Midwives' articles

Guidelines for care of a woman expecting Twins

Oct 22 2007

By Mary Cronk

October 2007

Antenatal care
Depending on the gestation when the diagnosis of the twin pregnancy is made, the following should be discussed with the woman, and her partner if appropriate.

Nutrition and Diet
I find it helpful to ask the woman to keep a diet diary for a few days, including a weekend day. I then go through the diary with her identifying whether there is an adequate intake of :
Calories with a good balance of carbohydrate protein and fat
Adequate vitamins
Adequate sources of the important minerals and trace elements.
If we identify any deficiencies we discuss ways of improving nutrition. I stress the importance of eating well.

 

What every pregnant woman should know about ceasarean section

Sep 11 2007

Click on the link below to read this informative booklet put together by the childbirthconnection in 2004 and revised in 2006.

You will need to login to the childbirthconnection website in order to view this PDF:

"What every pregnant woman should know about ceasarean section"

 

Routine Antenatal Anti-D - A review of the evidence

Sep 11 2007

by Sara Wickham

While the postnatal administration of anti-D immunoglobulin to rhesus negative woman who have given birth to a rhesus positive baby has been considered by many as an acceptable and beneficial routine intervention for the last thirty years, the question of whether it is appropriate to offer routine antenatal administration of this product has been hotly debated for almost as long. There is little question that women who experience potentially sensitising events in pregnancy should be given appropriate information and offered this as an option. Rather, the debate concerns the issue of so-called 'silent' feto-maternal transfusion - the existence (or otherwise) of which phenomena forms part of the basis for arguments in favour of routine antenatal prophylaxis.

 

Midwifery Skills needed for Breech Birth by Mary Cronk

Jun 16 2007

This article is about pregnancies where the baby presents by the breech and what we as midwives can do when the diagnosis is made: "It's a breech!"

We need first of all to ask ourselves, why is this baby presenting this way? It could simply be due to prematurity - many babies present by the breech until 30 weeks or so, and if labour starts before then, we have a breech baby. There is some evidence that very premature babies do better if delivered abdominally. Though there is always the 28 week baby who arrives on the labour ward with the buttocks at the vulva.

 

VBAC RCOG guidelines

Jun 5 2007

Click here to open the PDF

 

WE WILL ONLY HAVE MEDICS GET OFF THEIR THRONES…

Jun 5 2007

WE WILL ONLY HAVE MEDICS GET OFF THEIR THRONES WHEN WE GET UP OFF OUR KNEES. They are our medical colleagues, not our superiors.

- Mary Cronk

 

Protocol for Management of Rh D negative Women in Pregnancy

Jun 5 2007

Click here to open the Word document

 

Nutrition and Preterm Labor

Jun 5 2007

A variety of contributing factors are associated with preterm labor and birth. The most common physical reason for preterm labor is inadequate maternal nutrition. Poor nutrition, or a lack of sufficient quantities of good quality foods, can lead to an array of maternal/fetal complications. Perhaps the most well-recognized complication is metabolic toxemia of later pregnancy. However, the contracted blood volume resulting from a poor quality or otherwise inadequate diet can have myriad other repercussions.

 

Neonatal Jaundice

Jun 5 2007

Jaundice is clinically detectable in the newborn when the serum bilirubin levels are greater than 85 micromols per litre. This occurs in approximately 60% of term infants and 80% of preterm infants. Hyperbilirubinaemia is either unconjugated (which is potentially toxic but may be physiological or pathological) or conjugated (not toxic; always pathological).

 

Detection of scar problems during VBAC

Jun 5 2007

Mary Cronk MBE, has been a midwife since the early 60s and been practicing independently since 1990, has extensive experience of caring for VBAC and HBAC women. She discusses ways she feels she can enhance the safety of such women.

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I have had quite a few women with CS scars on my caseload and while the risk of scar problems is low 1% or less in a spontaneous labour it does exist. This woman's uterus has been compromised.

 
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