Essential Midwifery Practice: Postnatal Care doc

Essential Midwifery Practice: Postnatal Care Edited by Sheena Byrom RGN, RM, MA Grace Edwards RGN, RM, ADM, Cert Ed, Med, PhD Debra Bick RM, BA, MMedSc, PhD A John Wiley & Sons, Ltd., Publication Essential Midwifery Practice: Postnatal Care Essential Midwifery Practice: Postnatal Care Edited by Sheena Byrom RGN, RM, MA Grace Edwards RGN, RM, ADM, Cert Ed, Med, PhD Debra Bick RM, BA, MMedSc, PhD A John Wiley & Sons, Ltd., Publication This edition first published 2010  2010 Blackwell Publishing Ltd Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing programme has been merged with Wiley’s global Scientific, Technical, and Medical business to form Wiley-Blackwell. 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Some content that appears in print may not be available in electronic books. Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. Library of Congress Cataloging-in-Publication Data Essential midwifery practice. Postnatal care / edited by Sheena Byrom, Grace Edwards, Debra Bick. p. ; cm. Includes bibliographical references and index. ISBN 978-1-4051-7091-8 (pbk. : alk. paper) 1. Postnatal care. 2. Midwifery. I. Byrom, Sheena. II. Edwards, Grace, RN. III. Bick, Debra. IV. Title: Postnatal care. [DNLM: 1. Postnatal Care. 2. Maternal Welfare. 3. Midwifery. WQ 500 E78 2010] RG801.E87 2010 618.6 – dc22 2009020249 A catalogue record for this book is available from the British Library. Set in 10/12.5pt Palatino by Laserwords Private Limited, Chennai, India Printed in Singapore 1 2010 Contents Foreword vii Preface ix Notes on the Contributors xiii Chapter 1 The History of Postnatal Care, National and International Perspectives 1 Sally Marchant Chapter 2 Contemporary Postnatal Care in the Twenty-first Century 27 Debra Bick Chapter 3 Women’s and Midwives’ Views of Early Postnatal Care 49 Jane Yelland Chapter 4 Transition into Parenthood: Ideology and Reality 71 Kathryn Gutteridge Chapter 5 Empowering Mothers: Strengthening the Future 95 Sheena Byrom and Anna Gaudion Chapter 6 Morbidity during the Postnatal Period: Impact on Women and Society 113 Maria Helena Bastos and Christine McCourt Chapter 7 Baby-Friendly Hospitals: What Can They Achieve? 139 Val Finigan vi Contents Chapter 8 Engaging Vulnerable Women and Families: Postnatal Care 165 Anita Fleming and Jill Cooper Chapter 9 Working with Partners: Forming the Future 189 Selina Nylander and Christine Shea Chapter 10 Nurture and Nature: The Healthy Newborn 211 Annie Dixon Chapter 11 Sexual Health, Postnatal Care and Parenthood 237 Grace Edwards and Susie Gardiner Index 255 Foreword The care of a woman and her baby in the immediate hours, days and weeks following birth can make an enormous difference to their long- term health and well-being. The content and timing of postnatal care led by midwives was formalised in the United Kingdom following a statutory legislation that was first introduced in England in 1902. Then there were concerns that too many women were dying following birth. The provision of midwifery care for all women including postnatal contacts in hospital and in the home, together with improved public health and advances in medicine, led to a dramatic fall in the UK maternal mortality rate. Sadly, the main causes of death at the beginning of the twentieth century in the United Kingdom, haemorrhage and sepsis, continue to kill hundreds of thousands of women globally. Postnatal care has frequently been portrayed as the ‘Cinderella’ of the maternity service, and often appears to be the least important and resourced part of the woman’s journey through pregnancy and birth. In the United Kingdom, the last decade has witnessed a decline in the provision of midwifery postnatal care contacts; conversely evidence of the potential benefits of effective postnatal care for maternal health has been published. The increasing ‘invisibility’ of postnatal care is an issue that should concern all who recognise the importance of good maternal health not only for the well-being of a family but also for the well-being of wider society. Postnatal services have been affected by a shortage of midwifery staff and increased pressure on our units as a result of the increasing birth rate. We also know that women may be entering pregnancy in poorer health, which in turn has implications for the level of care they require during and after they have given birth. It is within this current context of care that this book has been written. It will be an extremely valuable asset for those who wish to understand why postnatal care is an invaluable component of good public health and how the planning and content of care could make a difference to all women and in particular to the most vulnerable women and families in viii Foreword our society. The authors of each chapter are all acknowledged experts in their field. Many are also midwives in practice and as such not only are they aware of the pressures on postnatal services but they also offer insights into how current resources could be used more effectively. I hope that by reading the book you will also view the need to accord equal priority to the planning and provision of postnatal care, as with all other aspects of pregnancy and birth care. For many women, the postnatal period is the time when they feel most vulnerable, and sadly it is also the time when they feel most neglected by the health services. This book will make a tremendous contribution to understanding the public health consequences of effective postnatal care and why it should not persist as the ‘poor relation’ of our maternity services. Cathy Warwick General Secretary of the Royal College of Midwives, UK [...]... which lies more in the remit of postnatal care within the community setting than primary haemorrhage (largely covered in Chapter 6) The effect on postnatal care of formalising midwifery as a profession It was around the mid-nineteenth century when the Victorian era of enlightenment was at its peak, that more women began to emerge 10 Essential Midwifery Practice: Postnatal Care as campaigners for the status... acknowledged the potential benefit of postnatal care for public health In developing countries where thousands of women continue to die each year as a consequence of post-partum haemorrhage, the need to view postnatal care as part of a continuum of care for Safe Motherhood has been highlighted Although maternal health needs differ greatly across the globe, effective postnatal care could make an enormous difference... better standards of care for women overall Good practice point This point relates to the role of all health -care professionals and possibly other health -care workers in what care is available to women after they have given birth You might want to think through the different aspects of post-partum care; these might include the need for direct care to relieve pain, the need for nursing care to reduce the... influence 4 Essential Midwifery Practice: Postnatal Care of prolactin for breastfeeding affects the production of oestrogen and progesterone, reducing the woman’s level of fertility The time frame for these occurrences has traditionally been around 6 weeks, or 40 days and as such, as noted previously, also appears to have been incorporated into many religious and social frameworks for motherhood and care. .. timing of care, which had altered little x Preface during the course of the previous century, resulted in a system that did not identify or meet women’s needs Despite evidence that revising midwifery care could make a difference to aspects of women’s health, pressure on maternity services continues to impact on resources for postnatal care, with a seemingly low priority placed on provision of care planned... of the mother and the care provided to her after birth This will be addressed in terms of management of care for the most serious aspects of ill health post-partum, rather than in relation to the entire range of possible post-partum health problems Care of the newborn is not included in this chapter Historical references to midwifery and post-birth care There is evidence that midwifery as a female... doctors in matters associated with normal childbirth alongside the establishment of formal certification of midwives meant 14 Essential Midwifery Practice: Postnatal Care that very few untrained midwives continued to practise, and there was increasing inequality in the provision of care to non-white women in America (Bair & Caylett 1993) This picture of the midwife with skills but no formal qualifications... University until she became the editor for the MIDIRS Midwifery Digest, a post she has held for the last 6 years Throughout this time, postnatal care has been her main interest and was the focus for her PhD looking at the role of midwives in the postnatal assessment of uterine involution As part of her PhD work, she also became interested in aspects of midwifery history that led to many forages in the... with doctors (van Teijlingen 2004) while others had less formal training and, where they often used a range of traditional remedies, they were viewed with suspicion and, to some extent, disdain (Donnison 1988; Southern 1998) It was only comparatively recently, considering the longevity of the work of midwives in society, that there was a more objective recognition of 2 Essential Midwifery Practice: Postnatal. .. health initiatives were essential if the population’s health were to improve, a raft of measures were introduced including the first Midwives Act in England, which paved the way for the supervision and regulation of midwifery practice and training The implications of the Midwives Act for women’s health, midwifery practice and subsequent impact on the timing and content of postnatal care are outlined Debra . & Sons, Ltd., Publication Essential Midwifery Practice: Postnatal Care Essential Midwifery Practice: Postnatal Care Edited by Sheena Byrom RGN,. paper) 1. Postnatal care. 2. Midwifery. I. Byrom, Sheena. II. Edwards, Grace, RN. III. Bick, Debra. IV. Title: Postnatal care. [DNLM: 1. Postnatal Care. 2.