The Midwife’s Labour and Birth Handbook ‘Highly recommended for midwives and student midwives in their final year. Includes all aspects of labour and birth including obstetric emergencies, how to suture (step by step and for left‐handers too), malpositions and presentations and lots more. Explains things in great detail but easy to understand.’ (Amazon review) ‘This intelligently laid out, well sourced and expertly written handbook would be a boon to any student or practising midwife. Comprehensive and accessible with a good index, this work of reference is an essential addition to the midwife’s library. I would certainly recommend it to my students.’ (Amazon review) ‘Looking back I wished I had this book during my SHO rotation through obstetrics in general and labour ward in particular. Although aimed at midwives, I think all doctors (foundation, GP and core trainees) rotating through labour ward will benefit from this book. It is very well written.’ (Amazon review) The Midwife’s Labour and Birth Handbook Fourth Edition Edited by Vicky Chapman Derbyshire UK Cathy Charles Wiltshire UK This fourth edition first published 2018 © 2018 by John Wiley & Sons Ltd Edition History John Wiley & Sons Ltd (3rd Edition, 2013) All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions. The right of Cathy Charles and Vicky Chapman to be identified as the authors in this work has been asserted in accordance with law. 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Library of Congress Cataloging‐in‐Publication Data Names: Chapman, Vicky, editor. | Charles, Cathy, editor. Title: The Midwife’s Labour and Birth Handbook / edited by Vicky Chapman, Cathy Charles. Description: Fourth edition. | Hoboken, NJ : Wiley, 2017. | Includes bibliographical references and index. | Identifiers: LCCN 2017033956 (print) | LCCN 2017034946 (ebook) | ISBN 9781119235101 (pdf) | ISBN 9781119235095 (epub) | ISBN 9781119235118 (pbk.) Subjects: | MESH: Midwifery–methods | Labor, Obstetric | Parturition | Prenatal Care | Handbooks Classification: LCC RG950 (ebook) | LCC RG950 (print) | NLM WQ 165 | DDC 618.2–dc23 LC record available at https://lccn.loc.gov/2017033956 Cover Design by Wiley Cover Images by Lucy Pryor www.angelfirephotography.co.uk Set in 9.5/12pt Palatino by SPi Global, Pondicherry, India 10 9 8 7 6 5 4 3 2 1 Contents Preface vii Contributors ix 1 Labour and normal birth 1 Cathy Charles 2 Vaginal examinations and amniotomy 49 Vicky Chapman 3 Fetal heart rate monitoring in labour 61 Bryony Read 4 Perineal trauma and suturing 75 Vicky Chapman 5 Examination of the newborn baby at birth 105 Caroline Rutter 6 Home birth 123 Cathy Charles 7 Water for labour and birth 139 Cathy Charles 8 Malpositions and malpresentations in Labour 155 Vicky Chapman 9 Slow progress in labour 171 Vicky Chapman 10 Assisted birth: ventouse and forceps 189 Cathy Charles 11 Caesarean section 211 Cathy Charles 12 Vaginal birth after caesarean section 227 Vicky Chapman 13 Preterm birth 239 Charlise Adams 14 Breech birth 257 Lesley Shuttler 15 Twins and higher order births 285 Jo Coggins 16 Obstetric haemorrhage 297 Hannah Bailey 17 Emergencies in labour and birth 315 Hannah Bailey 18 Neonatal and maternal resuscitation 339 Nick Castle vv vi Contents 19 Induction of labour 353 Cathy Charles 20 Pre‐eclampsia and diabetes 367 Annette Briley 21 Stillbirth and neonatal death 385 Cathy Charles 22 Risk management, litigation and complaints 407 Cathy Charles 23 Intrapartum blood tests 417 Vicky Chapman 24 Medicines and the midwife 433 Vicky Chapman Index 441 Preface Vicky Chapman Cathy Charles We have been delighted at the success of The Midwife’s Labour and Birth Handbook, now in its fourth edition. We have continued our collaboration in writing and editing a handbook for midwives and students. Our aim is to make the book easy to read and grounded in research (both anecdotal and quantitative), with a strong women‐centred perspective. We have expanded our subject matter to include female genital mutilation, freebirth- ing, sepsis, the OASI Care Bundle and a new section on caring for women with diabetes. This edition also includes new visual material. We now include photos of a footling breech and a breech waterbirth, in addition to the existing extended breech birth photos. Also a new range of stunning images capturing one woman’s journey through labour at home, to active birth in hospital and another series of photos of a beautiful waterbirth. Many thanks to all the parents who gave permission for use of their p hotos, including Brittany, Sue, Anna, Jacqui, Tor, Steve, Lisa, Mel and Aaron. Some of the twin and placenta photos are Vicky’s own, and even our commissioning editor Magenta donated a photo in Chapter 11. Special thanks to Lucy Pryor (www.angelfirephoto graphy.co.uk) for our cover image, capturing her sister Mel and partner Aaron at the birth of baby Amelie and their fabulous midwife Samantha. As this edition goes to publication we are mourning a major blow to independent midwifery. Without independent midwives, many of the photos in this edition – and many of the anecdotal and non‐hospital experiences from which as a profession we all learn, may in future no longer be available. Additionally, the Nursing and Midwifery Council (NMC) is curtailing midwifery representation at the NMC and abolishing midwifery supervision. This is a historical low for midwifery in the UK and demand for an all‐midwifery body is more pressing than ever. vviiii viii Preface Many midwives today continue to give flexible individualised care to women in the face of increasingly prescriptive policies and protocols, with the spectre of investiga- tion, risk and litigation always looming in the background. For all that, it is still deeply rewarding to care for women in labour and to try to offer them a safe and fulfilling birth. Our hope is that midwives everywhere maintain their joy in helping a woman to birth her baby, and are committed to ensuring that she has the best experience possible. Once again we thank our great team of writers for their patience and hard work. Cathy Charles and Vicky Chapman Contributors The editors Vicky Chapman RGN, RM(Dip), MA As a midwife Vicky has worked in a variety of hospital settings, and as a caseload midwife. She has a particular interest in normal birth, as well as an interest in the politics of childbirth and their impact on women’s birth experiences. She has also been a visit- ing lecturer. Vicky has juggled her career with her four children, the last three of whom were born at home, including twins. Cathy Charles RGN, RM, BSc(Hons), BA(Hons) Cathy is a midwife and ventouse practitioner, practising in acute and community set- tings in Wiltshire and Somerset. She has lectured and written on the subject of practis- ing as a midwife ventouse practitioner in a stand‐alone birthing centre. Like Vicky, Cathy has an interest in waterbirth and home births. She also gained experience in investigating adverse events as a clinical audit/risk management co‐ordinator and has been a supervisor of midwives and a visiting lecturer. She teaches aquanatal classes. The contributors Charlise Adams BSc Charlise qualified as a midwife in 2003 and has practised in a consultant‐led unit, a stand‐alone birthing centre and the private sector. She currently works in a major Wiltshire hospital. She has been published in various midwifery journals and facili- tated teaching obstetric emergencies. She has also been involved with a local univer- sity, interviewing and clinically assessing students. Charlise is married with one gorgeous son! Hannah Bailey RM, DipHE (Midwifery) Hannah qualified as a midwife in 2001. She has worked in both community and acute settings; as a labour ward sister at the Great Western Hospital in Swindon; and as a practice development midwife at the Royal United Hospital in Bath. She worked closely with her consultant obstetric and anaesthetic colleagues to build a robust pro- gramme of regular staff simulation training to complement annual PROMPT training. Hannah’s interest in quality improvement includes a 3 year project to raise awareness of stillbirth in pregnant women, and she has just become head of quality and improve- ment at a local mental health trust. She plans to keep her midwifery registration by working at local birthing centres. iixx x Contributors Annette Briley SRN, RM, MSc, PhD Annette is a consultant midwife/clinical trials manager within the Division of Women’s Health at St Thomas’ Hospital, London. She was a clinical midwife for many years, working in all areas of maternity services, including obstetric ultrasound. Annette joined the St Thomas’ research team in 1997 and was involved in a major study on vitamins in pre‐eclampsia. She has since worked on numerous national and interna- tional pregnancy‐related clinical trials, including the UK Pregnancies Better Eating and Activity Trial (UPBEAT). She is a National Institute for Health Research (NIHR) Midwife Champion for London South, NIHR Advocate for Allied Health Professionals (Midwifery), Research and Development Lead for Women’s Services at Guy’s and St Thomas’ NHS Foundation Trust (GSTFT) and NIHR Co‐Speciality Lead for Reproductive Health and Childbirth (London South). She completed her PhD in 2014 focusing on pre‐pregnancy, pregnancy‐acquired and intrapartum risk factors for blood loss in childbirth. Annette works with Tommy’s, the baby charity, and is a trustee of Maternity Worldwide. Nick Castle PhD, MSc (Dist), DIMC, RGN Nick is Head of Professions for the Hamad Medical Corporation Ambulance Service, Qatar, and an Honorary Research Fellow at the Durban University of Technology, South Africa. He is a dual registered nurse and critical care paramedic who is the pro- fessional lead for over 1500 ambulance and nursing staff employed by the ambulance service in Qatar. Despite being an Assistant Executive Director Nick still maintains a minimum of 48 clinical patient‐facing hours per month. Nick is widely published in the field of emergency care, being the author of 68 peer‐reviewed papers as well as two books and numerous book chapters. Jo Coggins DipHE (Midwifery) (Dist), BSc (Hons), MSc Jo is a community midwife in Wiltshire, where she lives with her husband and two children. She previously practised in acute and community settings in Bath. Her role incorporates antenatal, intrapartum and postnatal care for women giving birth at the local birthing centre and at home. Jo enjoys writing and has published articles in sev- eral midwifery journals. Bryony Read RM, BA (Hons) Bryony gained her midwifery degree from Oxford Brookes in 2001, and first worked at the John Radcliffe Hospital, Oxford. She then moved to the Princess Royal University Hospital in the London borough of Bromley, where she worked for 10 years as a case‐ loading midwife in the Young Parents team. This was an inspiring and challenging job, leading to increased breastfeeding rates, which Bryony presented at the Royal College of Midwives (RCM) conference. In 2013 Bryony moved with her husband and young family to Wiltshire and she now works in a Young Parents team, shortly to expand into caring for other vulnerable women, at a stand‐alone birthing centre. Bryony has gained great experience in safeguarding and is keen to specialise in this going forward into the future.