Alleviating perineal trauma: The APT study

This poster presentation aims to evaluate the effectiveness of a new cooling device (gel pad) with a standard regimen (ice pack) and compare these with no localised treatment regimen (control). 450 women partipcated in this study at St James's University Hospital and their own homes. The trial confirmed earlier findings to support the use of a specially designed cooling gel pad (Feme pad)to alleviate perineal trauma.The APT study was funded by the NHS Executive Northern and Yorkshire region

Maternal health & well-being project

A Maternal Health & Well-Being Initative that involved workshops and exercise classes that promoted normal birth and public health

The maze of midwife practice

This presentation discusses the role of a midwife and debates whether she practises as an expert,a specialist or obstetric nurse. Essential midwifery practice focuses on autonomy, normality, holistic care, woman centredness and respecting differences. 'Every Midwife Matters', the challenges and barriers to midwifery care in the UK in the 21st century are explored and debated

Engaging fathers in childbirth: A meta synthesis

This presentation explores the evidence from a meta synthesis undertaken as part of a programme of work entitled, Engaging Fathers in Childbirth (EPIC). There is growing evidence that active involvement of fathers in maternity care is associated with many health and social benefits for the mother and baby. However, maternity care expectations and experiences of expectant and new fathers have received little attention from policy makers and maternity service providers. Twenty three papers were included in the meta-synthesis and studies where undertaken in 9 countries (7 UK, 5 Australia, 4 Sweden, 2 USA, 1 Japan, 1 Taiwan, 1 South Africa, 1 Finland, 1 New Zealand). Ten of these focused on the prenatal period (prenatal diagnosis, A/N education & care), 5 focused on the intrapartum period (place of birth, premature birth & experiences),8 focussed on the postnatal period (transition to fatherhood & post-traumatic stress disorder). Six themes emerged from the included studies: risk and uncertainty,exclusion, fear and frustration, the ideal and the reality, issues of support, experiencing transition. 'As Partner and Parent’ fathers experience as not-patient and not-visitor situates them in an interstitial and undefined space with the consequence that many feel excluded and fearful. They cannot support their partner effectively unless they are themselves supported, included, and prepared for the reality of risk and uncertainty in pregnancy, labour and parenthood and for their role in this context.Engaging Partners in Childbirt

Learning from the Outcomes of Existing Prison Parenting Education Programs for Women Experiencing Incarceration: A Scoping Review

This scoping review addresses the question, what are the outcomes of existing prison parenting education programs for women experiencing incarceration and what can we learn? The framework used was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Significant positive changes were identified after attending prison parenting programs and women generally provided positive feedback about their experiences however, there were also insights into the distress caused. The content covered in the programs is also explored. In conclusion, prison can be an opportunity for parenting education and support although currently the best way to provide this support to women has not been established. This review gives insight to those wanting to develop a parenting program specifically for women

Postures and positions in labour: Best practice

This presentation discussed the evidence and demonstrated different postures and positions that women can adopt during labour

Vaginal breech birth or Caesarean?

This presentation will firstly explore the evidence in supporting the phenomenal shift in clinical practice from vaginal breech birth to routine caesarean breech birth, in particular the impact of a single research trial, the Term Breech Trial (TBT) on current worldwide policy and practice. Secondly, will explore the best available evidence for the use of External Cephalic Version (ECV)and moxibustion to turn a breech baby to a cephalic presentation as this may reduce a woman’s risk of having a caesarean section

A randomised controlled trial to compare the effectiveness of ice-packs and Epifoam with cooling maternity gel pads at alleviating postnatal perineal trauma

This is the author's PDF version of an article published in Midwifery© 2000. The definitive version is available at http://www.elsevier.comOBJECTIVE: To evaluate the effectiveness of standard regimes (ice packs and Epifoam) at relieving perineal trauma and compare these with a new cooling device (maternity gel pad). DESIGN: A randomised controlled trial involving three treatment groups. The women were free to choose the time of initial application (within four hours after delivery) in all treatment groups and the number of subsequent treatments up to 48 hours after suturing. SETTING: A midwifery unit in the north of England and then continued in the women's own homes. PARTICIPANTS: 120 women who had undergone an instrumental delivery and had a 48 hours post-delivery stay in a postnatal ward. MEASUREMENTS AND FINDINGS: The ordinal scale of none, mild, moderate and severe was used to determine the levels of perineal oedema and bruising at initial assessment (less than 4 hours), 24 hours and at 48 hours, by use of a newly developed visual evaluating tool. Self-assessed pain was recorded using a 10-point visual analogue scale within four hours, at 24 hours, 48 hours, and finally at five days after suturing. Women's opinions as to the effectiveness of their treatment was rated by use of a 5-point scale describing the categories; poor, fair, good, very good and excellent. A high proportion of women had some perineal oedema at initial assessment. A statistically significant difference in the proportion of women with oedema was found between treatment groups at 48 hours (p = 0.01), which was in favour of the maternity gel pad group. This was particularly noticeable for women with initial levels of mild oedema (p = 0.017). Localised treatment with the gel pad caused a significant decrease in reported pain at 48 hours in women who initially demonstrated moderate or severe pain (p = 0.048). A significant increase in the proportion of women with some bruising was seen across all treatment groups from initial assessment, through 24 hours to 48 hours (p < 0.0005). The bruising was significantly less in the gel-pad group in women who initially had no bruising (p = 0.021). There was no statistically significant effect of treatment at other initial levels of severity for oedema, bruising or pain at 24 hours, 48 hours and five days (for pain). Women in the gel-pad group rated the effectiveness of their localised treatment to be significantly higher than women in the other two treatment groups (p < 0.0005). KEY CONCLUSIONS: This trial demonstrated that a high proportion of women experience perineal oedema, bruising and pain following an instrumental delivery, which continues for at least five days for perineal pain, despite oral analgesia. Maternity gel pads, which were specially designed to cool the perineal region, were more effective in alleviating perineal trauma when compared with hospital standard regimens and were more highly rated by women.Elizabeth Clark Charitable Trus

The Parenting Education Needs of Aboriginal Women Experiencing Incarceration

The aim of this study was to listen to the voices of women experiencing incarceration and understand their parenting education needs. This paper reports on data from focus group interviews with 13 Aboriginal women in prison. The data were analysed using reflexive thematic analysis, creating five themes: (1) working towards a positive self; (2) communication (3) parenting from a distance; (4) jumping through hoops to get connected; and (5) connecting with Aboriginal cultures. The women were seeking guidance and clarity about the Child Protection system and how to regain child custody. Many women were wanting to invest in self-care and expressed a need to connect with their community and cultures, suggesting the opportunity to have a yarning circle with their Elders whilst in prison. The majority of women wanted to attend a parenting education program that included Aboriginal and/or Torres Strait Islander women only. The need for a parenting program that will be guided by a trauma-informed approach and utilise reflective practice of ‘lived experiences’ to develop skills and wisdom was identified as being vitally important to meet the needs of women experiencing incarceration

"My midwife said that having a glass of red wine was actually better for the baby" : A focus group study of women and their partner's knowledge and experiences relating to alcohol consumption in pregnancy

Background: While it is well established that alcohol can cross the placenta to the foetus and can affect an infant's development, many women continue to drink during pregnancy. For this reason it is important to determine what information is being provided, what information may be missing, and the preferred sources of information on this issue. In order to improve prevention strategies, we sought to understand the knowledge and experiences of pregnant women and their partners regarding the effects of alcohol consumption during pregnancy.\ud \ud Methods: The current study utilised a qualitative study design in order to gain insight into the views and experiences of pregnant women, newly delivered mothers and their partners. Focus groups examined the participant’s knowledge about the effects of alcohol consumption during pregnancy, the sources of information on this issue, and the psycho-social influences on their drinking behaviour. Five focus groups were conducted involving a total of 21 participants (17 female). A six-stage thematic analysis framework was used to analyse all focus group discussions in a systematic way.\ud \ud Results: Seven major themes were identified from the focus group data: 1) knowledge of Foetal Alcohol Spectrum Disorders; 2) message content and sources; 3) healthcare system; 4) society and culture; 5) partner role; 6) evaluation of risk; and 7) motivation. The findings indicated that although the majority of participants knew not to drink alcohol in pregnancy they had limited information on the specific harmful effects. In addition, routine enquiry and the provision of information by health care professionals were seen as lacking.\ud \ud Conclusions: The findings of this research provide important insights in to the relationship between pregnant women, their partners, and their healthcare providers. Several recommendations can be made on the basis of these findings. Firstly, public health messages and educational materials need to provide clear and consistent information about the effects of alcohol consumption on the developing baby. Additionally, more thorough and consistent routine enquiry for alcohol consumption in pregnant women needs to occur. Finally, it is important to ensure ongoing education for health professionals on the issue of alcohol consumption during pregnancy