Women and Birth RSS feed: Current Issue. Women and Birth publishes on all matters that affect women and birth, from pre-conceptual counselling, through pregnancy, birth, and early parenting. We are interested in articles on issues relevant to the full scope of midwifery practice as defined by the International Confederation of Midwives (2005). We are also concerned with the longer term health effects of childbearing for women and babies. Our woman-centred focus is inclusive of the woman's baby, unborn , newborn and infant, both well and ill, and covers both normal and complex pregnancies. The Journal seeks papers from midwives, other health professionals, consumers and scholars from other disciplines who have a contribution to make to our understanding of matters affecting women and birth. Sociologists, anthropologists, economists and historians are also invited to submit papers. The types of papers we will consider include research reports, both qualitative and quantitative, methodology papers, theoretical and philosophical papers, case studies and literature reviews. Clinical practice updates, opinion pieces and book reviews may also be submitted for consideration To purchase books on Midwifery or to browse our comprehensive range of Midwifery titles, please visit us at shop.elsevier.com.au. For a limited time we are offering 10% discount and free freight to all ANZ orders. Shop.elsevier.com.au/Midwifery http://www.womenandbirth.org/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Women and Birth1871-5192233September 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.womenandbirth.org/article/PIIS1871519210000491/abstract?rss=yesContents Page10.1016/S1871-5192(10)00049-1Women and Birth 23, 3 (2010)2010-09-01Women and Birth2010-09-01233S1871-5192(10)X0004-Xiiiihttp://www.womenandbirth.org/article/PIIS1871519209000717/abstract?rss=yesSummary: Background: The cause of hypertension in pregnancy remains unknown and results in increased risk of complications for mother and baby. Symptoms of developing pre-eclampsia, such as an elevated blood pressure, can be vague and singular. The purpose of this literature review is to evaluate research investigating antenatal screening practices for hypertension which fall within the midwives scope of practice.Method: Inclusion criteria for this literature review were English language, peer reviewed primary research journal articles, published in the previous 20 years where the population under study was pregnant with reported outcomes of prevention, screening or prediction of hypertension in pregnancy. A large number of papers (n=201) were identified and these were screened and subsequently excluded if they addressed diagnostic testing, screening and interpretation that depended solely on a medical practitioner.Results: There was no single predictive factor found, however the relevant papers included in this review (n=33) found evidence of modifiable, non-modifiable and clinical assessment factors for inclusion in a midwifery screening model.Conclusions: Further research should be focused on the factors observed by midwives during history taking and the antenatal course in the second and third trimesters and whether or not these can be synthesised in to a hypertension-specific diagnostic tool for use in midwifery practice.Antenatal screening and predicting hypertension in pregnancy for midwivesAnn S. Peacock, Fiona Bogossian10.1016/j.wombi.2009.09.002Women and Birth 23, 3 (2010)2010-09-01Women and Birth2010-09-01233S1871-5192(10)X0004-XReview8193http://www.womenandbirth.org/article/PIIS187151920900047X/abstract?rss=yesSummary: Background: Educational portfolios have been used across a variety of disciplines in university education as means of encouraging reflective practice in students and as a form of assessment by which a cumulative record of the student's experience can be substantiated. More recently, the development of ePortfolios has provided the potential to transform portfolio learning for students in the 21st century.Aim: Development of a pilot ePortfolio for the Bachelor of Midwifery at the University of South Australia (UniSA).Methods: This study adopted an action research methodology and followed the action research cycle of planning, action, observation and reflection in order to develop, implement and evaluate a pilot ePortfolio. An action research group was established to develop the ePortfolio.Results: Once the ePortfolio was developed, it was piloted with 18 first year midwifery students undertaking their second clinical placement. Eleven students provided feedback by completing an anonymous electronic questionnaire and, of these, eight also participated in interviews.Discussion: One of the overriding findings from this project is that midwifery students studying at UniSA consider the portfolio, in any form, a valuable record of their experience. It provides students with an authentic record of achievement, proof of their competency and a final summary of their learning journey. A number of issues with paper-based portfolios were identified; essentially students found that they were confusing at first, cumbersome and created anxiety but that they provided a tangible means of consolidating their learning experiences. With regards to the ePortfolio, students agreed that it seemed more simple, streamline and safe, but there were a number of suggestions for improvement put forward.Conclusion: The paper concludes that ePortfolio is considered ‘the way of the future’ for midwifery students, however a number of issues must be addressed through further collaboration prior to replacing the paper-based ePortfolio.ePortfolio in Midwifery Practice: “The Way of The Future”Jan Pincombe, Lois McKellar, Marlene Weise, Elizabeth Grinter, Gerardine Beresford10.1016/j.wombi.2009.05.001Women and Birth 23, 3 (2010)2010-09-01Women and Birth2010-09-01233S1871-5192(10)X0004-XResearch articles94102http://www.womenandbirth.org/article/PIIS187151921000017X/abstract?rss=yesSummary: Objective: To examine maternal birth outcomes and birth experiences of low-risk women in the Netherlands in different sized midwifery practices.Design: Descriptive study using postal questionnaires six weeks after the estimated due date.Setting: Women were recruited from urban, semi-rural and rural areas from small-sized practices (1–2 midwives), medium-sized practices (3–4 midwives) or large-sized practices (5 or more). Participants: 718 Dutch speaking women with uncomplicated pregnancies, a representative sample of women in 143 midwifery practices in the Netherlands who had given birth in the period between 20 April and 20 May 2007.Measurements: Distribution of place of birth categories and intervention categories, birth experience, woman–midwife relationship and presence of own midwife after referral. Data were analyzed with Statistical Package for Social Sciences (SPSS).Findings: Women in practices with a maximum of two midwives were significantly more likely to experience lower rates of referral, interventions in general and specifically pain relief by means of pethidine, CTG registration and unplanned caesarean sections. Women with a maximum of two midwives were significantly more likely to know their midwife or midwives and were more frequently supported by their own midwife after referral in comparison to women in practices with more than two midwives. The presence of the woman's own midwife added value to the birth experience. Women with a maximum of two midwives had higher levels of a positive birth experience than women in practices with more than two midwives.Key conclusion: Midwifery practices with a maximum of two midwives contribute to non-interventionist birth and a positive birth experience.Implications: Awareness of the study results and further study is recommended to discuss reorganization of care in order to achieve significant reductions on referral and interventions during childbirth and positive maternal birth experiences.The comparison of birth outcomes and birth experiences of low-risk women in different sized midwifery practices in the NetherlandsJ.A.C.A. Yvonne Fontein10.1016/j.wombi.2010.01.002Women and Birth 23, 3 (2010)2010-09-01Women and Birth2010-09-01233S1871-5192(10)X0004-XResearch articles103110http://www.womenandbirth.org/article/PIIS1871519210000168/abstract?rss=yesAbstract: Background: In Norway pregnant women who are not regarded to be in a risk group are offered one routine ultrasound around the 18th week of pregnancy. If serious abnormalities are diagnosed, the women may apply for a termination.Research Question: The aim of this study was to describe and understand some pregnant women's thoughts, feelings and dilemmas of choice when unexpected findings were diagnosed after a routine ultrasound examination.Methods: This study was based on 22 semi-structured life world interviews. The women interviewed were informed of unexpected findings after undergoing routine ultrasound examinations around the 18th week of pregnancy. The analysis of the data was inspired by phenomenological research and followed the meaning condensation approach described by Kvale (1).Results: The informants’ experiences are presented by showing how they described shifts between juxtaposed emotional states: hope–acceptance, distancing–denial and grief–guilt. All of the informants described these swings between different emotions as a state of continuous chaos.Discussion: The discovery of abnormality in a wanted child at a late stage of pregnancy can evoke an emotional crisis for women. All the informants in this study described swings between different emotions as being in a state of continuous chaos. The women had to make difficult choices regarding their own future and that of their child.Conclusion: Eliminating the anxiety and anguish experienced by women following a diagnosis of fetal abnormality is impossible. It must be possible, however, to mitigate their distress. Further research should develop methods to prepare women for coping in crises like these.Women's experiences when ultrasound examinations give unexpected findings in the second trimesterEva Sommerseth, Johanne Sundby10.1016/j.wombi.2010.01.001Women and Birth 23, 3 (2010)2010-09-01Women and Birth2010-09-01233S1871-5192(10)X0004-XResearch articles111116http://www.womenandbirth.org/article/PIIS1871519209000882/abstract?rss=yesSummary: Advanced midwifery practice is a controversial notion in midwifery, particularly at present in Australia. The proposed changes in legislation around access to the publicly funded Medical Benefits Scheme (MBS) and the Pharmaceutical Benefits Scheme (PBS) in 2009–2010 have meant that the issue of advanced midwifery practice has again taken prominence. Linking midwifery access to MBS and PBS to a safety and quality framework that includes an ‘advanced midwifery credentialling framework’ is particularly challenging. The Haxton and Fahy paper in the December 2009 edition of Women and Birth is timely as it enables a reflection upon these issues and encourages debate and discussion about exactly what is midwifery, what are we educating our students for and is working to the full scope of practice practising at advanced level? This paper seeks to address some of these questions and open up the topic for further debate.Advanced midwifery practice or advancing midwifery practice?Rachel Smith, Nicky Leap, Caroline Homer10.1016/j.wombi.2009.11.002Women and Birth 23, 3 (2010)2010-09-01Women and Birth2010-09-01233S1871-5192(10)X0004-XDiscussion117120http://www.womenandbirth.org/article/PIIS1871519210000430/abstract?rss=yesWe are pleased that our paper, “Reducing the length of stay for women who present as outpatients to delivery suite: a clinical practice improvement project” has generated debate. Smith et al. applaud the work of the midwives we reported on who are providing independent care for women when they present to delivery suite with pregnancy-related concerns. These authors have however, challenged our use of the term ‘advanced practice midwife’. We acknowledge that the choice of the term ‘advanced practice midwife’ is contentious given the different professional philosophical views held around the notion of levels of midwifery practice. Our justification for doing so lies in the reality that currently midwifery exists under regulatory and legal frameworks, including industrial awards, which recognise higher levels of appointment and higher levels of payment. In our report we were writing about midwifery practice as it exists today in large tertiary settings. The majority of Smith et al's discourse does not address the substance of our paper. Rather they have used the paper as a spring board for a philosophical discussion about what, ideally, should be the role of the midwife and scope of midwifery practice. Additionally Smith and colleagues argue the importance of separating midwifery from nursing by not going down an advanced practice pathway.Rejoinder to Smith, R., Leap, N. & Homer, C Advanced midwifery practice or advancing midwifery practice?Kathleen Margaret Fahy10.1016/j.wombi.2010.06.002Women and Birth 23, 3 (2010)2010-09-01Women and Birth2010-09-01233S1871-5192(10)X0004-XLetters to the editor121121http://www.womenandbirth.org/article/PIIS1871519210000405/abstract?rss=yesI read with interest Fiona Bogossian's article entitled “An urgent call to implement systematic monitoring of a comprehensive set of quality indicators for maternity services.”Qld Maternity Perinatal CouncilMichael Humphrey10.1016/j.wombi.2010.05.001Women and Birth 23, 3 (2010)2010-09-01Women and Birth2010-09-01233S1871-5192(10)X0004-XLetters to the editor122122http://www.womenandbirth.org/article/PIIS1871519210000399/abstract?rss=yesThank you to Professor Michael Humphrey for the advice that the Queensland Maternity Perinatal Quality Council was reborn in the latter half of 2010, concurrent with the preparation of my article. I appreciate the challenges that the re-established Council must now respond to. One major challenge is to synthesise, interpret and report on data from 2004 onwards, so that it may be used to inform decision making, and to do so in a timely way. Having served briefly on a previous Council working party, I have seen up close how critical the quality of data is to timely analysis. I urge all midwives to be meticulous and comprehensive in their reporting on Perinatal Data Collection forms, so that the first-time quality of data is maximised, and wish Professor Humphrey and the Council every success in the important work that lies ahead.Rejoinder—QLD Maternity Perinatal Quality CouncilFiona Bogossian10.1016/j.wombi.2010.04.006Women and Birth 23, 3 (2010)2010-09-01Women and Birth2010-09-01233S1871-5192(10)X0004-XLetters to the editor123123http://www.womenandbirth.org/article/PIIS1871519210000351/abstract?rss=yesJenny is just completing her PhD on the impact of childbearing on women's sense of self. The stories in this book arose out of that PhD. ‘Feelings of Change’ is a collection of fourteen Australian women's unique and individual stories about their first birthing journey. The stories chronicle this journey through pregnancy, birth and the first few months post-birth. The first part of the women's stories explores their relationships and sexuality. The women examine aspects of their past which have impacted upon who they are as individuals and as a couple. It looks at how these aspects of self have influenced their preparation for their birthing journey and their expectations of birth: the environment and the people they want present. An important theme in this part of the book is the women's need to be heard during their birthing journey by professionals, those close to them and those she loves.Elaine Jefford10.1016/j.wombi.2010.04.003Women and Birth 23, 3 (2010)2010-09-01Women and Birth2010-09-01233S1871-5192(10)X0004-XBook reviews124124http://www.womenandbirth.org/article/PIIS1871519210000375/abstract?rss=yes The lived reality of becoming a mother for the first time is delightfully described in this book by Nicole Hall. I found Hall's six chapter account of life with baby ‘Viv’ and partner ‘Jules’ entertaining and revealing. Beginning at day one with an outline of her birth experience, the chapters are presented as day by day diary entries that gradually became less frequent. Chapter titles such as ‘Endless poo: the first month’, ‘Settling in: one to three months’, ‘Falling in love: three to six months’ and ‘So tired: six to twelve months’ act as chronological markers for key parts of Hall's experience. In the final chapter Hall discusses life after Viv's first birthday; the birth of her second baby and Viv's reaction to his brother are included. Each chapter also contains later reflections made by Hall.Jenny A. Parratt10.1016/j.wombi.2010.04.005Women and Birth 23, 3 (2010)2010-09-01Women and Birth2010-09-01233S1871-5192(10)X0004-XBook reviews125125