CHAPTER CONTENTS Internationalization/globalization Definition and scope of the midwife The ICM Global Midwifery Education Standards The ERASMUS Programme The Millennium Development Goals (MDGs) The emotional context of midwifery What is ‘emotion work’? Sources of emotion work in midwifery practice Managing emotions in midwifery Challenges Developing emotional awareness The social context of pregnancy, childbirth and motherhood Disadvantaged groups Women from disadvantaged groups Midwives meeting the needs of women from disadvantaged groups Research Evidence The stated rationale for evidence-based practice (EBP) The randomized controlled trial (RCT) Discussion References Further reading Useful websites Over 500 multiple-choice questions enable students to test their knowledge. • Full image bank of illustrations to make study more visual and assist with projects. INTERNATIONALIZATION/ GLOBALIZATION Globalization and internationalization against the background of midwifery practice are difficult terms to define, compounded by the fact that the terms are often used interchangeably and synonymously, even though they are construed as distinctly separate entities. Globalization is not a new phenomenon (Baumann and Blythe 2008) with a number of varying definitions evident in the literature. The definition with the greatest resonance for midwives is that provided by the World Health Organization (2013), who states that globalization is:

Specialist Midwife (FGM), Nottingham University Hospitals NHS Trust (City Campus), Hucknall Road, Nottingham, UK Chapter 15 Care of the perineum, repair and female genital mutilation Elsevier Ltd. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). First edition 1953 Second edition 1956 Third edition 1958 Fourth edition 1961 Fifth edition 1964 Sixth edition 1968 Seventh edition 1971 Eighth edition 1975 Definition and scope of the midwife Midwives should be informed about the legal framework in which their role and scope of practice are enshrined. A definition of the midwife was developed by the ICM in 1972, which was later adopted by the International Federation of Gynaecology and Obstetrics (FIGO) followed by the World Health Organization (WHO). In 1990, at the Kobe Council meeting, the ICM amended the definition, later ratified in 1991 and 1992 by FIGO and WHO respectively. In 2005 and 2011 it was amended slightly by the ICM Council (Box 1.1). At the European level, member states of the EU (known at the time as the European Community [EC]) prepared a list of activities (Box 1.2) that midwives should be entitled to take up within its territory (EC Midwives Directive 1980; WHO 2009). Although midwives must learn about all of these activities, in the UK, where there is skilled medical care available to all pregnant women, it is recognized that it is highly unlikely that midwives would be expected to be proficient in all the activities identified by the EU. The manual removal of the placenta, for example, would routinely be carried out by a doctor unless no doctor is available and the mother’s life is at risk.urn:lcp:mylestextbookfor0000unse_m4q1:epub:4659b5a4-edd7-426a-a65f-38c9eff95242 Foldoutcount 0 Identifier mylestextbookfor0000unse_m4q1 Identifier-ark ark:/13960/t8jf4mn79 Invoice 1652 Isbn 0443055866 Elsevier is a leading publisher of health science books and journals, helping to advance medicine by delivering superior education, reference information and decision support tools to doctors, nurses, health practitioners and students. With titles available across a variety of media, we are able to supply the information you need in the most convenient format. Amanda Sullivan, BA(Hons) PGDip PhD RM RGN Director of Quality and Governance for NHS Nottinghamshire County, NHS Nottinghamshire County, Mansfield, Nottinghamshire, UK Chapter 11 Antenatal screening of the mother and fetus Jenny Hassall, BSc(Hons) MSc MPhil RN RM School of Nursing and Midwifery, University of Brighton, Eastbourne, UK Chapter 9 Change and adaptation in pregnancy Box 1.2 European Union Standards for Nursing and Midwifery: Article 42 – Pursuit of the professional activities of a midwife The provisions of this section shall apply to the activities of midwives as defined by each Member State, without prejudice to paragraph 2, and pursued under the professional titles set out in Annex V, point 5.5.2. The Member States shall ensure that midwives are able to gain access to and pursue at least the following activities: (a) provision of sound family planning information and advice; (b) diagnosis of pregnancies and monitoring normal pregnancies; carrying out the examinations necessary for the monitoring of the development of normal pregnancies; (c) prescribing or advising on the examinations necessary for the earliest possible diagnosis of pregnancies at risk; (d) provision of programmes of parenthood preparation and complete preparation for childbirth including advice on hygiene and nutrition; (e) caring for and assisting the mother during labour and monitoring the condition of the fetus in utero by the appropriate clinical and technical means; (f) conducting spontaneous deliveries including where required episiotomies and in urgent cases breech deliveries; (g) recognizing the warning signs of abnormality in the mother or infant which necessitate referral to a doctor and assisting the latter where appropriate; taking the necessary emergency measures in the doctor’s absence, in particular the manual removal of the placenta, possibly followed by manual examination of the uterus; (h) examining and caring for the newborn infant; taking all initiatives which are necessary in case of need and carrying out where necessary immediate resuscitation; (i) caring for and monitoring the progress of the mother in the postnatal period and giving all necessary advice to the mother on infant care to enable her to ensure the optimum progress of the new-born infant; (j) carrying out treatment prescribed by doctors; (k) drawing up the necessary written reports. Source: WHO (World Health Organization) 2009 European Union Standards for Nursing and Midwifery: information for accession countries, 2nd edn. www.euro.who.int/__data/assets/pdf_ file/0005/102200/E92852.pdf

Carole England, BSc(Hons) ENB405 CertEd(FE) RGN RM Midwife Teacher, Academic Division of Midwifery, School of Health Sciences, University of Nottingham, Derby, UK Chapter 28 Recognizing the healthy baby at term through examination of the newborn screening Chapter 29 Resuscitation of the healthy baby at birth: the importance of drying, airway management and establishment of breathing Chapter 30 The healthy low birth weight baby Chapter 33 Significant problems in the newborn babyForeword The strength and longevity of Myles Textbook for Midwives lies in its ability to juxtapose continuity and change from the first edition in 1953 to this sixteenth edition, over 60 years later. In continuity, some of the excellent early illustrations have been replicated throughout the editions. These provide clarity of understanding of essential anatomy for students. Changes of and additional colours in this edition have made a dramatic improvement to this clarity. In addition the clearly set out sections, chapter titles and index, aid systematic learning as well as facilitating easy reference when a new situation is encountered in practice. Of equal importance is how this text demonstrates the changes that have taken place in midwifery practice. Unlike the early editions, when midwives relied on one textbook and teachers alone, this sixteenth edition draws together theory, current practices, research and best evidence. In contrast to the first edition where Myles, in the Preface,wrote: ‘No bibliographical references have been given because of the vast number of sources which have been tapped in compiling the text (by Margaret Myles herself) and because pupil midwives become confused when they study from more than one or two textbooks’, this edition signposts students to further resources to increase their depth and breadth of knowledge. This is essential as no textbook can capture all the information needed for contemporary midwifery practice. In all editions the needs of women and their families have been central and this edition continues to emphasize the emotional, socio-economic, educational and physical needs of women during the life changing experience of pregnancy and parenthood, or bereavement. These events have a lasting impact on women’s lives. Of importance is always how well women are listened to and involved in making decisions about their or their babies’ care. Running through this edition is an emphasis on the need for midwives to be emotionally aware and develop good communication and interpersonal relationships with women, their partners and colleagues in the interdisciplinary team. The midwife has a key role to play in assisting women to make choices and feel in control, even when presented with difficult options and dilemmas. This text demonstrates the midwife’s role as lead professional when pregnancy is straightforward and co-ordinator of care when others need to be involved. The maternity services have seen major changes in recent years, in particular the massive increase in the birth rate, the changing demographics of women who become pregnant and the politics surrounding childbirth. Section One effectively brings together the issues that midwives need to understand, not just during their education programme, but also as part of their future responsibility in helping to bring about improvements in maternity care both in the UK and internationally. The vision for UK midwifery set out in Midwifery 2020 (Midwifery 2020 UK Programme, 2010) and the global initiatives of the International Confederation of Midwives are well summarized. Whilst Margaret Myles in her first 10 editions drew upon the knowledge of obstetricians and paediatricians in England and Scotland, she wrote the entire book herself. Recent edited editions demonstrate the need to draw upon the expertise of other midwives and health professionals in chapter writing. Thakar’s and Sultan’s inclusion of diagrams and photographs of perineal anatomy and trauma in chapter three are very timely given the increasing number of students who now learn to suture. These will help understanding of the importance of accurate diagnosis and effective perineal repair to aid women’s physical and emotional recovery. The value of antenatal education has been emphasized since the inception of this textbook, yet today not all women or their partners attend. Mary Nolan stresses the importance of sessions to be women-centred and expertly facilitated, not lecture based. She reminds readers that many women Professional Editor, RCM Journal, Professor of Midwifery, University of Chester, Chester, UK, Adjunct Professor of Midwifery, University of South Australia (UniSA), Adelaide, Australia Chapter 23 Physiology and care during the puerperium Chapter 24 Physical health problems and complications in the puerperium

Moira McLean, RGN RM ADM PGCEA PGDIP SOM Senior Lecturer – Midwifery and Supervisor of Midwives, School of Nursing and Midwifery, De Montfort University, Leicester, UK Chapter 13 Medical conditions of significance to midwifery practice Individuals from other disciplines who teach in the midwifery programme are competent in the content they teach. 5. Midwife teachers provide education, support and supervision of individuals who teach students in practical learning sites. 6. Midwife teachers and midwife clinical preceptors/ clinical teachers work together to support (facilitate), directly observe and evaluate students’ practical learning. 7. The ratio of students to teachers and clinical preceptors/clinical teachers in classroom and practical sites is determined by the midwifery programme and the requirements of regulatory authorities. 8. The effectiveness of midwifery faculty members is assessed on a regular basis following an established process.

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