The midwife's labour and birth handbook

Praise for previous editions:

"An excellent resource for both student midwives and qualified staff alike." (Alison James, Midwifery Lecturer, Plymouth University)

" A lovely book with a lot of practical advice and easy to navigate . (Jayne Samples, Midwifery Lecturer, University of Huddersfield)

This fully revised and updated third edition of The Midwife's Labour and Birth Handbook is a practical and accessible guide to midwifery care.

It addresses important questions such as:

Why are women being pressured into caesarean section for breech presentation when the evidence is equivocal? If a baby needs assisted ventilation breaths at birth, why not bring the ambubag to the baby and leave the cord intact so the baby can benefit from the extra maternal oxygen supply? Why is skin-to-skin contact at birth so rarely offered to preterm babies when there is evidence of benefit?

This well-regarded text promotes normality and woman-centred care, using research, evidence-based guidelines and anecdotal accounts from women. It challenges practice and guidelines which are biased or based on poor evidence. Guidance is offered on how to deal with difficult, sometimes controversial, situations.

The Midwife's Labour and Birth Handbook 3rd edition is an essential guide for both student midwives and experienced practising midwives.

New to this edition:

Full colour photographs including a kneeling breech birth Suturing diagrams to assist left-handed midwives. Expanded chapters on slow progress in labour and malposition/malpresentations, including a rare photograph of a face presentation birth.

• Preface p. xiii
• Contributors p. xv
• 1 Labour and normal birth p. 1 Cathy Charles
• Introduction p. 1
• The birth environment p. 3
• Signs that precede labour p. 5
• First stage of labour p. 6
• Second stage of labour p. 18
• Pushing p. 20
• The birth p. 22
• Third stage of labour p. 25
• After the birth p. 30
• Summary p. 31
• Useful contacts and information p. 32
• References p. 32
• 2 Vaginal examinations and artificial rupture of the membranes p. 39 Vicky Chapman
• Vaginal examinations p. 39
• Accuracy and timing of VEs p. 40
• Consent or compliance? p. 41
• Performing a VE p. 42
• Some common problems p. 45
• Artificial rupture of the membranes p. 47
• Summary p. 49
• References p. 49
• 3 Fetal heart rate monitoring in labour p. 52 Bryony Read
• Introduction p. 52
• Intermittent auscultation p. 52
• Electronic fetal monitoring p. 54
• Fetal scalp electrode p. 56
• Classification of fetal heart rate features p. 56
• Positive and negative aspects of EFM p. 59
• Summary p. 60
• References p. 61
• Appendix: Continuous EFM algorithm (NICE, 2007) p. 63
• 4 Perineal trauma and suturing p. 64 Vicky Chapman
• Introduction p. 64
• Reducing perineal trauma p. 65
• Assessment of perineal trauma p. 66
• First and second degree tears: to suture or not to suture? p. 67
• Suturing procedure p. 69
• Summary p. 82
• Recommended reading p. 82
• References p. 82
• 5 Examination of the newborn baby at birth p. 86 Caroline Rutter
• Introduction p. 86
• The midwife's assessment of the baby at birth p. 87
• Measurements of the newborn p. 89
• Vitamin K prophylaxis p. 90
• Top-to-toe check p. 91
• Neonatal infection p. 96
• Giving upsetting news to parents p. 98
• Useful contacts p. 99
• References p. 99
• 6 Home birth p. 102 Janet Gwillim and Cathy Charles
• Introduction p. 102
• Benefits of home birth p. 103
• Issues to consider before choosing home birth p. 104
• Preparing for a home birth p. 106
• Care in labour p. 108
• Possible transfer to hospital p. 112
• Summary p. 115
• Useful contacts p. 115
• References p. 115
• 7 Water for labour and birth p. 117 Cathy Charles
• Introduction p. 117
• Benefits of warm water immersion p. 118
• Possible risks of warm water immersion p. 119
• Criteria for labouring in water p. 120
• Relative contraindications p. 120
• Preparation p. 121
• Labour care p. 123
• Possible problems p. 125
• Summary p. 127
• Useful contacts p. 128
• Recommended reading p. 128
• References p. 128
• 8 Malpositions and malpresentations in labour p. 130 Vicky Chapman
• Introduction p. 130
• Definitions p. 130
• Occipitoposterior position p. 133
• Face presentation p. 140
• Brow presentation p. 141
• Transverse lie (shoulder presentation) p. 142
• Summary p. 143
• References p. 144
• 9 Slow progress in labour p. 146 Vicky Chapman
• Introduction p. 146
• Prolonged labour p. 147
• Causes of a prolonged labour p. 148
• Prolonged latent phase p. 149
• Prolonged active first stage p. 150
• Prolonged second stage p. 153
• Summary p. 155
• Recommended reading p. 156
• References p. 156
• 10 Assisted birth: ventouse and forceps p. 160 Cathy Charles
• Introduction p. 160
• Avoiding an instrumental delivery p. 161
• Indications for an instrumental delivery p. 161
• Types of instrument p. 162
• Choice of instrument p. 162
• Care of a woman undergoing instrumental delivery p. 163
• Assisting at an instrumental delivery p. 166
• Midwife instrumental delivery p. 167
• Post-birth discussion and care p. 172
• Summary p. 174
• References p. 174
• Appendix 10.1 Midwife ventouse practitioner log book record p. 177
• Appendix 10.2 Decision to decline midwife ventouse delivery p. 178
• 11 Caesarean section p. 179 Cathy Charles
• Introduction p. 179
• Risks and benefits of CS p. 180
• Stemming the flow p. 182
• Indications for elective CS p. 183
• The experience of CS p. 183
• Elective CS birth plan p. 184
• Midwifery care for CS p. 184
• Summary p. 189
• Support groups for women following CS p. 190
• Further reading p. 190
• References p. 190
• 12 Vaginal birth after caesarean section p. 193 Vicky Chapman
• Introduction p. 193
• The influence and opinions of professionals p. 194
• VBAC or elective CS p. 194
• What improves the success rate in VBAC? p. 196
• Induction of labour for VBAC p. 196
• Midwifery care for VBAC labour p. 197
• Summary p. 201
• References p. 201
• 13 Preterm birth p. 204 Charlise Adams
• Introduction p. 204
• Incidence and facts p. 205
• Causes and associated factors of preterm birth p. 206
• Place of delivery p. 206
• Preterm prelabour rupture of membranes (PPROM) p. 206
• Corticosteroids for threatened preterm birth p. 208
• Tocolysis in threatened preterm labour p. 208
• Monitoring the fetal heart in preterm labour p. 209
• Midwifery care p. 209
• Mode of delivery p. 210
• Care immediately after birth p. 211
• Skin-to-skin contact p. 212
• Resuscitation p. 213
• Care related to specific types of preterm labour p. 214
• Postnatal care p. 215
• Summary p. 216
• Useful contacts p. 217
• References p. 217
• 14 Breech birth p. 220 Lesley Shuttler
• Introduction p. 220
• Types of breech presentation p. 221
• Women's options and the provision of care p. 223
• Concerns and possible complications with a breech birth p. 225
• Labour and birth p. 226
• Summary p. 236
• Useful contacts p. 236
• Recommended reading p. 236
• References p. 236
• 15 Twins and higher-order births p. 240 Jo Coggins
• Introduction p. 240
• Place of delivery p. 241
• Mode of delivery p. 241
• Care in labour p. 243
• Third stage of labour p. 246
• Care after the birth p. 248
• Summary p. 249
• Useful contacts p. 249
• References p. 249
• 16 Haemorrhage p. 252 Sheila Miskelly
• Introduction p. 252
• Placenta praevia p. 253
• Vasa praevia p. 255
• Placental abruption p. 255
• Postpartum haemorrhage p. 260
• The 4Ts: Tone, Tissue, Trauma, Thrombophilias p. 261
• Retained placenta p. 265
• Summary p. 267
• References p. 268
• 17 Emergencies in labour and birth p. 271 Sheila Miskelly
• Introduction p. 271
• Snapped cord p. 272
• Cord prolapse and cord presentation p. 272
• Amniotic fluid embolism p. 274
• Uterine rupture p. 276
• Shoulder dystocia p. 278
• Inverted uterus p. 284
• Maternal collapse/shock p. 286
• Summary p. 287
• References p. 288
• 18 Neonatal and maternal resuscitation p. 292 Nick Castle
• Introduction p. 292
• Risk management: anticipation p. 293
• Basic neonatal resuscitation p. 293
• Ongoing neonatal resuscitation/complications p. 297
• Maternal resuscitation p. 301
• Summary p. 304
• References p. 304
• 19 Induction of labour p. 306 Mary-Lou Elliott
• Introduction p. 306
• Risks and side effects p. 307
• Information giving and informed consent p. 308
• Determining expected date of delivery (EDD) p. 308
• IOL for social reasons p. 309
• Induction for post-term pregnancy p. 309
• IOL versus expectant management for PROM at term p. 309
• Assessing the cervix p. 310
• Methods of induction p. 310
• Care of a woman during IOL p. 313
• Summary p. 315
• Recommended reading p. 316
• References p. 316
• 20 Pre-eclampsia p. 318 Annette Briley
• Introduction p. 318
• Signs and symptoms p. 321
• Care during labour p. 323
• Monitoring the maternal and fetal condition in moderate/severe pre-eclampsia p. 324
• Drugs used in the treatment of severe hypertension p. 326
• Management of eclampsia p. 327
• Care during/following an eclamptic fit p. 328
• HELLP syndrome p. 330
• Summary p. 332
• Useful resources p. 333
• References p. 333
• 21 Stillbirth and neonatal death p. 336 Barbara Kavanagh and Cathy Charles
• Introduction p. 336
• Definition p. 337
• Incidence and facts p. 337
• Causes and predisposing factors for perinatal death p. 337
• Diagnosing fetal death and decision making p. 338
• Midwifery care in labour following intrauterine death p. 341
• Neonatal death and unexpected death at/after birth p. 342
• Immediate care following stillbirth/NND: precious moments with the baby p. 343
• Ongoing postnatal care p. 345
• Supporting staff p. 349
• Summary p. 350
• Useful contacts p. 350
• References p. 350
• Appendix: Checklist following a pregnancy loss after 24 weeks p. 353
• 22 Risk management, litigation and complaints p. 355 Cathy Charles
• Introduction p. 355
• Clinical risk management: learning from adverse events p. 356
• Litigation p. 357
• Vicarious liability of employer p. 358
• Clinical risk management organisations p. 359
• Records p. 359
• Complaints p. 360
• Writing a statement p. 360
• Caring for the mother or father following an adverse event p. 361