Mayes' Midwifery

16th Edition - May 23, 2023
Editors: Sue Macdonald, Gail Johnson
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 8 3 4 8 2 - 7
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 8 3 4 8 3 - 4

Mayes’ Midwifery is a core text for students in the UK, known and loved for its in-depth approach and its close alignment with curricula and practice in this country. The sixteenth… Read more

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Mayes’ Midwifery is a core text for students in the UK, known and loved for its in-depth approach and its close alignment with curricula and practice in this country. The sixteenth edition has been fully updated by leading midwifery educators Sue Macdonald and Gail Johnson, and input from several new expert contributors ensures this book remains at the cutting edge.

The text covers all the main aspects of midwifery in detail, including the various stages of pregnancy, possible complexities around childbirth, and psychological and social considerations related to women’s health. It provides the most recent evidence along with detailed anatomy and physiology information, and how these translate into practice.

Packed full of case studies, reflective activities and images, and accompanied by an ancillary website with 600 multiple choice questions and downloadable images, Mayes’ Midwifery makes learning easy for nursing students entering the profession as well as midwives returning to practice and qualified midwives working in different settings in the UK and overseas.

Cover image
Title page
Table of Contents
Copyright
Contributors
Foreword
Preface
Acknowledgements
PART 1. The midwife in context
1. Global midwifery—an international perspective
Introduction
Global policy context for midwifery in the 2030s
Gender and gender-related issues
The concept of agency
Factors affecting equality and equity
Promoting health and wellbeing
Perinatal mortality
Inequities associated with being a mother
The significance of the Human Development Index
Coverage and skilled attendance at birth
Socioeconomic factors affecting coverage of midwifery care
Midwifery in humanitarian and complex situations
International perspectives and challenges
Important considerations for midwives working cross-culturally
Conclusion
2. An introduction to midwifery history in the United Kingdom
Please note
Introduction: history — why bother?
Historical veracity
‘Doing history’
Women’s voices
Vital statistics as a historical lens
Interpreting texts
Men midwives: the early medicalisation of childbirth
The changing face of midwifery in Britain
Midwifery registration
Uncovering 20th-century discriminatory attitudes in midwifery
Pelvic theory—an exercise in sexism and racism
Learning from the past to build the future
Conclusion
3. The regulation of midwives
Introduction
The legislative framework of regulation
Conclusion
4. Clinical governance and the midwife
Introduction
Clinical governance
The healthcare safety investigation branch
Maternity risk management
Maternity leadership
Conclusion
5. Learning, being, and developing as a midwife
Introduction
Learning to be a midwife
Courses, programmes, and curricula
The cost of education
Lifelong learning ... and in practice ...
Pre-registration programmes and learning
Learning
Learning theory
After qualification and registration: continuing professional development and revalidation
Impacting issues
Computers, e-learning, and the Internet
Changes and developments
Mentorship, coaching, and the midwife as a role model
Conclusion
6. Being a student midwife
Introduction
Choosing midwifery as a career
Towards application and selection
Preparing to apply
A growing workforce
Becoming a student midwife
Balancing information and evidence
The challenges
Representation matters
Calls for change—changing curricula... challenging assumptions
The student midwife cohort
Learning
Digital technology
Clinical practice placements
Assignments and assessments
Dealing with difficult situations as a student
Conclusion
7. Evidence-based practice and research for practice
Introduction
Defining research and ‘midwifery’ research
Evidence-based practice in nursing and midwifery
Process steps to improve practice
Conclusion
8. Leadership and management in midwifery
Introduction
Leadership and management: two sides of a coin?
Leadership: traditional and contemporary thinking
Leadership and management in the NHS
Leadership in midwifery
Conclusion
9. An introduction to ethics for midwifery practice
Introduction
What is ethics?
Principles
Conclusion
10. Law and the midwife
Introduction
The accountable midwife
The law
Judicial function
Prudent patient test
Material risks
Trespass to the person
Obtaining consent
Best interests
Who determines a person’s best interests
Determining a best interest
Guidance from the Court of Protection
Welfare order
Independent mental capacity advocate (IMCA)
Circumstances where the best interests doctrine does not apply
Duty of confidence
Duty of candour
Conclusion
11. Pharmacology and the midwife
Introduction
Therapeutics in pregnancy and childbirth
Transgenerational adverse reactions
Drug administration and absorption
Drug distribution
Elimination / clearance of drugs
Pharmacodynamics
Drugs in labour
Legal aspects
Conclusion
PART 2. Childbirth in context
12. Sociocultural and spiritual context of childbearing
Introduction
Cultural competence, culture, and ethnicity
Midwives and cultural competence
Cultural awareness: the influence and relevance of cultural identity
Aristotle’s golden mean and wise compassion
Family and gender
Religion and spirituality
Conclusion
13. Psychological context of childbirth
Introduction
Psychological adjustment across the perinatal period
Midwife–woman relationship
Conclusion
14. Sex, gender, sexuality, and childbearing
Introduction
Sex, gender, and sexuality
Sexual health and sexuality
Sexual violence and abuse
LGBTI+ families
Breastfeeding and chest-feeding
Conclusion
15. National Health Service policy and midwifery
Introduction
Legislation and policy—an overview
Standards of proficiency for midwives and the policy context
Special advisers and media managers
Think tanks
The influence of academics
Adverse events
A highly politicised service
Affording the NHS—the political football
Conclusion
16. Maternity service provision
Introduction
What makes up a maternity service?
Models of care
Those who use maternity services shape it
Responding to the needs of local communities
Conclusion
17. Legal frameworks for the care of the child
Introduction
The Children Act 1989
Support for children and families
Family support services
Children with disabilities
Assessing children ‘in need’ and their families
The emergency protection order (EPO)
The child protection conference
Conclusion
PART 3. Public health, health promotion and childbirth
18. Epidemiology
Introduction
Pregnancy outcome
Maternal mortality
Stillbirth and infant mortality rates
Care in pregnancy and at birth
International comparisons
Conclusion
19. Infection prevention and control in maternity care
Introduction
The chain of infection
The reservoir of infection
Mode of transmission
Infection prevention and control
Conclusion
20. Nutrition for a healthy pregnancy
Introduction
Dietary requirements
Healthy eating for pregnancy
Nutritionally vulnerable pregnant women
Maternal weight in pregnancy
Weight managment in pregnancy
Conclusion
21. Complementary therapies and natural remedies in pregnancy and birth
Introduction
Complementary therapies commonly used in pregnancy and birth
Midwives’ responsibilities regarding complementary therapies
Conclusion
22. Public health, health promotion, and education
Introduction
Definition of the meaning of health
Health promotion
Health inequalities and social determinants of health
Midwives’ role in health promotion
Barriers to behaviour change
Communication tools to support health promotion activities
Health promotion activities
Tobacco use during pregnancy
Obesity in pregnancy and the role of the midwife
COVID-19 and the health promotion role of the midwife
Evaluation
Conclusion
23. Preconception care
Introduction
Preconception care challenges
Aims and objectives of preconception care and interventions
Conclusion
24. Education for parenthood
Introduction
Modern parenthood education
Empowering women
Curriculum and lesson planning
The learning group
Group activities
Tailoring education
Conclusion
25. Physical preparation for childbirth and beyond
Introduction
Maternal movement important for labour and birth
Relaxation and breathing
Physical activity and exercise during pregnancy
Monitoring exertion
Occupational activity
Pregnancy-related lumbopelvic pain
Postnatal recovery
Conclusion
26. Vulnerable women and families
Introduction
Domestic violence and abuse
Substance misuse (alcohol and/or drugs)
Pregnant teenagers and young parents
Parents with learning disabilities/intellectual disability
Black, Asian, and minority ethnic women
Gypsy, Roma, and Traveller women
Poverty and destitution
Conclusion
PART 4. The anatomy and physiology of fertility, conception and pregnancy
27. Anatomy of male and female reproduction
Introduction
The pelvis
Female reproductive anatomy
Fetal development
Male reproductive anatomy
Midwifery implications
Conclusion
28. Female reproductive physiology — cyclical changes in the ovaries, uterus, and mammary gland, across the infertile cycle
Introduction
Hypothalamic control of reproduction
Neuronal orchestration of GnRH pulsatility
The ovarian cycle
Cyclical changes in the reproductive system
Conclusion
29. Genetics and genomics
Introduction
Genes, chromosomes, and DNA
The human genome
Cell division
Chromosomal analysis and anomalies
Modes of inheritance
Introduction to genomics
The midwife and genomics
Gathering information
Family Health History (FHH) (‘pedigree’)
Genetic red flags (GRF)
Genetic referral
Laboratory Techniques
Conclusion
30. Fertility and its control
Introduction
The role of the midwife in the provision of contraceptive advice
Resuming sexual relationships following childbearing
Methods of fertility control
Intrauterine devices
Tubal sterilisation
Special groups
Conclusion
31. Infertility and assisted conception
Introduction
The Human Fertilisation and Embryology Authority
Causes of infertility
Male infertility
Female infertility — treatment and management
Outcomes from IVF treatments
Stress and infertility
Conclusion
32. From fertilisation to feto-placental development
Introduction
The fallopian tubes - where life begins
The deciduochorial placenta - from embryo to fetus
Conclusion
33. The fetal skull
Introduction
Development of the fetal skull
The external structures of the newborn skull
The skull
Sutures
Fontanelles
Sinuses
Measurements of the fetal skull
Internal structures of the fetal skull
Moulding of the fetal skull during labour
Injuries to the fetal skull and surrounding tissues
Internal injuries
The relevance of the fetal skull to parents
Conclusion
PART 5. Pregnancy
34. Maternal cardiovascular, respiratory, haemodynamic, uterine, and gastrointestinal-mammary adaptations to the fertile cycle
Introduction
Maternal central and peripheral adaptations to fertility
Cardiovascular and pulmonary adaptations
Adaptations in fluid and electrolyte regulation
Renal haemodynamic adaptations
Cardiovascular adaptations
Cardiovascular adaptations to fertility
Adaptations in the vascular renin-angiotensin-aldosterone system
Conclusion
35. Antenatal care
Introduction
Confirmation of pregnancy
Estimated date of delivery
Initial appointment (Booking)
Assessments in pregnancy
Physiological changes—‘minor disorders of pregnancy’
Fetal wellbeing assessment
Conclusion
36. Antenatal investigations
Introduction
Screening and diagnosis
Blood tests
Antenatal maternal blood tests to assess the fetus
Assessment of fetal wellbeing
Ultrasound
Invasive tests
Conclusion
37. The choice and personalisation agenda: place of birth and care
Introduction
Choice rhetoric and maternity care
Managing risk or facilitating safety?
Human rights and birth choice
Facilitating choice: what can the midwife do?
Conclusion
PART 6. Labour and birth
38. Neuroendocrinology of parenting: from nocturnal uterine activation to suckling-lactation and emotional connectivity between parents and infant
Introduction
Adaptations in maternal stress, immune response, and emotional sensitivity
Maternal sleep
Placental steroids, CRH, fetal cortisol, and uterine activation
Uterocervical myometrium
Maternal-fetoplacental regulation of circadian uterine activation
Circadian pattern of labour and birth
Active labour
The stress of being born: fetoplacental adaptations for labour, birth, and suckling
Conclusion
39. Care in the first stage of labour
Introduction
The continuum of labour
Characteristics of labour
Physiology of the labour continuum
Onset of labour
Care during the first stage of labour
The birth environment
Individualised care and assessing needs
Planning individualised care
General midwifery care in labour
‘Being with’, not ‘doing to’ women in labour
Nutrition in labour
Assessing the fetal condition
Evaluation of care
Conclusion
40. Care in the second stage of labour
Introduction
Signs of progress of labour
Physiology of the active second stage of labour
Mechanism of labour
Duration of the second stage of labour
Positions in the second stage of labour
Midwifery care
Preparation for the birth
The activities of the midwife during the birth
Observations and recordings
Future research in this area
Conclusion
41. Supporting choices in reducing pain and fear during labour
Introduction
An exploration of pain in labour
The birthing environment
Antenatal education and preparation for birth
Continuous support in labour
Complementary and alternative therapies
Pharmacological pain relief
Conclusion
42. Care in the third stage of labour
Introduction
Physiology of the third stage
Management of the third stage of labour
Care after birth (the fourth stage)
Record keeping
Abnormalites of the placenta
Abnormalities of the umbilical cord
Conclusion
43. The pelvic floor
Introduction and background
The pelvic floor
Considerations for midwifery practice
Perineal trauma
Episiotomy
The principles of perineal repair
Systematic assessment of perineal trauma
Conclusion
PART 7. Postnatal care and the care of the newborn baby
44. Women and family-centred postnatal care
Introduction
Aims of postnatal care
The organisation of postnatal care
The role of the midwife and other health professionals in postnatal care
The content of postnatal care
Care of women’s health during the postnatal period
Care of women’s psychological health
Conclusion
45. Physiology, assessment, and care of the newborn
Introduction
Applied physiology
Care at birth
Examination of the newborn
Daily examination
Identifying and managing pain and stress in the term newborn
Mother–baby attachment
Postnatal Care
Metabolic diseases
Vaccinations
Follow-up
Record-keeping
Conclusion
46. Thermoregulation
Introduction
Physiology of thermoregulation
Neonatal heat production
The role of the midwife
Monitoring and maintaining temperature
Minimising the risks of hypothermia
The sick neonate
Equipment
Conclusion
47. Infant feeding and relationship building
Introduction
Importance of human milk and breastfeeding
Public health and infant feeding
The UNICEF UK Baby Friendly Initiative (BFI)
The United Nations Convention on the Rights of the Child (UNCRC)
The needs of the newborn baby – food and love
Physiology of the infant gastrointestinal tract
Physiology of lactation
Common challenges
Formula feeding
The International Code of Marketing of Breastmilk Substitutes
Conclusion
PART 8. Women and babies with complex needs
48. The preterm baby and the small baby
Introduction
Prematurity
Problems of the preterm baby
Low birthweight
Long-term complications in the preterm and low birthweight baby
Caring for the family of the preterm or low birthweight baby
Conclusion
49. Respiratory and cardiac disorders in the neonate
Introduction
Normal respiratory and cardiac development
The fetal circulation
Transition to extrauterine life
Normal neonatal circulation and respiratory function
Compromised fetal cardiac and respiratory development
Resuscitation of the newborn
Respiratory disorders in the newborn
Cardiac abnormalities
Parental care
Conclusion
50. Neonatal jaundice
Introduction
Physiology
Physiological jaundice
Evaluation of jaundice
Unconjugated hyperbilirubinaemia
Prolonged jaundice
Conjugated hyperbilirubinaemia
The role of the midwife with the parents
Follow-up
The future
Conclusion
51. Neonatal infection
Introduction
Acquisition of infection
Newborn immunity
Management for early-onset neonatal sepsis
Parental education reflection
Infections acquired around the time of birth
Conclusion
52. Congenital anomalies and metabolic and endocrine disorders
Introduction
Aetiology
Abnormalities of the alimentary tract
Disorders of the respiratory system
Disorders of the central nervous system
Disorders of the genitourinary system
Kidney disorders
Disorders of sexual development
Chromosomal abnormalities
Abnormalities of the skeletal system
Neonatal pain management
Disorders of metabolism
Conclusion
53. Pregnancy loss and baby deaths
Introduction
Background
Human, social, and financial impact
Sources of information relating to perinatal and infant mortality
Datasets
Reasons why babies die
Sudden unexpected death in infancy (SUDI) and sudden infant death syndrome (SIDS)
Reducing perinatal and infant mortality
Public health messages
Health and social inequalities
Conclusion
54. Nausea and vomiting
Introduction
Conclusion
55. Bleeding in pregnancy
Introduction
Bleeding before the 24th week of pregnancy
Abortion
Gestational trophoblastic neoplasia (hydatidiform or carneous Mole and choriocarcinoma
Ectopic or extrauterine gestation
Heterotopic pregnancy
Secondary abdominal pregnancy
Bleeding from associated conditions
Bleeding after the 24th week - antepartum haemorrhage
Placenta praevia
Placental abruption
Management of antepartum haemorrhage and the midwife's role
Conclusion
56. Hypertensive and medical disorders in pregnancy
Introduction
Hypertensive disorders
Gestational hypertension
Pre-eclampsia
Anaemia
Haemoglobinopathies
Cardiac disorders
Thyroid disorders
Renal disorders
Diabetes
Respiratory disorders
Epilepsy
Intrahepatic cholestasis of pregnancy
Conclusion
57. Sexually transmitted infections
Introduction
Chlamydia
Gonorrhoea
Syphilis
Herpes
Genital warts: human papillomavirus
Hepatitis B virus
Human immunodeficiency virus
Conclusion
58. Abnormalities and anomalies of the genital tract
Introduction
Developmental anomalies
Displacements of the uterus
Female genital mutilation
Transgender people and childbearing
Conclusion
59. Multiple pregnancy and birth: implications for midwives, women, and their families
Introduction
The incidence of multiple births
Determination of zygosity
Diagnosis of a multiple pregnancy
Antenatal screening
Antenatal preparation
Complications associated with a multiple pregnancy
Fetal abnormalities associated with monozygotic twins
Antenatal care
Intrapartum care
Postnatal care
Conclusion
60. Preterm labour and birth
Introduction
Definition
Incidence and outcomes
Identifying preterm birth risk factors
Prelabour rupture of membranes (PROM) and preterm prelabour rupture of membranes (PPROM)
Management of preterm labour
The midwife’s role in caring for women with preterm babies
Conclusion
61. Induction of labour and post-term pregnancy
Induction of labour
Induction of labour at term
Assessing the need for induction
International perspectives
Post-term pregnancy
Conclusion
62. Presentation and prolapse of the umbilical cord
Introduction
Causes
Predisposing factors
Diagnosis
Management of cord presentation
Management of cord prolapse
Bladder filling
Psychological care
Conclusion
63. Rhythmic variations of labour
Introduction
The partogram
Prolonged labour
Overefficient uterine action (precipitate labour)
Tonic uterine action
Cervical dystocia
Conclusion
64. Malpositions and malpresentations
Introduction
Malpositions
Clinical assessment
Malposition of the occiput
Fetal Positioning
Malpresentations of the fetus
Postnatal and neonatal implications
Conclusion
65. Obstructed labour and uterine rupture
Introduction
Obstructed labour
Uterine rupture
Conclusion
66. Obstetric interventions
Introduction
Assisted vaginal deliveries/birth (AVD/AVB)
Caesarean section
Conclusion
67. Shoulder dystocia
Introduction
Mechanism
Incidence and risk
Manoeuvres for the management of shoulder dystocia
Other procedures
Maternal outcomes
Birth injury and fetal outcomes
Notes and record keeping
Education, training, and development
Conclusion
68. Complications related to the third stage of labour
Introduction
Postpartum haemorrhage
Hypovolaemic shock
Prolonged third stage and retained placenta
Acute uterine inversion
Amniotic fluid embolism
Psychological considerations
Conclusion
69. Maternal morbidity following childbirth
Introduction
The midwife’s role
Life-threatening health problems
Haemorrhage
Common health problems
Longer-term implications
Culturally and linguistically diverse considerations
Lesbian, gay, bisexual, transgender, queer, intersex, asexual and more (LGBTQ+) community
Conclusion
70. Mental health and well being in pregnancy and childbirth
Introduction
Global perspectives on women’s mental health
Violence against women
Sexual assault, rape, sexual violence, and mental health
Who is ‘at risk’?
The midwife’s role
Pregnancy assessment
Recognising risk and suicide
Coordinated maternity care
Childbirth mental illness
Postnatal depression
Puerperal psychosis
Fear and trauma
Tokophobia
Post-traumatic stress disorder (PTSD)
Generalised anxiety disorder (GAD)
Conclusion
71. Pregnancy loss and the death of a baby: grief and bereavement care
Introduction
The National Bereavement Care Pathway (NBCP)
Understanding perinatal loss and grief
Coping with bereavement
Different parental responses in bereavement
The role of the midwife
Miscarriage
Termination of pregnancy for fetal anomaly (TOPFA)
Stillbirth
Neonatal death
Multiple loss
Preparing for labour and birth
Birth
Spiritual care
Creating memories
Seeing and holding the baby
Explaining to and involving siblings
Family and friends
Postnatal care
Seeing the baby and taking baby home
Investigations
Postmortem
Coroner's postmortem
Placental histology
Aftercare and the months ahead
The follow-up appointment
Subsequent pregnancy
Looking after ourselves as professionals
Training and education
Conclusion
72. Midwifery—practising in a complex world
Introduction
Reviewing maternity services
Working with women
Educating midwives
Human factors
Clinical governance
The midwife leader
The global pandemic
The global midwife
Conclusion
Index

Sue Macdonald

Affiliations and expertise

Midwife Consultant and Educationalist; Formerly Education and Research Manager and Lead Midwife for Education, Royal College of Midwives, London, UK

Gail Johnson

Gail Johnson began her career in nursing and has been a midwife for more than 30 years. In her midwifery practice Gail worked largely in the community with a focus on normality before moving into midwifery education. Gail’s current role is as a professional advisor in education at the Royal College of Midwives (RCM). She is responsible for the delivery of continuing professional development (CPD) activities for midwives across the UK and overseas. As part of this role Gail has designed and delivered a number of successful large conferences for midwives, including the RCM Legal birth conference and the Bereavement conference. The model for these events has been rolled out across the UK. Gail is also the professional lead on the RCM e-learning initiative, i-learn. The success of the online learning has seen the content increase with over 80 courses available with new content online throughout the year. In addition Gail has worked with the RCM's Chief Executive Professor Cathy Warwick in advising the NHS Leadership Academy on leadership challenges for midwives and nurses, attending a number of development meetings. Her leadership work has enabled her to work closely with midwives at all levels and recently worked with colleagues to design and deliver multidisciplinary workshops for labour ward leaders, addressing the challenges and cultures of maternity service. She also provides advice and consultancy to a number of external agencies both at national and international level on issues which impact on wider health or public health issues. For examples she is the designated lead on stillbirth and bereavement care and works with the Department of Health (England) and Sands (UK) on the role of maternity services in reducing stillbirth and improving bereavement care. In supporting midwives and representing the midwifery profession Gail is frequently asked to speak to the press and media on midwifery, maternity and women's health issues.

Affiliations and expertise

Professional Advisor Education, Royal College of Midwives, London, UK

Life Sciences

Physical Sciences & Engineering

Social Sciences & Humanities

Health