Highlighting the experiences of midwives who provide care to women opting outside of guidelines in the pursuit of physiological birth, Claire Feeley looks at the impact on midwives themselves, and explores how teams and organisations support or discourage women’s birth choices. This book investigates the processes, experiences and sociocultural-political influences upon midwives who support women’s alternative birthing choice and argues for a shift in perspective from notions of an individual’s professional responsibility to deliver woman-centred care, to a broader, collective responsibility. The book begins by contextualising the importance of quality midwifery care with an exploration of the current debates to demonstrate how hegemonic birth discourse and maternity practices have detrimentally affected physiological birth rates, and the wellbeing of women who opt outside of maternity guidelines. It provides real life examples of how midwives can facilitate a range of birthing decisions within mainstream midwifery services. Moreover, an exploration of midwives’ experiences of delivering such care is presented, revealing deeply polarised accounts from moral injury to job fulfilment. The polarised accounts are then presented within a new model to explore how a midwife’s socio-political working context can significantly mediate or exacerbate the vulnerability, conflict and stigmatisation that they may experience as a result of supporting alternative birth choices. Finally, this book explores the implications of the findings, looking at how team and organisational culture can be developed to better support women and midwives, making recommendations for a systems approach to improving maternity services. Discussing the invisible nature of midwifery work, what it means to deliver woman-centred care, and the challenges and benefits of doing so, this is a thought-provoking read for all midwives and future midwives. It is also an important contribution to interprofessional concerns around workforce development, sustainability, moral distress and compassion in health and social care.

This book about the art, craft and science of expert midwifery care, while focusing on ‘alternative physiological births’ that are those ‘outside’ of guidelines, the contents can be applied to any birthing choices. Drawing upon the findings of a PhD that captured the experiences of midwives who proactively supported alternative physiological births while working in the National Health Service, their practice was conceptualised as ‘skilled heartfelt practice’. Skilled heartfelt practice denotes the interrelationship between midwives’ attitudes and beliefs in support of women’s choices, their values of cultivating meaningful relationships, and their expert practical clinical skills. It is these qualities combined that give rise to what is called ‘full-scope midwifery’ as defined by the Lancet Midwifery Series. This book illuminates why and how these midwives facilitated safe, relational care. Using a combination of emotional intelligence skills and clinical expertise while centring women’s bodily autonomy, they ensured safe care was provided within a holistic framework. Moreover, this book offers insights for midwives to move beyond ‘rule-based’ practice, where the benefits of expert practice are illuminated. Midwives facilitating ‘alternative’ physiological births epitomise evidence-based practice, which centres the woman or birthing person as the expert in their life, and the midwife meets them where they are with expert skills to support them. But what does this look like in clinical practice, particularly for those employed by institutions, those ‘working within the system’ who have constraints that private or self-employed midwives don’t have? How does a midwife cultivate those skills within a culture and climate that devalues both relationships, midwives and women’s autonomy? This book aims to provide a roadmap for those seeking to cultivate these skills. The core focus will be the midwife-mother relationship from the perspectives of the midwives, rather than the midwives wider working relationships or workplace contexts. This is purposeful so to offer a deep dive into the nuanced and varied ways of delivering this type of care. However, the realities of practice are also firmly embedded with the book, tensions will be explored, limitations acknowledged.

Supporting a Physiologic Approach to Pregnancy and Birth: A Practical Guide provides an overview of current evidence and a range of practical suggestions to promote physiologic birth within the United States healthcare system. Presenting the latest evidence available on practical approaches and minimal interventions, this book looks into clinic exam rooms and hospital labor units to investigate the possibilities for improving the pregnancy and labor experience. Contributors discuss recent research and other published information and present a range of ideas, tools, and solutions for maternity care clinicians, including midwives, nurses, physicians, and other members of the perinatal team. An invaluable resource, Supporting a Physiologic Approach to Pregnancy and Birth is a must-have practical guide for those involved in all aspects of pregnancy and birth.

The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.

Supporting Women to Give Birth at Home describes and discusses the main challenges and issues that midwives and maternity services encounter when preparing for and attending a home birth. To ensure that a home birth is a real option for women, midwives need to be able to believe in a woman’s ability to give birth at home and to promote this birth option, providing evidence-based information about benefits and risks. This practical guide will help midwives to have the necessary skills, resources and confidence to support homebirth. The book includes: the present birth choices a woman has the implications homebirth has upon midwifery practice how midwives can prepare and support women and their families the midwife’s role and responsibilities national and local policies, guidelines and available resources pain management options With a range of recent home birth case studies brought together in the final chapter, this accessible text provides a valuable insight into those considering homebirth. Supporting Women to Give Birth at Home will be of interest to students studying issues around normal birth and will be an important resource for clinically based midwives, in particular community based midwives, home birth midwifery teams, independent midwives, and all who are interested in homebirth as a genuine choice.

This accessible, evidence-based book explores how important it is for midwives to understand the psychological aspects of care, in order to create positive experiences for mothers and families. The book provides simple explanations for why psychological care matters in midwifery practice and uses different theoretical perspectives of psychology to illustrate how it fundamentally contributes to good midwifery practice. The book addresses many core concepts and principles of psychology, including: Mother-midwife relationship Emotions during the childbearing continuum Perinatal mental illness Communications in midwifery practice The birth environment Stress and anxiety Providing support to families Attachment and bonding Reflective questions, activities, illustrations, tables, summary boxes and a glossary help readers navigate the book.Psychology for Midwives is essential reading for all midwives, students and allied health care professionals interested in the psychological dimensions of childbearing.

Fear of childbirth, the increasing use of epidurals and soaring caesarean section rates are the focus of much apprehension, debate, and controversy in contemporary maternity care. Across the world, support in labour has been shown to reduce obstetric interventions and improve outcomes for women and babies, yet women often report feeling unhappy with the support they receive. This textbook provides a clear and practical guide to supporting women in labour, looking at a range of techniques and approaches that promote a safe and positive experience of birth for women and their families. Written by two highly experienced midwifery authors, this text draws on up-to-date research, identifying how evidence can be applied to everyday practice. It includes narratives from women and practitioners, including midwives, doulas, childbirth educators and students. These are used to illustrate a range of situations where the quality of support is central to the quality of the experience and outcome. Supporting Women for Labour and Birth encourages readers to reflect on their experiences and examine the evidence provided by both research and the experiences of women and practitioners in order to explore how this could be incorporated into their practice. The only book to deal directly with the practical and emotional issues associated with labour support, it is an ideal text for student midwives and an important reference for practising midwives, doulas and other childbirth practitioners.

The main aim of this practical Handbookis to strengthen counselling and communication skills of skilled attendants (SAs) and other health providers, helping them to effectively discuss with women, families and communities the key issues surrounding pregnancy, childbirth, postpartum, postnatal and post-abortion care. Counselling for Maternal and Newborn Health Careis divided into three main sections. Part 1 is an introduction which describes the aims and objectives and the general layout of the Handbook. Part 2 describes the counselling process and outlines the six key steps to effective counselling. It explores the counselling context and factors that influence this context including the socio-economic, gender, and cultural environment. A series of guiding principles is introduced and specific counselling skills are outlined. Part 3 focuses on different maternal and newborn health topics, including general care in the home during pregnancy; birth and emergency planning; danger signs in pregnancy; post-abortion care; support during labor; postnatal care of the mother and newborn; family planning counselling; breastfeeding; women with HIV/AIDS; death and bereavement; women and violence; linking with the community. Each Session contains specific aims and objectives, clearly outlining the skills that will be developed and corresponding learning outcomes. Practical activities have been designed to encourage reflection, provoke discussions, build skills and ensure the local relevance of information. There is a review at the end of each session to ensure the SAs have understood the key points before they progress to subsequent sessions.

"Midwives, nurses, and physicians support physiologic birth by partnering with women in a midwifery care model that includes shared-decision making, non-intervention in the absence of complications, collaborative teamwork, and empowerment. This model of care is cost effective and results in high value care among healthy laboring women compared to routine medical model care. As front-line health professionals with the most contact with laboring women, nurses, and the cultures they establish in hospital maternity care units, influence the success and sustainability of practice changes to support physiologic birth. A hospital system in the Mid-Atlantic United States with a dominant obstetric care model desired to implement a midwifery service and transition to a team model to provide a full range of maternity care. However, nurses working in an obstetric setting are unlikely to have the knowledge, skills, and attitudes to support physiologic birth. Over a six-week period, nurses voluntarily engaged with evidence-based unit resources, journal club, and simulation for intermittent auscultation outside of employment requirements. Nurses' attitudes and beliefs were measured before and after the interventions. The interventions demonstrated small increases in positive attitudes and beliefs about physiologic birth after the intervention. Organizational support for larger scale interventions is warranted. Nursing support for physiologic birth is essential for a successful transition to a new maternity care model and can improve costs, satisfaction, and health outcomes. Key words: nurse, physiologic, labor, birth, attitude, unit culture, evidence-based " -- Abstract

Midwives and other healthcare providers are grappling with the issue of rising intervention rates in childbirth and trying to identify ways to reverse the trend. It is increasingly accepted that intervention in childbirth has long-term consequences for women and their children. Birth Territory provides practical, evidence-based ideas for restructuring the birth territory to facilitate normal birth. Links new research findings to birth environments and outcomes. Describes the elements of an ideal birthing environment. Suggests how to modify existing maternity services to achieve optimal results. Investigates the links between the experiences of women and babies, and outcomes. Explores the effects of legal and socio-political factors.