Supporting Physiological Birth Choices in Midwifery Practice

Supporting Physiological Birth Choices in Midwifery Practice

Author: Claire Feeley

Publisher: Taylor & Francis

Published: 2023-02-28

Total Pages: 146

ISBN-13: 1000842177

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Highlighting the experiences of midwives who provide care to women opting outside of guidelines in the pursuit of physiological birth, Claire Feeley looks at the impact on midwives themselves, and explores how teams and organisations support or discourage women’s birth choices. This book investigates the processes, experiences and sociocultural-political influences upon midwives who support women’s alternative birthing choice and argues for a shift in perspective from notions of an individual’s professional responsibility to deliver woman-centred care, to a broader, collective responsibility. The book begins by contextualising the importance of quality midwifery care with an exploration of the current debates to demonstrate how hegemonic birth discourse and maternity practices have detrimentally affected physiological birth rates, and the wellbeing of women who opt outside of maternity guidelines. It provides real life examples of how midwives can facilitate a range of birthing decisions within mainstream midwifery services. Moreover, an exploration of midwives’ experiences of delivering such care is presented, revealing deeply polarised accounts from moral injury to job fulfilment. The polarised accounts are then presented within a new model to explore how a midwife’s socio-political working context can significantly mediate or exacerbate the vulnerability, conflict and stigmatisation that they may experience as a result of supporting alternative birth choices. Finally, this book explores the implications of the findings, looking at how team and organisational culture can be developed to better support women and midwives, making recommendations for a systems approach to improving maternity services. Discussing the invisible nature of midwifery work, what it means to deliver woman-centred care, and the challenges and benefits of doing so, this is a thought-provoking read for all midwives and future midwives. It is also an important contribution to interprofessional concerns around workforce development, sustainability, moral distress and compassion in health and social care.


Book Synopsis Supporting Physiological Birth Choices in Midwifery Practice by : Claire Feeley

Download or read book Supporting Physiological Birth Choices in Midwifery Practice written by Claire Feeley and published by Taylor & Francis. This book was released on 2023-02-28 with total page 146 pages. Available in PDF, EPUB and Kindle. Book excerpt: Highlighting the experiences of midwives who provide care to women opting outside of guidelines in the pursuit of physiological birth, Claire Feeley looks at the impact on midwives themselves, and explores how teams and organisations support or discourage women’s birth choices. This book investigates the processes, experiences and sociocultural-political influences upon midwives who support women’s alternative birthing choice and argues for a shift in perspective from notions of an individual’s professional responsibility to deliver woman-centred care, to a broader, collective responsibility. The book begins by contextualising the importance of quality midwifery care with an exploration of the current debates to demonstrate how hegemonic birth discourse and maternity practices have detrimentally affected physiological birth rates, and the wellbeing of women who opt outside of maternity guidelines. It provides real life examples of how midwives can facilitate a range of birthing decisions within mainstream midwifery services. Moreover, an exploration of midwives’ experiences of delivering such care is presented, revealing deeply polarised accounts from moral injury to job fulfilment. The polarised accounts are then presented within a new model to explore how a midwife’s socio-political working context can significantly mediate or exacerbate the vulnerability, conflict and stigmatisation that they may experience as a result of supporting alternative birth choices. Finally, this book explores the implications of the findings, looking at how team and organisational culture can be developed to better support women and midwives, making recommendations for a systems approach to improving maternity services. Discussing the invisible nature of midwifery work, what it means to deliver woman-centred care, and the challenges and benefits of doing so, this is a thought-provoking read for all midwives and future midwives. It is also an important contribution to interprofessional concerns around workforce development, sustainability, moral distress and compassion in health and social care.


Skilled Heartfelt Midwifery Practice

Skilled Heartfelt Midwifery Practice

Author: Claire Feeley

Publisher: Springer Nature

Published: 2023-11-25

Total Pages: 131

ISBN-13: 3031436431

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This book about the art, craft and science of expert midwifery care, while focusing on ‘alternative physiological births’ that are those ‘outside’ of guidelines, the contents can be applied to any birthing choices. Drawing upon the findings of a PhD that captured the experiences of midwives who proactively supported alternative physiological births while working in the National Health Service, their practice was conceptualised as ‘skilled heartfelt practice’. Skilled heartfelt practice denotes the interrelationship between midwives’ attitudes and beliefs in support of women’s choices, their values of cultivating meaningful relationships, and their expert practical clinical skills. It is these qualities combined that give rise to what is called ‘full-scope midwifery’ as defined by the Lancet Midwifery Series. This book illuminates why and how these midwives facilitated safe, relational care. Using a combination of emotional intelligence skills and clinical expertise while centring women’s bodily autonomy, they ensured safe care was provided within a holistic framework. Moreover, this book offers insights for midwives to move beyond ‘rule-based’ practice, where the benefits of expert practice are illuminated. Midwives facilitating ‘alternative’ physiological births epitomise evidence-based practice, which centres the woman or birthing person as the expert in their life, and the midwife meets them where they are with expert skills to support them. But what does this look like in clinical practice, particularly for those employed by institutions, those ‘working within the system’ who have constraints that private or self-employed midwives don’t have? How does a midwife cultivate those skills within a culture and climate that devalues both relationships, midwives and women’s autonomy? This book aims to provide a roadmap for those seeking to cultivate these skills. The core focus will be the midwife-mother relationship from the perspectives of the midwives, rather than the midwives wider working relationships or workplace contexts. This is purposeful so to offer a deep dive into the nuanced and varied ways of delivering this type of care. However, the realities of practice are also firmly embedded with the book, tensions will be explored, limitations acknowledged.


Book Synopsis Skilled Heartfelt Midwifery Practice by : Claire Feeley

Download or read book Skilled Heartfelt Midwifery Practice written by Claire Feeley and published by Springer Nature. This book was released on 2023-11-25 with total page 131 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book about the art, craft and science of expert midwifery care, while focusing on ‘alternative physiological births’ that are those ‘outside’ of guidelines, the contents can be applied to any birthing choices. Drawing upon the findings of a PhD that captured the experiences of midwives who proactively supported alternative physiological births while working in the National Health Service, their practice was conceptualised as ‘skilled heartfelt practice’. Skilled heartfelt practice denotes the interrelationship between midwives’ attitudes and beliefs in support of women’s choices, their values of cultivating meaningful relationships, and their expert practical clinical skills. It is these qualities combined that give rise to what is called ‘full-scope midwifery’ as defined by the Lancet Midwifery Series. This book illuminates why and how these midwives facilitated safe, relational care. Using a combination of emotional intelligence skills and clinical expertise while centring women’s bodily autonomy, they ensured safe care was provided within a holistic framework. Moreover, this book offers insights for midwives to move beyond ‘rule-based’ practice, where the benefits of expert practice are illuminated. Midwives facilitating ‘alternative’ physiological births epitomise evidence-based practice, which centres the woman or birthing person as the expert in their life, and the midwife meets them where they are with expert skills to support them. But what does this look like in clinical practice, particularly for those employed by institutions, those ‘working within the system’ who have constraints that private or self-employed midwives don’t have? How does a midwife cultivate those skills within a culture and climate that devalues both relationships, midwives and women’s autonomy? This book aims to provide a roadmap for those seeking to cultivate these skills. The core focus will be the midwife-mother relationship from the perspectives of the midwives, rather than the midwives wider working relationships or workplace contexts. This is purposeful so to offer a deep dive into the nuanced and varied ways of delivering this type of care. However, the realities of practice are also firmly embedded with the book, tensions will be explored, limitations acknowledged.


Supporting a Physiologic Approach to Pregnancy and Birth

Supporting a Physiologic Approach to Pregnancy and Birth

Author: Melissa D. Avery

Publisher: John Wiley & Sons

Published: 2013-03-28

Total Pages: 287

ISBN-13: 1118612000

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Supporting a Physiologic Approach to Pregnancy and Birth: A Practical Guide provides an overview of current evidence and a range of practical suggestions to promote physiologic birth within the United States healthcare system. Presenting the latest evidence available on practical approaches and minimal interventions, this book looks into clinic exam rooms and hospital labor units to investigate the possibilities for improving the pregnancy and labor experience. Contributors discuss recent research and other published information and present a range of ideas, tools, and solutions for maternity care clinicians, including midwives, nurses, physicians, and other members of the perinatal team. An invaluable resource, Supporting a Physiologic Approach to Pregnancy and Birth is a must-have practical guide for those involved in all aspects of pregnancy and birth.


Book Synopsis Supporting a Physiologic Approach to Pregnancy and Birth by : Melissa D. Avery

Download or read book Supporting a Physiologic Approach to Pregnancy and Birth written by Melissa D. Avery and published by John Wiley & Sons. This book was released on 2013-03-28 with total page 287 pages. Available in PDF, EPUB and Kindle. Book excerpt: Supporting a Physiologic Approach to Pregnancy and Birth: A Practical Guide provides an overview of current evidence and a range of practical suggestions to promote physiologic birth within the United States healthcare system. Presenting the latest evidence available on practical approaches and minimal interventions, this book looks into clinic exam rooms and hospital labor units to investigate the possibilities for improving the pregnancy and labor experience. Contributors discuss recent research and other published information and present a range of ideas, tools, and solutions for maternity care clinicians, including midwives, nurses, physicians, and other members of the perinatal team. An invaluable resource, Supporting a Physiologic Approach to Pregnancy and Birth is a must-have practical guide for those involved in all aspects of pregnancy and birth.


Birth Settings in America

Birth Settings in America

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2020-05-01

Total Pages: 369

ISBN-13: 0309669820

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The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.


Book Synopsis Birth Settings in America by : National Academies of Sciences, Engineering, and Medicine

Download or read book Birth Settings in America written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-05-01 with total page 369 pages. Available in PDF, EPUB and Kindle. Book excerpt: The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.


Supporting Women to Give Birth at Home

Supporting Women to Give Birth at Home

Author: Mary Steen

Publisher: Routledge

Published: 2012-03-12

Total Pages: 284

ISBN-13: 1136595821

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Supporting Women to Give Birth at Home describes and discusses the main challenges and issues that midwives and maternity services encounter when preparing for and attending a home birth. To ensure that a home birth is a real option for women, midwives need to be able to believe in a woman’s ability to give birth at home and to promote this birth option, providing evidence-based information about benefits and risks. This practical guide will help midwives to have the necessary skills, resources and confidence to support homebirth. The book includes: the present birth choices a woman has the implications homebirth has upon midwifery practice how midwives can prepare and support women and their families the midwife’s role and responsibilities national and local policies, guidelines and available resources pain management options With a range of recent home birth case studies brought together in the final chapter, this accessible text provides a valuable insight into those considering homebirth. Supporting Women to Give Birth at Home will be of interest to students studying issues around normal birth and will be an important resource for clinically based midwives, in particular community based midwives, home birth midwifery teams, independent midwives, and all who are interested in homebirth as a genuine choice.


Book Synopsis Supporting Women to Give Birth at Home by : Mary Steen

Download or read book Supporting Women to Give Birth at Home written by Mary Steen and published by Routledge. This book was released on 2012-03-12 with total page 284 pages. Available in PDF, EPUB and Kindle. Book excerpt: Supporting Women to Give Birth at Home describes and discusses the main challenges and issues that midwives and maternity services encounter when preparing for and attending a home birth. To ensure that a home birth is a real option for women, midwives need to be able to believe in a woman’s ability to give birth at home and to promote this birth option, providing evidence-based information about benefits and risks. This practical guide will help midwives to have the necessary skills, resources and confidence to support homebirth. The book includes: the present birth choices a woman has the implications homebirth has upon midwifery practice how midwives can prepare and support women and their families the midwife’s role and responsibilities national and local policies, guidelines and available resources pain management options With a range of recent home birth case studies brought together in the final chapter, this accessible text provides a valuable insight into those considering homebirth. Supporting Women to Give Birth at Home will be of interest to students studying issues around normal birth and will be an important resource for clinically based midwives, in particular community based midwives, home birth midwifery teams, independent midwives, and all who are interested in homebirth as a genuine choice.


EBOOK: Psychology For Midwives

EBOOK: Psychology For Midwives

Author: Maureen Raynor

Publisher: McGraw-Hill Education (UK)

Published: 2010-04-16

Total Pages: 224

ISBN-13: 0335240348

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This accessible, evidence-based book explores how important it is for midwives to understand the psychological aspects of care, in order to create positive experiences for mothers and families. The book provides simple explanations for why psychological care matters in midwifery practice and uses different theoretical perspectives of psychology to illustrate how it fundamentally contributes to good midwifery practice. The book addresses many core concepts and principles of psychology, including: Mother-midwife relationship Emotions during the childbearing continuum Perinatal mental illness Communications in midwifery practice The birth environment Stress and anxiety Providing support to families Attachment and bonding Reflective questions, activities, illustrations, tables, summary boxes and a glossary help readers navigate the book.Psychology for Midwives is essential reading for all midwives, students and allied health care professionals interested in the psychological dimensions of childbearing.


Book Synopsis EBOOK: Psychology For Midwives by : Maureen Raynor

Download or read book EBOOK: Psychology For Midwives written by Maureen Raynor and published by McGraw-Hill Education (UK). This book was released on 2010-04-16 with total page 224 pages. Available in PDF, EPUB and Kindle. Book excerpt: This accessible, evidence-based book explores how important it is for midwives to understand the psychological aspects of care, in order to create positive experiences for mothers and families. The book provides simple explanations for why psychological care matters in midwifery practice and uses different theoretical perspectives of psychology to illustrate how it fundamentally contributes to good midwifery practice. The book addresses many core concepts and principles of psychology, including: Mother-midwife relationship Emotions during the childbearing continuum Perinatal mental illness Communications in midwifery practice The birth environment Stress and anxiety Providing support to families Attachment and bonding Reflective questions, activities, illustrations, tables, summary boxes and a glossary help readers navigate the book.Psychology for Midwives is essential reading for all midwives, students and allied health care professionals interested in the psychological dimensions of childbearing.


Supporting Women for Labour and Birth

Supporting Women for Labour and Birth

Author: Nicky Leap

Publisher: Routledge

Published: 2016-06-10

Total Pages: 314

ISBN-13: 1317390989

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Fear of childbirth, the increasing use of epidurals and soaring caesarean section rates are the focus of much apprehension, debate, and controversy in contemporary maternity care. Across the world, support in labour has been shown to reduce obstetric interventions and improve outcomes for women and babies, yet women often report feeling unhappy with the support they receive. This textbook provides a clear and practical guide to supporting women in labour, looking at a range of techniques and approaches that promote a safe and positive experience of birth for women and their families. Written by two highly experienced midwifery authors, this text draws on up-to-date research, identifying how evidence can be applied to everyday practice. It includes narratives from women and practitioners, including midwives, doulas, childbirth educators and students. These are used to illustrate a range of situations where the quality of support is central to the quality of the experience and outcome. Supporting Women for Labour and Birth encourages readers to reflect on their experiences and examine the evidence provided by both research and the experiences of women and practitioners in order to explore how this could be incorporated into their practice. The only book to deal directly with the practical and emotional issues associated with labour support, it is an ideal text for student midwives and an important reference for practising midwives, doulas and other childbirth practitioners.


Book Synopsis Supporting Women for Labour and Birth by : Nicky Leap

Download or read book Supporting Women for Labour and Birth written by Nicky Leap and published by Routledge. This book was released on 2016-06-10 with total page 314 pages. Available in PDF, EPUB and Kindle. Book excerpt: Fear of childbirth, the increasing use of epidurals and soaring caesarean section rates are the focus of much apprehension, debate, and controversy in contemporary maternity care. Across the world, support in labour has been shown to reduce obstetric interventions and improve outcomes for women and babies, yet women often report feeling unhappy with the support they receive. This textbook provides a clear and practical guide to supporting women in labour, looking at a range of techniques and approaches that promote a safe and positive experience of birth for women and their families. Written by two highly experienced midwifery authors, this text draws on up-to-date research, identifying how evidence can be applied to everyday practice. It includes narratives from women and practitioners, including midwives, doulas, childbirth educators and students. These are used to illustrate a range of situations where the quality of support is central to the quality of the experience and outcome. Supporting Women for Labour and Birth encourages readers to reflect on their experiences and examine the evidence provided by both research and the experiences of women and practitioners in order to explore how this could be incorporated into their practice. The only book to deal directly with the practical and emotional issues associated with labour support, it is an ideal text for student midwives and an important reference for practising midwives, doulas and other childbirth practitioners.


Counselling for Maternal and Newborn Health Care

Counselling for Maternal and Newborn Health Care

Author: World Health Organization

Publisher: World Health Organization

Published: 2010

Total Pages: 240

ISBN-13: 9241547626

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The main aim of this practical Handbookis to strengthen counselling and communication skills of skilled attendants (SAs) and other health providers, helping them to effectively discuss with women, families and communities the key issues surrounding pregnancy, childbirth, postpartum, postnatal and post-abortion care. Counselling for Maternal and Newborn Health Careis divided into three main sections. Part 1 is an introduction which describes the aims and objectives and the general layout of the Handbook. Part 2 describes the counselling process and outlines the six key steps to effective counselling. It explores the counselling context and factors that influence this context including the socio-economic, gender, and cultural environment. A series of guiding principles is introduced and specific counselling skills are outlined. Part 3 focuses on different maternal and newborn health topics, including general care in the home during pregnancy; birth and emergency planning; danger signs in pregnancy; post-abortion care; support during labor; postnatal care of the mother and newborn; family planning counselling; breastfeeding; women with HIV/AIDS; death and bereavement; women and violence; linking with the community. Each Session contains specific aims and objectives, clearly outlining the skills that will be developed and corresponding learning outcomes. Practical activities have been designed to encourage reflection, provoke discussions, build skills and ensure the local relevance of information. There is a review at the end of each session to ensure the SAs have understood the key points before they progress to subsequent sessions.


Book Synopsis Counselling for Maternal and Newborn Health Care by : World Health Organization

Download or read book Counselling for Maternal and Newborn Health Care written by World Health Organization and published by World Health Organization. This book was released on 2010 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: The main aim of this practical Handbookis to strengthen counselling and communication skills of skilled attendants (SAs) and other health providers, helping them to effectively discuss with women, families and communities the key issues surrounding pregnancy, childbirth, postpartum, postnatal and post-abortion care. Counselling for Maternal and Newborn Health Careis divided into three main sections. Part 1 is an introduction which describes the aims and objectives and the general layout of the Handbook. Part 2 describes the counselling process and outlines the six key steps to effective counselling. It explores the counselling context and factors that influence this context including the socio-economic, gender, and cultural environment. A series of guiding principles is introduced and specific counselling skills are outlined. Part 3 focuses on different maternal and newborn health topics, including general care in the home during pregnancy; birth and emergency planning; danger signs in pregnancy; post-abortion care; support during labor; postnatal care of the mother and newborn; family planning counselling; breastfeeding; women with HIV/AIDS; death and bereavement; women and violence; linking with the community. Each Session contains specific aims and objectives, clearly outlining the skills that will be developed and corresponding learning outcomes. Practical activities have been designed to encourage reflection, provoke discussions, build skills and ensure the local relevance of information. There is a review at the end of each session to ensure the SAs have understood the key points before they progress to subsequent sessions.


Birth Models That Work

Birth Models That Work

Author: Robbie E. Davis-Floyd

Publisher: Univ of California Press

Published: 2009-04-06

Total Pages: 495

ISBN-13: 0520943333

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This groundbreaking book takes us around the world in search of birth models that work in order to improve the standard of care for mothers and families everywhere. The contributors describe examples of maternity services from both developing countries and wealthy industrialized societies that apply the latest scientific evidence to support and facilitate normal physiological birth; deal appropriately with complications; and generate excellent birth outcomes—including psychological satisfaction for the mother. The book concludes with a description of the ideology that underlies all these working models—known internationally as the midwifery model of care.


Book Synopsis Birth Models That Work by : Robbie E. Davis-Floyd

Download or read book Birth Models That Work written by Robbie E. Davis-Floyd and published by Univ of California Press. This book was released on 2009-04-06 with total page 495 pages. Available in PDF, EPUB and Kindle. Book excerpt: This groundbreaking book takes us around the world in search of birth models that work in order to improve the standard of care for mothers and families everywhere. The contributors describe examples of maternity services from both developing countries and wealthy industrialized societies that apply the latest scientific evidence to support and facilitate normal physiological birth; deal appropriately with complications; and generate excellent birth outcomes—including psychological satisfaction for the mother. The book concludes with a description of the ideology that underlies all these working models—known internationally as the midwifery model of care.


Decision-Making in Midwifery Practice

Decision-Making in Midwifery Practice

Author: Maureen D. Raynor

Publisher: Elsevier Health Sciences

Published: 2005-04-01

Total Pages: 196

ISBN-13: 0702039764

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The eBook version of this title gives you access to the complete book content electronically*. Evolve eBooks allows you to quickly search the entire book, make notes, add highlights, and study more efficiently. Buying other Evolve eBooks titles makes your learning experience even better: all of the eBooks will work together on your electronic "bookshelf", so that you can search across your entire library of Midwifery eBooks. *Please note that this version is the eBook only and does not include the printed textbook. Alternatively, you can buy the Text and Evolve eBooks Package (which gives you the printed book plus the eBook). Please scroll down to our Related Titles section to find this title. The book looks at a broad perspective of decision making and each chapter focuses on a specific aspect related to making crucial decisions. Following an initial introduction the book explores the concept of autonomy and the many factors that influence autonomous practise. The role of knowledge in decision making, using evidence to inform decisions, as well as different approaches to decision making are also examined - including the traditional or rational approach, decision analysis and the development of professional judgement. Dilemmas arise when decisions are made and therefore ethical decision making is an important component of this book. Management decisions may be different from those related to giving specific care to women, hence one chapter focuses on making management decisions. Emphasis is also placed on the role of the midwife in helping women make their own decisions, the role of reflection in enhancing the decisions midwives make and the support midwives can receive from their Supervisor of Midwives. Flowcharts explain and facilitate the decision-making process. A very practical approach to decision-making in midwifery, with contributions from midwives who have considerable experience in this area Provides guidelines on how to achieve successful autonomous midwifery practice, enabling theory to be effectively applied to practice Includes coverage of management roles and decision-making as well as clinical scenarios, offering frameworks and flowcharts to guide the inexperienced Suggests different approaches to making difficult decisions


Book Synopsis Decision-Making in Midwifery Practice by : Maureen D. Raynor

Download or read book Decision-Making in Midwifery Practice written by Maureen D. Raynor and published by Elsevier Health Sciences. This book was released on 2005-04-01 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt: The eBook version of this title gives you access to the complete book content electronically*. Evolve eBooks allows you to quickly search the entire book, make notes, add highlights, and study more efficiently. Buying other Evolve eBooks titles makes your learning experience even better: all of the eBooks will work together on your electronic "bookshelf", so that you can search across your entire library of Midwifery eBooks. *Please note that this version is the eBook only and does not include the printed textbook. Alternatively, you can buy the Text and Evolve eBooks Package (which gives you the printed book plus the eBook). Please scroll down to our Related Titles section to find this title. The book looks at a broad perspective of decision making and each chapter focuses on a specific aspect related to making crucial decisions. Following an initial introduction the book explores the concept of autonomy and the many factors that influence autonomous practise. The role of knowledge in decision making, using evidence to inform decisions, as well as different approaches to decision making are also examined - including the traditional or rational approach, decision analysis and the development of professional judgement. Dilemmas arise when decisions are made and therefore ethical decision making is an important component of this book. Management decisions may be different from those related to giving specific care to women, hence one chapter focuses on making management decisions. Emphasis is also placed on the role of the midwife in helping women make their own decisions, the role of reflection in enhancing the decisions midwives make and the support midwives can receive from their Supervisor of Midwives. Flowcharts explain and facilitate the decision-making process. A very practical approach to decision-making in midwifery, with contributions from midwives who have considerable experience in this area Provides guidelines on how to achieve successful autonomous midwifery practice, enabling theory to be effectively applied to practice Includes coverage of management roles and decision-making as well as clinical scenarios, offering frameworks and flowcharts to guide the inexperienced Suggests different approaches to making difficult decisions