 | ||
| Examination of the Newborn | 774 | ||
| History | 774 | ||
| General rules for examining newborn babies | 775 | ||
| General measurements | 775 | ||
| Crown-to-heel length | 775 | ||
| Weight | 776 | ||
| Head circumference | 776 | ||
| Gestational age assessment | 776 | ||
| Temperature | 777 | ||
| Examination of specific areas | 778 | ||
| Lungs | 778 | ||
| Heart | 778 | ||
| Heart murmurs | 779 | ||
| Head | 779 | ||
| Positional plagiocephaly | 780 | ||
| Face | 780 | ||
| Eyes | 780 | ||
| Vision | 781 | ||
| Nose | 781 | ||
| Mouth | 781 | ||
| Ears | 781 | ||
| Hearing | 781 | ||
| Neck | 781 | ||
| Skin | 782 | ||
| Common skin variations | 782 | ||
| Chest | 784 | ||
| Umbilicus | 784 | ||
| Abdomen | 784 | ||
| Liver | 784 | ||
| Kidneys and bladder | 784 | ||
| Femoral pulses | 784 | ||
| Limbs | 785 | ||
| Upper limbs | 785 | ||
| Lower limbs | 785 | ||
| Spine and back | 785 | ||
| Genitalia | 785 | ||
| Female | 785 | ||
| Male | 785 | ||
| Ambiguous genitalia | 785 | ||
| Elimination | 785 | ||
| Neurological examination | 786 | ||
| Posture | 786 | ||
| Rooting, sucking and swallowing | 786 | ||
| Grasp reflexes | 786 | ||
| Traction response | 786 | ||
| Asymmetric tonic neck reflex | 786 | ||
| Moro reflex (startle reflex) | 787 | ||
| Stepping response | 787 | ||
| Hips | 787 | ||
| Symmetry of thigh and buttock creases, leg length | 787 | ||
| Abduction / adduction tests | 787 | ||
| Record of neonatal examination | 789 | ||
| Care of Newborn Infants | 789 | ||
| Development: birth to 6 weeks | 789 | ||
| Senses and perception | 789 | ||
| Vision | 790 | ||
| Hearing | 790 | ||
| Smell, taste and touch | 790 | ||
| Sleep–wake states | 790 | ||
| Crying | 790 | ||
| Ongoing care | 790 | ||
| Midwifery support and assessment until transfer of care to wellchild services | 790 | ||
| Information shared | 791 | ||
| Information from examination | 791 | ||
| Everyday assessment for mothers and midwives | 791 | ||
| The thriving baby | 791 | ||
| Possible tests | 791 | ||
| Newborn metabolic screening programs | 791 | ||
| Newborn metabolic screening test blood spot collection | 791 | ||
| Considering additional care | 793 | ||
| Other information shared | 793 | ||
| Warmth and hygiene | 793 | ||
| Immunisation | 793 | ||
| Prevention of injury or accident and reducing the risk of SUDI | 793 | ||
| Car safety | 795 | ||
| Discharge from midwifery care and transfer to well child services | 795 | ||
| review questions | 796 | ||
| online resources | 796 | ||
| Health ministries and departments | 796 | ||
| Other immunisation sites | 796 | ||
| Other sites | 797 | ||
| references | 797 | ||
| further reading | 801 | ||
| 33 Supporting the breastfeeding mother | 802 | ||
| Learning outcomes | 802 | ||
| Key Terms | 802 | ||
| Introduction | 803 | ||
| Breast Structure and Function | 803 | ||
| Breast structure | 803 | ||
| Physiology of lactation | 804 | ||
| Mammogenesis | 804 | ||
| Lactogenesis I | 804 | ||
| Lactogenesis II | 804 | ||
| Lactogenesis III | 805 | ||
| Weaning (involution) | 805 | ||
| Regulation of milk synthesis | 805 | ||
| Endocrine regulation | 805 | ||
| Prolactin | 805 | ||
| Oxytocin | 805 | ||
| Autocrine regulation | 806 | ||
| Feedback inhibitor of lactation | 806 | ||
| Breast-milk storage capacity | 807 | ||
| Benefits of breastfeeding | 807 | ||
| Infant morbidity and mortality | 807 | ||
| Intellectual and motor development | 807 | ||
| Long-term health outcomes | 808 | ||
| Maternal health outcomes | 808 | ||
| Composition of Breast Milk | 808 | ||
| Colostrum | 808 | ||
| Transitional breast milk | 809 | ||
| Mature breast milk | 809 | ||
| Foremilk / hindmilk compositional variations | 809 | ||
| Nutritional Properties of Breast Milk | 809 | ||
| Fats | 809 | ||
| Carbohydrates | 809 | ||
| Protein | 809 | ||
| Vitamins | 810 | ||
| Minerals | 810 | ||
| Protecting, Promoting and Supporting Breastfeeding | 810 | ||
| Global initiatives to protect breastfeeding | 810 | ||
| International code of breast-milk substitutes | 810 | ||
| The WHO Code in Australia and New Zealand | 811 | ||
| International Baby Food Action Network | 811 | ||
| The Ten Steps to Successful Breastfeeding | 811 | ||
| Innocenti Declaration | 811 | ||
| Breastfeeding policy in Australia and New Zealand | 812 | ||
| Baby Friendly Health Initiative | 812 | ||
| BFHI in Australia and New Zealand | 812 | ||
| Breastfeeding Community Initiative | 812 | ||
| Preparation for Breastfeeding | 813 | ||
| Variables influencing breastfeeding outcome | 813 | ||
| Breastfeeding education and midwifery support | 815 | ||
| Breastfeeding education | 816 | ||
| Positioning and attachment | 816 | ||
| Infant-led attachment | 817 | ||
| Biological nurturing | 819 | ||
| Effective milk transfer | 819 | ||
| Initiation of Breastfeeding | 820 | ||
| Natural rhythm of breastfeeding | 820 | ||
| Variations in breastfeeding frequency | 821 | ||
| Exclusive breastfeeding | 821 | ||
| Supplementation and pacifier use | 821 | ||
| Breastfeeding Assessment | 821 | ||
| Infant urine output | 822 | ||
| Infant bowel habits | 822 | ||
| Infant weight assessment | 822 | ||
| Management of Breastfeeding Challenges | 822 | ||
| Nipple pain and trauma | 823 | ||
| Breast engorgement | 824 | ||
| Blocked milk ducts | 824 | ||
| Lactational breast inflammation | 825 | ||
| Flat or inverted nipples | 825 | ||
| Insufficient milk supply | 825 | ||
| Ankyloglossia (tongue tie) | 827 | ||
| The premature infant | 827 | ||
| Breastfeeding multiples | 829 | ||
| Employment outside of the home | 830 | ||
| Donor milk and human milk banking | 830 | ||
| Breastfeeding in an emergency | 830 | ||
| Contraindications to breastfeeding | 831 | ||
| Considerations of infant formula | 831 | ||
| review questions | 832 | ||
| online resources | 833 | ||
| references | 833 | ||
| 34 Completing the midwife–woman partnership | 842 | ||
| Learning outcomes | 842 | ||
| Key Terms | 842 | ||
| Introduction | 843 | ||
| The Woman’s Health | 843 | ||
| Concluding the partnership | 844 | ||
| Physical assessment | 844 | ||
| Emotional health | 845 | ||
| Spiritual and cultural health | 846 | ||
| Family violence screening | 847 | ||
| Sexual health | 847 | ||
| Contraception, sexuality and sexual function | 847 | ||
| When should contraception begin again? | 848 | ||
| Well woman referral | 848 | ||
| Cervical screening | 848 | ||
| The Baby’s Health | 849 | ||
| Full physical examination of the baby | 849 | ||
| Infant feeding | 850 | ||
| Unsettled behaviours | 851 | ||
| Vaccination and immunisation | 851 | ||
| Well child referral | 852 | ||
| Documentation: Health Record | 853 | ||
| Retention of documentation | 853 | ||
| Midwifery Standards Review | 853 | ||
| review questions | 854 | ||
| online resources | 854 | ||
| references | 855 | ||
| 35 Pharmacology and prescribing | 858 | ||
| Learning outcomes | 858 | ||
| Key Terms | 858 | ||
| Introduction | 859 | ||
| Scope of Midwifery Prescribing | 859 | ||
| Safety of Drugs during Pregnancy and Lactation | 860 | ||
| Principles of Pharmacology | 860 | ||
| Pharmacokinetics | 861 | ||
| Absorption | 861 | ||
| Distribution | 861 | ||
| Hepatic portal system | 861 | ||
| General circulation | 861 | ||
| Metabolism and excretion | 862 | ||
| Bioavailability | 862 | ||
| Plasma concentration | 862 | ||
| Therapeutic range | 862 | ||
| Half-life | 862 | ||
| Steady-state concentration | 862 | ||
| Pharmacodynamics | 863 | ||
| Antimicrobials | 863 | ||
| Bacterial resistance | 864 | ||
| Spectrum of activity | 864 | ||
| Adverse reactions | 864 | ||
| Types of antimicrobials | 864 | ||
| Beta-lactam antibiotics | 864 | ||
| Penicillins | 865 | ||
| Narrow-spectrum beta-lactamase-resistant penicillins | 865 | ||
| Extended-spectrum penicillins | 865 | ||
| Cephalosporins | 866 | ||
| Macrolide antibiotics | 866 | ||
| Nitrofurantoin | 866 | ||
| Trimethoprim | 866 | ||
| Metronidazole | 867 | ||
| Antivirals: aciclovir | 867 | ||
| Aminoglycosides | 867 | ||
| Topical antibiotics in relation to neonates | 867 | ||
| Commonly Administered Drugs and Conditions Associated with Childbirth | 867 | ||
| Oxytocin | 868 | ||
| Local anaesthetic: lignocaine hydrochloride (lidocaine) | 868 | ||
| Tocolytic drugs | 868 | ||
| Non-steroidal anti-inflammatory drugs | 869 | ||
| Codeine | 869 | ||
| Topical treatment for haemorrhoids | 869 | ||
| Lactulose | 870 | ||
| Antiemetic drugs | 870 | ||
| Folic acid | 870 | ||
| Iron supplementation (anaemia) | 870 | ||
| Why iron is important | 871 | ||
| Potential hazards of excess iron supplementation | 871 | ||
| Interpreting blood indices to diagnose iron deficiency and IDA | 871 | ||
| Haemoglobin (Hb) | 871 | ||
| Mean cell volume (MCV) and mean cell haemoglobin (MCH) | 871 | ||
| Serum ferritin | 871 | ||
| Iron studies or additional tests | 872 | ||
| How much supplementation is required? | 872 | ||
| Recommended midwifery practice | 872 | ||
| Postpartum anaemia | 873 | ||
| Medical prescribing of intramuscular and intravenous iron therapy | 873 | ||
| Antacids | 874 | ||
| Recommended prescribing | 874 | ||
| Thrush (candidiasis or moniliasis) | 874 | ||
| Vaginal thrush | 874 | ||
| Recommended prescribing | 875 | ||
| Thrush on nipples | 875 | ||
| Neonatal candidiasis | 875 | ||
| Urinary tract infection | 875 | ||
| Recommended assessment, diagnosis and prescribing | 876 | ||
| Asymptomatic bacteriuria | 876 | ||
| Symptomatic UTI in pregnancy | 876 | ||
| Antibiotics that can be used for UTI (these are not in order of preference) | 877 | ||
| Sexually transmitted infections (STIs) | 877 | ||
| Treatment for STIs | 877 | ||
| Chlamydia | 878 | ||
| Trichomoniasis | 878 | ||
| Gonorrhoea | 878 | ||
| Human immune-deficiency virus (HIV) | 878 | ||
| Mastitis | 878 | ||
| Recommended practice re assessment, diagnosis and prescribing | 878 | ||
| Postpartum sepsis / endometritis | 879 | ||
| Lower-segment caesarean-section wound infection | 879 | ||
| Postpartum Contraception | 880 | ||
| Progestogen-only pill (progestin-only oral contraception) | 880 | ||
| Assessment and prescribing recommendations | 880 | ||
| Combined oral contraceptive (COC) / combined hormonal contraceptive (CHC) | 880 | ||
| Assessment and prescribing recommendations | 881 | ||
| Injectable progestogen contraceptive | 881 | ||
| Rules for Writing Prescriptions | 881 | ||
| 39 Conditions under which authorised NZ prescribers may prescribe prescription medicines | 882 | ||
| What does this mean? | 882 | ||
| Form of prescription NZ (Medicines Regulation 1984: Reprint as at 1 July 2013, Part 7, 40) | 882 | ||
| Writing a prescription NZ (note that controlled drug prescription has additional requirements) | 883 | ||
| Practicalities | 883 | ||
| What is the law regarding oral communication of a prescription in New Zealand? | 883 | ||
| Application to practice situation | 884 | ||
| Why was the legislation changed to include the telephone number of the prescriber and why is there a need for a postal address? | 884 | ||
| What is the period of supply for prescriptions? | 884 | ||
| Requirement from the Section 88 Primary Maternity Services Notice (2007) NZ | 884 | ||
| CB13 practitioners to include the required information on all prescriptions and referrals | 884 | ||
| Pharmacist’s role within NZ | 884 | ||
| review questions | 885 | ||
| online resources | 885 | ||
| references | 886 | ||
| Statutes (NZ) | 889 | ||
| Statutes (Australia) | 890 | ||
| further reading | 890 | ||
| 36 Contraception | 891 | ||
| Learning outcomes | 891 | ||
| Key Terms | 891 | ||
| Introduction | 892 | ||
| Contraception Counselling: the Role of the Midwife | 892 | ||
| Natural Methods of Contraception | 895 | ||
| Lactational amenorrhoea method | 895 | ||
| Fertility-awareness-based methods (FABM) | 896 | ||
| Calendar-based methods | 896 | ||
| Symptoms-based methods | 897 | ||
| Basal body temperature (BBT) | 897 | ||
| Breastfeeding considerations | 897 | ||
| Postpartum considerations | 897 | ||
| Barrier Methods | 897 | ||
| Male condom | 897 | ||
| Breastfeeding considerations | 898 | ||
| Postpartum considerations | 898 | ||
| Female condom (FC2) | 898 | ||
| Photo Credits | 1224 | ||
| Index | 1226 | ||
| A | 1226 | ||
| B | 1228 | ||
| C | 1230 | ||
| D | 1233 | ||
| E | 1234 | ||
| F | 1236 | ||
| G | 1237 | ||
| H | 1238 | ||
| I | 1239 | ||
| J | 1241 | ||
| K | 1241 | ||
| L | 1241 | ||
| M | 1243 | ||
| N | 1246 | ||
| O | 1249 | ||
| P | 1249 | ||
| Q | 1254 | ||
| R | 1254 | ||
| S | 1255 | ||
| T | 1258 | ||
| U | 1259 | ||
| V | 1259 | ||
| W | 1260 | ||
| X | 1261 | ||
| Y | 1261 | ||
| Z | 1261 |