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The Midwife's Labour and Birth Handbook, 3rd Edition

The Midwife's Labour and Birth Handbook, 3rd Edition

Vicky Chapman , Cathy Charles

ISBN: 978-1-118-48010-6

Jan 2013, Wiley-Blackwell

416 pages



Praise for previous editions:

“An excellent resource for both student midwives and qualified staff alike.” (Alison James, Midwifery Lecturer, Plymouth University)

"A lovely book with a lot of practical advice and easy to navigate. (Jayne Samples, Midwifery Lecturer, University of Huddersfield)

This fully revised and updated third edition of The Midwife’s Labour and Birth Handbook is a practical and accessible guide to midwifery care.


It addresses important questions such as:


  • Why are women being pressured into caesarean section for breech presentation when the evidence is equivocal?
  • If a baby needs assisted ventilation breaths at birth, why not bring the ambubag to the baby and leave the cord intact so the baby can benefit from the extra maternal oxygen supply?
  • Why is skin-to-skin contact at birth so rarely offered to preterm babies when there is evidence of benefit?

This well-regarded text promotes normality and woman-centred care, using research, evidence-based guidelines and anecdotal accounts from women. It challenges practice and guidelines which are biased or based on poor evidence. Guidance is offered on how to deal with difficult, sometimes controversial, situations.

The Midwife's Labour and Birth Handbook 3rd edition is an essential guide for both student midwives and experienced practising midwives.

New to this edition:

  • Full colour photographs including a kneeling breech birth
  • Suturing diagrams to assist left-handed midwives.
  • Expanded chapters on slow progress in labour and malposition/malpresentations, including a rare photograph of a face presentation birth.

Preface xiii

Contributors xv

1 Labour and normal birth – Cathy Charles 1

Introduction 1

The birth environment 3

Signs that precede labour 5

First stage of labour 6

Second stage of labour 18

Pushing 20

The birth 22

Third stage of labour 25

After the birth 30

Summary 31

Useful contacts and information 32

References 32

2 Vaginal examinations and artificial rupture of the membranes – Vicky Chapman 39

Vaginal examinations 39

Accuracy and timing of VEs 40

Consent or compliance? 41

Performing a VE 42

Some common problems 45

Artificial rupture of the membranes 47

Summary 49

References 49

3 Fetal heart rate monitoring in labour – Bryony Read 52

Introduction 52

Intermittent auscultation 52

Electronic fetal monitoring 54

Fetal scalp electrode 56

Classification of fetal heart rate features 56

Positive and negative aspects of EFM 59

Summary 60

References 61

Appendix: Continuous EFM algorithm (NICE, 2007) 63

4 Perineal trauma and suturing – Vicky Chapman 64

Introduction 64

Reducing perineal trauma 65

Assessment of perineal trauma 66

First and second degree tears: to suture or not to suture? 67

Suturing procedure 69

Summary 82

Recommended reading 82

References 82

5 Examination of the newborn baby at birth – Caroline Rutter 86

Introduction 86

The midwife’s assessment of the baby at birth 87

Measurements of the newborn 89

Vitamin K prophylaxis 90

Top-to-toe check 91

Neonatal infection 96

Giving upsetting news to parents 98

Useful contacts 99

References 99

6 Home birth – Janet Gwillim and Cathy Charles 102

Introduction 102

Benefits of home birth 103

Issues to consider before choosing home birth 104

Preparing for a home birth 106

Care in labour 108

Possible transfer to hospital 112

Summary 115

Useful contacts 115

References 115

7 Water for labour and birth – Cathy Charles 117

Introduction 117

Benefits of warm water immersion 118

Possible risks of warm water immersion 119

Criteria for labouring in water 120

Relative contraindications 120

Preparation 121

Labour care 123

Possible problems 125

Summary 127

Useful contacts 128

Recommended reading 128

References 128

8 Malpositions and malpresentations in labour – Vicky Chapman 130

Introduction 130

Definitions 130

Occipitoposterior position 133

Face presentation 140

Brow presentation 141

Transverse lie (shoulder presentation) 142

Summary 143

References 144

9 Slow progress in labour – Vicky Chapman 146

Introduction 146

Prolonged labour 147

Causes of a prolonged labour 148

Prolonged latent phase 149

Prolonged active first stage 150

Prolonged second stage 153

Summary 155

Recommended reading 156

References 156

10 Assisted birth: ventouse and forceps – Cathy Charles 160

Introduction 160

Avoiding an instrumental delivery 161

Indications for an instrumental delivery 161

Types of instrument 162

Choice of instrument 162

Care of a woman undergoing instrumental delivery 163

Assisting at an instrumental delivery 166

Midwife instrumental delivery 167

Post-birth discussion and care 172

Summary 174

References 174

Appendix 10.1 Midwife ventouse practitioner log book record 177

Appendix 10.2 Decision to decline midwife ventouse delivery 178

11 Caesarean section – Cathy Charles 179

Introduction 179

Risks and benefits of CS 180

Stemming the flow 182

Indications for elective CS 183

The experience of CS 183

Elective CS birth plan 184

Midwifery care for CS 184

Summary 189

Support groups for women following CS 190

Further reading 190

References 190

12 Vaginal birth after caesarean section – Vicky Chapman 193

Introduction 193

The influence and opinions of professionals 194

VBAC or elective CS 194

What improves the success rate in VBAC? 196

Induction of labour for VBAC 196

Midwifery care for VBAC labour 197

Summary 201

References 201

13 Preterm birth – Charlise Adams 204

Introduction 204

Incidence and facts 205

Causes and associated factors of preterm birth 206

Place of delivery 206

Preterm prelabour rupture of membranes (PPROM) 206

Corticosteroids for threatened preterm birth 208

Tocolysis in threatened preterm labour 208

Monitoring the fetal heart in preterm labour 209

Midwifery care 209

Mode of delivery 210

Care immediately after birth 211

Skin-to-skin contact 212

Resuscitation 213

Care related to specific types of preterm labour 214

Postnatal care 215

Summary 216

Useful contacts 217

References 217

14 Breech birth – Lesley Shuttler 220

Introduction 220

Types of breech presentation 221

Women’s options and the provision of care 223

Concerns and possible complications with a breech birth 225

Labour and birth 226

Summary 236

Useful contacts 236

Recommended reading 236

References 236

15 Twins and higher-order births – Jo Coggins 240

Introduction 240

Place of delivery 241

Mode of delivery 241

Care in labour 243

Third stage of labour 246

Care after the birth 248

Summary 249

Useful contacts 249

References 249

16 Haemorrhage – Sheila Miskelly 252

Introduction 252

Placenta praevia 253

Vasa praevia 255

Placental abruption 255

Postpartum haemorrhage 260

The 4Ts: Tone, Tissue, Trauma, Thrombophilias 261

Retained placenta 265

Summary 267

References 268

17 Emergencies in labour and birth – Sheila Miskelly 271

Introduction 271

Snapped cord 272

Cord prolapse and cord presentation 272

Amniotic fluid embolism 274

Uterine rupture 276

Shoulder dystocia 278

Inverted uterus 284

Maternal collapse/shock 286

Summary 287

References 288

18 Neonatal and maternal resuscitation – Nick Castle 292

Introduction 292

Risk management: anticipation 293

Basic neonatal resuscitation 293

Ongoing neonatal resuscitation/complications 297

Maternal resuscitation 301

Summary 304

References 304

19 Induction of labour – Mary-Lou Elliott 306

Introduction 306

Risks and side effects 307

Information giving and informed consent 308

Determining expected date of delivery (EDD) 308

IOL for social reasons 309

Induction for post-term pregnancy 309

IOL versus expectant management for PROM at term 309

Assessing the cervix 310

Methods of induction 310

Care of a woman during IOL 313

Summary 315

Recommended reading 316

References 316

20 Pre-eclampsia – Annette Briley 318

Introduction 318

Signs and symptoms 321

Care during labour 323

Monitoring the maternal and fetal condition in moderate/severe pre-eclampsia 324

Drugs used in the treatment of severe hypertension 326

Management of eclampsia 327

Care during/following an eclamptic fit 328

HELLP syndrome 330

Summary 332

Useful resources 333

References 333

21 Stillbirth and neonatal death – Barbara Kavanagh and Cathy Charles 336

Introduction 336

Definition 337

Incidence and facts 337

Causes and predisposing factors for perinatal death 337

Diagnosing fetal death and decision making 338

Midwifery care in labour following intrauterine death 341

Neonatal death and unexpected death at/after birth 342

Immediate care following stillbirth/NND: precious moments with the baby 343

Ongoing postnatal care 345

Supporting staff 349

Summary 350

Useful contacts 350

References 350

Appendix: Checklist following a pregnancy loss after 24 weeks 353

22 Risk management, litigation and complaints – Cathy Charles 355

Introduction 355

Clinical risk management: learning from adverse events 356

Litigation 357

Vicarious liability of employer 358

Clinical risk management organisations 359

Records 359

Complaints 360

Writing a statement 360

Caring for the mother or father following an adverse event 361

Conclusion 361

Summary 362

Useful contacts 362

References 362

23 Intrapartum blood tests – Vicky Chapman and Julie Davis 364

Blood tests 364

Haematology and coagulopathy 370

Blood bank (immunohaematology) 373

Blood tests for specific conditions and blood pictures 374

Fetal blood tests 376

References 379

24 Medicines and the midwife – Vicky Chapman 381

Introduction 381

Midwife exemption orders 382

Standing orders 385

Patient group directions (PGDs) 385

Documentation and drug errors 385

Common abbreviations 387

Useful contacts 388

References 388

Index 389

“With this latest edition, the authors have supplied a guide to contemporary midwifery practice that will be useful to both new and experienced midwives, and indeed to anyone involved with the care of mother and baby in the labour and birth setting. Highly recommended.”  (Nursing Times, 5 August 2014)

“This is a useful book, written at a level that students can clearly follow and easily understand.”  (Doody’s, 7 March 2014)

“It is not an exhaustive textbook of midwifery practice, but, rather, a very helpful handbook that the student will find invaluable for review and the experienced, seasoned midwife can use to maintain currency with evidence-based practice.”  (Birth, 3 September 2013)

“The Midwife's Labour and Birth Handbook appears in its third updated edition to provide a fine survey fully revised and updated for the latest midwifery practices. From professional questions in birthing options and recommendations based on anticipated issues to breech births, skin-to-skin contact at birth, and guidelines based on poor evidence and how to overcome them, this is a solid reference that includes new color photos, suturing diagrams to assist left-handed midwives, and expanded chapters on malposition and slow labor. At each step of the birth, midwifery requirements and recommendations are covered in depth, making for a fine reference loaded with bibliographical references and best practices based on the latest research.”  (Midwest Book Reviews, 1 July 2013)