Questioning induction of labour in older women Part 1.

In this column, Sara Wickham takes a sideways look at issues relevant to midwives, students, women and families, inviting us to sit down with a cup of tea and ponder what we think we know. There is a growing trend towards recommending induction of labour in older women. This is the first part of a two-part article in which Sara asks whether this recommendation is supported by the available evidence and asks us to consider how such policies are affecting women.

The importance of everyday birth wisdom.

In this column, Sara Wickham takes a sideways look at issues relevant to midwives, students, women and families, inviting us to sit down with a cup of tea and ponder what we think we know. This month, Sara shares details of a study which identified rituals undertaken by midwives looking after women in labour. Such studies, she argues, can be vital to helping us understand the nature of what we do in everyday practice as well as being a way of recording our knowledge for future generations.

Let there be mood lighting....

In this column, Sara Wickham takes a sideways look at issues relevant to midwives, students, women and families, inviting us to sit down with a cup of tea and ponder what we think we know. As it is always useful to consider how we can facilitate physiological labour and birth, this month Sara shares some of the tips that she has gathered from midwives and other birth workers about how they help women and families to lower the light levels and create the semi-darkness which many people feel is conducive to normal birth.

Whatever happened to the precautionary principle?

In this column, Sara Wickham takes a sideways look at issues relevant to midwives, students, women and families, inviting us to sit down with a cup of tea and ponder what we think we know. Here, she looks at one of the latest papers to join the trend of attempting to justify induction of labour in healthy women, raising questions about the language and stance used within the research and suggesting that women and midwives might gain from referring to the precautionary principle.

The ALTE mysteries: who's to blame?

In this column, Sara Wickham takes a sideways look at issues relevant to midwives, students, women and families, inviting us to sit down with a cup of tea and ponder what we think we know. A recent paper on apparent life-threatening events (ALTEs) in newborn babies brought to mind an experience from practice, the cause of which remains a mystery. As many similar events are unexplained, is it acceptable that there is a tendency in the literature to claim that skin-to-skin contact and breastfeeding are risk factors for ALTEs?

Being clear about continuity.

The phrase 'continuity of care' is often cited in relation to maternity care but, although we have evidence that continuity of care makes a difference to women, it is not well-defined as a concept and different types of continuity proposed by Freeman et al (2007), looking at how these might relate to might raise and suggesting other areas which need clarifying. I argue that it would be beneficial for midwives to continue to explore this concept can be taken to apply to a number of different elements of care. In this article, I consider the three maternity care, considering the issues that each amongst themselves and with women.

Stimulating conversation: does cold water wake babies in utero? Part 1.

The Royal College of Obstetricians and emerged in these discussions. Overall, the majority of respondents were open to using this practice in Gynaecologists (RCOG) library recently responded to a question about whether there was any evidence about the practice of offering a cold drink to a pregnant woman in order to encourage fetal movement or improve the reactivity of a cardiotocograph (CTG) trace. Their search conversations with midwives and other practice, which led me to have a number of practitioners about their experience of this. In the highlighted a dearth of research into this common first of two articles on this topic, I explain the theory and describe the range of responses that certain situations, but they felt it vital that it was used within a framework of providing individualised care and applying common sense.

Rethinking bugs. Part 2.

Bacteria seem to be getting mentioned everywhere at the moment, and could even be said to be 'trending'. In this second instalment of a two-part article, I argue that we need to re-think the care and treatment we offer to women for a number of reasons. Using the example of group B strep disease, I argue that avenues other than the current treatment pathway are worthy of exploration, and with antibiotic resistance an increasing problem, this may be the best way forward. I conclude that, because the need for reconsideration of some elements of maternity care is so great, the current focus on bacteria and the potential that this has to throw new light onto old areas may be very helpful.

A cautionary holiday tale.

In this column, Sara Wickham takes a sideways look at issues relevant to midwives, students, women and families, inviting us to sit down with a cup of tea and ponder what we think we know. This month's seasonal story tells the tale of Rudolph the red-nosed quantity surveyor, who gets more than he has bargained for when he visits the labour ward in order to weigh the birth balls for a trust health and safety exercise and decides to make tea for the tired midwives....

Who safeguards mothers?

While routine screening for group B streptococcus is not recommended in the UK, women are sometimes coincidentally found to be carrying these bacteria during investigations of symptoms in pregnancy. If such women decide to decline intravenous antibiotics for themselves in labour, they can seek support from midwives in appropriate roles. But once the woman's baby is born, the situation changes somewhat, as the legal context changes and the issue of safeguarding may be raised. This article considers the issues that arise in such scenarios and raises questions about who is there to support women who experience pressure to consent to their healthy newborn baby having prophylactic intravenous antibiotics.