The practising midwife
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Significant fear of birth (tocophobia) appears to be increasing, coinciding with an increase in requests for non-medical indication caesarean section. It can arise from previous birth trauma, or be present in late childhood or early adulthood prior to pregnancy. This article explores some of its origins, presentations, effects and the importance of using a midwifery model of care with referral to specialist services as appropriate, to facilitate a positive birth experience which will enhance the woman's wellbeing and family life.
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Maternal request for caesarean section in the absence of medical need is an ethical and moral dilemma for the NHS. When a woman makes such a request it requires careful exploration of the underlying motivation. Many of these women will be anxious or fearful of giving birth and require tailored support. The provision of an antenatal pathway that acknowledges these fears, focuses on enabling coping mechanisms and supports shared decision making can reduce the number of requests for a caesarean.
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Over the past decade, the numbers of women seeking asylum in the United Kingdom (UK) and requiring midwifery care have increased significantly (Office for National Statistics (ONS) 2012). This article describes findings from a small study that explored the experiences of midwives caring for asylum seeking women. ⋯ Caring for these women was emotionally challenging and at times frustrating due to poor access to information and support. In conclusion, whilst considerable knowledge and skills were required to care for this vulnerable group, these appeared to be learned almost solely 'on the job': Implications for service delivery and education are explored and recommendations made to improve experiences for women and midwives.
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The practising midwife · Jan 2014
Multiple-micronutrient supplementation for women during pregnancy.
The aim of this bi-monthly column is to highlight Cochrane Systematic Reviews of relevance to pregnancy and childbirth and to stimulate discussion on the relevance and implications of the review for practice. The Cochrane Collaboration is an international organisation that prepares and maintains high quality systematic reviews to help people make well-informed decisions about healthcare and health policy. ⋯ The Cochrane Database of Systematic Reviews (CDSR) is published monthly online. Residents in countries with a national licence to The Cochrane Library, including the UK and Ireland, can access the Cochrane Library online, free of charge, through www.thecochranelibrary.com.