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  • MidwivesThe Magazine of The Royal College of Midwives

    ISSUE 2 | 2013

    Taking time out

    Why women are waiting for motherhood

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  • rcm.org.uk/midwives 2013 ISSUE 2 MIDWIVES 3

    Midwives5 CATHY WARWICK The RCM chief executive on the Francis report and what lessons can be learned.

    7 NEWSKeeping active, home birth and the smoking ban... Midwifery stories hot off the press.

    12 GLOBAL NEWSThe latest news from around the world.

    15 IN FOCUS A look at the possible impact of the Francis report on the NHS.

    16 RCM NEWSULR project expansion and Agenda for Change... The latest RCM news and dates.

    18 COUNTRY NEWSRCM UK latest news for Northern Ireland and England.

    19 ON POLITICSStuart Bonar looks to the 2015 elections.

    20 WORK LIFEAmy Leversidge discusses pensions.

    23 ONE-TO-ONERob Dabrowski talks to a male midwife.

    26 ON COURSEA student explains why politics isnt sucha daunting subject.

    27 FEEDBACKMidwifery morale, hierarchy and religion.


    Volume 16 Issue 2 2013






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  • MIDWIVES ISSUE 2 2013 rcm.org.uk/midwives4

    MidwivesThe o cial magazine of The Royal College of Midwives15 Mans eld Street, London W1G 9NHTel: 0300 303 0444

    EDITORIALEditor and RCM Communities manager: Emma Godfrey-Edwardsemma@midwives.co.ukTel: 020 7324 2751Deputy editor: Rob Dabrowskirob@midwives.co.ukTel: 020 7324 2752Assistant editor: Rebecca Grantrebecca@midwives.co.ukTel: 020 7880 7667Sub editor: Helen Birdhelen@midwives.co.ukTel: 020 7324 2773News and features writer: Hollie Ewershollie@midwives.co.ukTel: 020 7880 6210Professional editor: Professor Mary SteenPhD MCGI PGDipHE PGCRM BHSc CIMI RM RGNGeneral enquiries: editorial@midwives.co.uk

    EDITORIAL BOARDLouise Silverton, Jon Skewes, Suzanne Tyler, Gail Johnson, Val Finigan, Kate Brintworth, Suzanne Truttero, Fiona Donaldson-Myles

    PUBLISHERSRedactive Publishing Ltd17-18 Britton Street, London EC1M 5TP Tel: 020 7880 6200Publishing director: Jason Grant

    ADVERTISINGDivisional sales director: Steve Gricesteve.grice@redactive.co.ukTel: 020 7880 6220Sales manager: Giorgio Romanogiorgio.romano@redactive.co.uk Tel: 020 7880 7556 Sales executive: James Condleyjames.condley@redactive.co.uk Tel: 020 7880 7661

    DESIGNArt editor: Carrie BremnerArt director: Mark Parry

    COVERImage: Peter Crowther

    PRODUCTIONProduction executive: Aysha Miahaysha.miah@redactive.co.ukTel: 020 7880 6241

    MEMBERSHIPTel: 0300 303 0444

    MAGAZINE SUBSCRIPTION RATES(For non-members only, per annum) UK: 130 European Union: 175Rest of the world: 185

    MAGAZINE SUBSCRIPTION QUERIESMidwives, PO Box 2068, Bushey, Herts WD23 3ZFTel: 020 8950 9117 rcm@alliance-media.co.uk

    Printed by Wyndeham Peterborough Limited. Mailed by Priority, Salisbury.All members and associates of the RCM receive the magazine free.The views expressed do not necessarilyrepresent those of the editor or of The Royal College of Midwives.All content is reviewed by midwives.

    Midwives ISSN: 1479-2915

    28 RCM COMMUNITIESDiscussing the illegal abortion scene in Call the Midwife.

    29 TWEETDECKA look at what youve been tweeting.

    33 CUTTING EDGEJan Wallis reviews the latest midwifery-related research.

    34 HOW TOProvide postnatal perineal care.

    36 EBMA summary of the latest EBM papers.

    37 OLDER MOTHERSExamining the issues aroundthe increasing number of middle-aged mothers.

    41 RCM AWARDSPromoting normal birth at two Birmingham birth centres.

    42 INDUCTIONSummarising the history of induction.

    44 FETAL OUTCOMESA study looks at the results of babies born in water following induction.

    46 DILUTIONAL HYPONATRAEMIAExplaining the occurence, symptoms and preventive measures.

    48 COMMUNICATIONHow has the HART tool improved communication in Northern Ireland?

    50 NVPLooking at hyperemesis gravidarum.

    52 MSWsPart two of the screening scenario.


    56 EVENTS









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  • Editorialrcm.org.uk/midwives 2013 ISSUE 2 MIDWIVES 5

    RCM chief executive Cathy Warwick

    A lesson learned

    T he Francis report into the needless deaths and appalling treatment of patients at Sta ord Hospital makes for depressing reading. The report catalogues how patients, often

    in a highly vulnerable condition, were exposed to unclean, understa ed and unsafe wards and treated in the most callous manner imaginable.

    What is perhaps most concerning is the system-wide failure, from ward management to the regional and local tiers of the NHS, to regulators and the DH, to spot and to act on the numerous signs that something had gone seriously wrong.

    It should be stressed that maternity services at Sta ord Hospital were not implicated in any way by the Francis inquiry. Butwhile maternity care does not feature in the report, there canbe no cause for complacency. The analysis of the shortcomings of the healthcare system and the reports recommendations apply across all NHS services, to every regulatory body and to the professions and other sta groups. While the fallout from the Francis report is set to dominate the policy landscape in England, be in no doubt that its impact will ripple across the rest of the UK.

    The RCM is working through the 290 recommendations, spread

    across the 1800-page report, and considering what the key implications are for maternity and midwifery services, both for the women and families who use our services and for midwives themselves. For the RCM too, the report has generated some critical

    points to address. Firstly, how do we play our part in identifying services that are struggling and in getting

    them the help and support they need at an early stage? What can we do to help a HoM who is nding it di cult to make their voice heard? And how can we do more to support RCM members who feel that their concerns about the quality and safety of care arent being taken seriously?

    A key recommendation concerns the RCN and its ability to act both as a trade union and a professional organisation. The same question could be addressed to the RCM, to which my response would be that we have always felt that our trade union focus of supporting our members is as important as our professional focus of advocating for women to get the best possible care.

    Francis makes many recommendations touching on regulation and, in particular, revalidation. The RCM will be arguing that the midwifery profession already has, in our system of supervision of midwives, a mechanism through which this recommendation can be achieved.

    Top picks Looking at the increasing trend of older mothers, a new tool for improving team communication and nausea and vomiting in pregnancy

    The rise of the middle-aged mother (p37) A meeting of minds (p48) Beyond the pale (p50)

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  • rcm.org.uk/midwives/news 2013 ISSUE 2 MIDWIVES 7

    HeadlinesThe latest professional news

    Hot off the press / News

    Any risk to pregnant women undertaking physical activity at work is likely to be very minor, new guidelines state.

    The news comes following an extensive, systematic review of evidence covering such activities as lifting, prolonged standing, working long hours and shift working.

    The review looked into the risks of adverse outcomes, including miscarriage, preterm delivery and delivering a small-for-gestational-age baby.

    Jane Munro, RCM quality and audit development advisor, said: For women who are pregnant with one baby, we would encourage them to remain active during pregnancy, because this brings many bene ts.

    But she added: Many women will want to reduce long working hours, prolonged standing and heavy physical work as their pregnancy progresses.

    The guidelines have been issued by the Health and Work Development Unit.

    They stress that employers should consider making reasonable adjustments to limit excessive work demands.



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