Myles Textbook for Midwives

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Individuals from other disciplines who teach in the midwifery programme are competent in the content they teach. 5. Midwife teachers provide education, support and supervision of individuals who teach students in practical learning sites. 6. Midwife teachers and midwife clinical preceptors/ clinical teachers work together to support (facilitate), directly observe and evaluate students’ practical learning. 7. The ratio of students to teachers and clinical preceptors/clinical teachers in classroom and practical sites is determined by the midwifery programme and the requirements of regulatory authorities. 8. The effectiveness of midwifery faculty members is assessed on a regular basis following an established process. SECTION 1 The midwife in context 1 The midwife in contemporary midwifery practice...................................... 3 2 Professional issues concerning the midwife and midwifery practice..............25

SECTION 3 Pregnancy 8 Antenatal education for birth and parenting.................................................127 Amanda Sullivan, BA(Hons) PGDip PhD RM RGN Director of Quality and Governance for NHS Nottinghamshire County, NHS Nottinghamshire County, Mansfield, Nottinghamshire, UK Chapter 11 Antenatal screening of the mother and fetus Over 500 multiple-choice questions enable students to test their knowledge. • Full image bank of illustrations to make study more visual and assist with projects. SECTION 2 Human anatomy and reproduction 3 The female pelvis and the reproductive organs..................................55 4 The female urinary tract........................... 81 5 Hormonal cycles: fertilization and early development.................................... 91 6 The placenta............................................ 101 7 The fetus...................................................111

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Myles Textbook for Midwives Elsevier eBook on Vitalsource, 17th Edition : Myles Textbook for Midwives Elsevier eBook on Vitalsource Moira McLean, RGN RM ADM PGCEA PGDIP SOM Senior Lecturer – Midwifery and Supervisor of Midwives, School of Nursing and Midwifery, De Montfort University, Leicester, UK Chapter 13 Medical conditions of significance to midwifery practice The book covers key frameworks that govern midwifery practice, exploring ethical and legal frameworks that are essential to every accountable, autonomous, professional midwife. Preface It is a great privilege to have been approached by Elsevier to undertake the editorship of the sixteenth edition of Myles Textbook for Midwives. It is over 60 years since the Scottish midwife Margaret Myles wrote the first edition and this book remains highly regarded as the seminal text for student midwives and practising midwives alike throughout the world. Over the ensuing decades, many changes have taken place in the education and training of future midwives alongside increasing demands and complexities associated with the health and wellbeing of childbearing women, their babies and families within a global context. Furthermore, the development of evidence-based practice and advances in technology have also contributed to major reviews of how undergraduate midwifery curricula are delivered to ensure that today’s graduate midwives are able to rise to the many challenges of the midwife’s multi-faceted role: being fit for both practice and purpose. It is with these issues in mind that the sixteenth edition of Myles has been developed as, without a doubt, women expect midwives to provide safe and competent care that is tailored to their individual needs, with a professional and compassionate attitude. The content and format of this edition of Myles has been developed in response to the collated views from students and midwives regarding the fifteenth edition. Midwifery practice clearly should always be informed by the best possible up-to-date evidence and, whilst it is acknowledged that it is impossible to expect any new text to contain the most contemporary of research and systematic reviews, this edition provides the reader with annotated further reading and appropriate websites in addition to comprehensive reference lists. There has been a major revision of chapters, which have been streamlined and structured into reflect similar themes and content. Throughout its history, Myles Textbook for Midwives has always included clear and comprehensible illustrations to compliment the text. In this sixteenth edition, full colour has been used throughout the book, and new diagrams have been added where appropriate. It is pleasing that a number of chapter authors have continued their contribution to successive editions of this pivotal text and we also welcome the invaluable contributions from new authors. Whilst it is vital to retain the ethos of the text being a textbook for midwives that is written by midwives with the appropriate expertise, it is also imperative that it reflects the eclectic nature of maternity care and thus, some of the chapters have been written in collaboration with members of the multiprofessional team. This clearly demonstrates the importance of health professionals working and learning together in order to enhance the quality of care women and their families receive, especially when complications develop in the physiological process throughout the childbirth continuum. The presence of the midwife is integral to all clinical situations and the role is significant in ensuring the woman always receives the additional care required from the most-appropriate health professional at the most-appropriate time. A significant change has been to the first section of the text where content from the final section has been included. From an international perspective, we believe that issues such as the globalization of midwifery education and practice, best depicted by the Millennium Development Goals, professional regulation and midwifery supervision, legal and ethical issues as well as risk management and clinical governance are fundamental to every midwife practising in the twenty-first century and should therefore be given more prominence. We acknowledge that medicalization and the consequential effect of a risk culture in the maternity services have eroded some aspects of the

SECTION 4 Labour 15 Care of the perineum, repair and female genital mutilation........................311 16 Physiology and care during the first stage of labour........................................327 17 Physiology and care during the transition and second stage phases of labour..................................................367 18 Physiology and care during the third stage of labour........................................395 19 Prolonged pregnancy and disorders of uterine action..................................... 417 20 Malpositions of the occiput and malpresentations....................................435 21 Operative births......................................455 22 Midwifery and obstetric emergencies.............................................475 Content Strategist: Mairi McCubbin Content Development Specialist: Carole McMurray Project Manager: Caroline Jones Designer/Design Direction: Miles Hitchen Illustration Manager: Jennifer Rose Illustrator: Antbits Change and adaptation in pregnancy................................................143 10 Antenatal care.........................................179 11 Antenatal screening of the mother and fetus..................................................203 12 Common problems associated with early and advanced pregnancy............... 221 13 Medical conditions of significance to midwifery practice..............................243 14 Multiple pregnancy.................................287 Elsevier Ltd. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). First edition 1953 Second edition 1956 Third edition 1958 Fourth edition 1961 Fifth edition 1964 Sixth edition 1968 Seventh edition 1971 Eighth edition 1975 Stephen P Wardle, MB ChB MD FRCPCH Consultant Neonatologist, Neonatal Intensive Care Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK Chapter 33 Significant problems in the newborn baby

Lccn 98048703 Ocr tesseract 4.1.1 Ocr_detected_lang en Ocr_detected_lang_conf 1.0000 Ocr_detected_script Latin Ocr_detected_script_conf 0.9730 Ocr_module_version 0.0.7 Ocr_parameters -l eng Old_pallet IA400058 Openlibrary_edition Consultant Obstetrician and Urogynaecologist, Department of Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK Chapter 3 The female pelvis and the reproductive organs Chapter 15 Care of the perineum, repair and female genital mutilation Maureen D Raynor, MA PGCEA ADM RMN RN RM Lecturer and Supervisor of Midwives, Academic Division of Midwifery, School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK Chapter 1 The midwife in contemporary midwifery practice Chapter 2 Professional issues concerning the midwife and midwifery practice Chapter 15 Care of the perineum, repair and genital mutilation Chapter 25 Perinatal mental health Foreword The strength and longevity of Myles Textbook for Midwives lies in its ability to juxtapose continuity and change from the first edition in 1953 to this sixteenth edition, over 60 years later. In continuity, some of the excellent early illustrations have been replicated throughout the editions. These provide clarity of understanding of essential anatomy for students. Changes of and additional colours in this edition have made a dramatic improvement to this clarity. In addition the clearly set out sections, chapter titles and index, aid systematic learning as well as facilitating easy reference when a new situation is encountered in practice. Of equal importance is how this text demonstrates the changes that have taken place in midwifery practice. Unlike the early editions, when midwives relied on one textbook and teachers alone, this sixteenth edition draws together theory, current practices, research and best evidence. In contrast to the first edition where Myles, in the Preface,wrote: ‘No bibliographical references have been given because of the vast number of sources which have been tapped in compiling the text (by Margaret Myles herself) and because pupil midwives become confused when they study from more than one or two textbooks’, this edition signposts students to further resources to increase their depth and breadth of knowledge. This is essential as no textbook can capture all the information needed for contemporary midwifery practice. In all editions the needs of women and their families have been central and this edition continues to emphasize the emotional, socio-economic, educational and physical needs of women during the life changing experience of pregnancy and parenthood, or bereavement. These events have a lasting impact on women’s lives. Of importance is always how well women are listened to and involved in making decisions about their or their babies’ care. Running through this edition is an emphasis on the need for midwives to be emotionally aware and develop good communication and interpersonal relationships with women, their partners and colleagues in the interdisciplinary team. The midwife has a key role to play in assisting women to make choices and feel in control, even when presented with difficult options and dilemmas. This text demonstrates the midwife’s role as lead professional when pregnancy is straightforward and co-ordinator of care when others need to be involved. The maternity services have seen major changes in recent years, in particular the massive increase in the birth rate, the changing demographics of women who become pregnant and the politics surrounding childbirth. Section One effectively brings together the issues that midwives need to understand, not just during their education programme, but also as part of their future responsibility in helping to bring about improvements in maternity care both in the UK and internationally. The vision for UK midwifery set out in Midwifery 2020 (Midwifery 2020 UK Programme, 2010) and the global initiatives of the International Confederation of Midwives are well summarized. Whilst Margaret Myles in her first 10 editions drew upon the knowledge of obstetricians and paediatricians in England and Scotland, she wrote the entire book herself. Recent edited editions demonstrate the need to draw upon the expertise of other midwives and health professionals in chapter writing. Thakar’s and Sultan’s inclusion of diagrams and photographs of perineal anatomy and trauma in chapter three are very timely given the increasing number of students who now learn to suture. These will help understanding of the importance of accurate diagnosis and effective perineal repair to aid women’s physical and emotional recovery. The value of antenatal education has been emphasized since the inception of this textbook, yet today not all women or their partners attend. Mary Nolan stresses the importance of sessions to be women-centred and expertly facilitated, not lecture based. She reminds readers that many women

For this edition several new chapters are introduced covering concealed pregnancy, fear of childbirth (tocophobia), care of the acutely unwell woman and end of life issues including rights of the fetus/neonate and ethical considerations. Cecily Begley, MSc MA PhD RGN RM RNT FFNRCSI FTCD Professor of Nursing and Midwifery, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland Chapter 18 Physiology and care during the third stage of labour Physiology and care during the puerperium..............................................499 24 Physical health problems and complications in the puerperium.......... 515 25 Perinatal mental health.......................... 531 26 Bereavement and loss in maternity care...........................................................555 27 Contraception and sexual health in a global society.......................................569III Student body 1. The midwifery programme has clearly written admission policies that are accessible to potential applicants. These policies include: a. entry requirements, including minimum requirement of completion of secondary education; b. a transparent recruitment process; c. selection process and criteria for acceptance; and d. mechanisms for taking account of prior learning. 2. Eligible midwifery candidates are admitted without prejudice or discrimination (e.g., gender, age, national origin, religion). 3. Eligible midwifery candidates are admitted in keeping with national health care policies and maternity workforce plans. 4. The midwifery programme has clearly written student policies that include: a. expectations of students in classroom and practical areas; b. statements about students’ rights and responsibilities and an established process for addressing student appeals and/or grievances; c. mechanisms for students to provide feedback and ongoing evaluation of the midwifery curriculum, midwifery faculty, and the midwifery programme; and d. requirements for successful completion of the midwifery programme. 5. Mechanisms exist for the student’s active participation in midwifery programme governance and committees. 6. Students have sufficient midwifery practical experience in a variety of settings to attain, at a minimum, the current ICM Essential Competencies for basic midwifery practice. the increased interconnectedness and interdependence of people and countries, is generally understood to include two interrelated elements: the opening of borders to increasingly fast flows of goods, services, finance, people and ideas across international borders; and the changes in institutional and policy regimes at the international and national levels that facilitates or promote such flows. Globalization is not without its critics but it is acknowledged that the consequences of globalization are not predetermined and can have both positive and negative outcomes (Baumann and Blythe 2008). It is essential therefore to have an awareness of both the good and harm globalization may impose on a society. Conversely, internationalization has no agreed definition but from a midwifery perspective it can be defined as the international process of planning and implementing midwifery education and services in order that there is a shared vision that can easily be translated or adapted to meet the local and national needs of individual nations in both resource-rich and resource-poor countries. Internationalization is important for the midwifery profession because in a global society midwives are required to have a broad understanding of cross-cultural issues. They need to be flexible and adaptable in order to provide care that is sensitive and responsive to women’s dynamic healthcare needs. This requires the midwife to be an effective change agent, and the onus is very much on the midwife to keep pace with change. This means having a good comprehension of internationalization, learning to deal with uncertainty, embracing the ethos of life-long learning as well as the gains and challenges of interprofessional or multidisciplinary collaboration, contributing to quality assurance issues such as audit, research, risk assessment and the wider clinical governance agenda. Even though skills of problem-solving, clinical judgement, decision-making and clinical competence in the practical Edited by Jayne E. Marshall, FRCM, PFHEA, PhD, MA, PGCEA, ADM, RM, RN, Foundation Professor of Midwifery and NMC Lead Midwife for Education, School of Allied Health Professions, College of Life Sciences, George Davies Centre, University of Leicester, UK