Australian journal of midwifery : professional journal of the Australian College of Midwives Incorporated

A quality improvement project was conducted by a major maternity provider (3000 births per year) in the western suburbs of Melbourne. The first part of the project explored the reasons for increased length of stay (LOS), beyond the average timeframe for women receiving postnatal care. The perceptions of 100 women on their length of stay was also measured in the second part of the project. Two information audits were conducted to explore reasons for increased LOS. These reasons were varied, and by the time of the second audit, there was a demonstrated reduction in LOS. A Length of Stay Questionnaire was used to investigate women's perceptions of their LOS on discharge from hospital, and by telephone follow-up 14 days post-discharge. Perceptions varied between women and related to issues such as individual health complications, models of care, postnatal education, and degree of support at home. This project has implications for postnatal midwifery care in relation to discharge planning and women's expectations of care following birth.

Sarah A. Roberts

Gina B. Kruger

The Australian Journal of Midwifery

Aust J Midwifery

Reasons for increased postnatal length of stay &amp; women's perceptions of length of stay

产后住院时间延长的原因及女性对住院时间的看法

Kathleen Fahy

Nurses first, midwives second?

护士优先，助产士次之？

Allison Buck

Desert storks - bush midwives

沙漠鹳鸟 - 灌木丛中的助产士

This paper examines practices in second stage labour of a woman with an epidural. Common practices are compared with the current literature. Recommendations from this comparison are that practices such as directed pushing should be discouraged and pushing should be delayed until the presenting part has descended to a vaginal station greater than +1. Implications for practice are discussed and recommendations made to implement changes.

Deborah Birrell

Management of second stage labour with an epidural — a problem in isolation?

硬膜外麻醉下第二产程管理——一个孤立的问题吗？

This paper analyses the history of the subordination of midwifery to medicine and nursing. With the important exception of Evan Willis’ work on medical dominance and Annette Summers’ work on the takeover of midwifery by nursing, other histories of Australian midwifery have taken a neutral approach to issue of power and control. The aim of analysing this period is to identify the strategies of power that were used to subordinate midwifery. With increased consciousness of how power has operated in the past, midwives and woman of today can be more empowered when seeking to promote normal birth and midwifery models of care.Concepts of ‘power’, ‘the state’ and midwife are defined and discussed. A summary of the decline of midwifery and the rise of obstetrics in Europe and the United Kingdom (UK) gives a background against which to understand the Australian experience. The historical account given here draws to a climax by focussing on the period 1886–1928. It was during this time that medicine forged an alliance with nursing and achieved both legal and disciplinary control of midwifery. Knowing how this was done is important because it helps us to recognise the power strategies that are currently being used by medicine. This is helpful when planning how these strategies might be matched or countered by contemporary woman and midwives when seeking to promote normal birth and midwifery models of care.

Vicki Startin

Midwifery and nursing — A tension for rural areas

助产与护理——农村地区的紧张关系

Multiple national and local data sources collected by healthcare systems across Europe contain information regarding coronary artery bypass grafts (CABG). Currently surveillance for surgical site infections (SSIs) in this patient group is voluntary in the UK.To investigate and compare the currently available data sources in England for SSI surveillance in CABG patients.Data were extracted from the Society for Cardiothoracic Surgery in Great Britain and Ireland (SCTS) Adult Cardiac Surgery Registry, the Health Protection Agency SSI surveillance, and the Patient Administration System (PAS) from a single large National Health Service Trust. These data were deterministically linked using patient identifiers, anonymized, and then underwent descriptive analysis.From 1 January 2011 to 30 June 2011, 306 patients were recorded in at least one dataset as having undergone CABG. Of these, 76% were recorded by all three data sources being investigated. Of the discordant patients, 5% were recorded by both the local cardiac registry and PAS, and 18% by both the HPA surveillance and PAS. A total of 28 surgical site infections were recorded, of which 21% were identified by all the data sources.Currently, the databases which collect and store data relating to CABG patients suffer from duplications and discrepancies. Integration of the discordant systems is recommended to create a streamlined, sustainable electronic surveillance system.

Debra K Creedy

Jan Horsfall

Jenny Gamble

Developing critical appraisal skills using a review of the evidence for postpartum debriefing

利用证据回顾发展产后反思的关键评估技能

This literature review highlights that research about the effect of maternal hypotension in pregnancy has either concentrated on an acute hypotensive episode, or looked at the influence of persistent maternal hypotension on fetal growth and/or premature birth. Whilst there is some German literature no published English study has specifically examined the possible significance of chronic maternal hypotension on the risk of stillbirth. There is, therefore, a significant gap in the research in this area.

Mrs Jane Warland

Helen McCutcheon

Is there an association between maternal hypotension and poor pregnancy outcome?: A review of contemporary literature

母体低血压与不良妊娠结局之间是否存在关联？：当代文献综述

Depression following childbirth is a common, distressing but frequently underreported disorder. It involves a spectrum of symptoms, some of which may be self-limiting, while others can have major mental health implications in the post partum period. A range of health professionals, including midwives and mental health nurses, come into contact with women who suffer from postnatal depression; however, there is often little attempt made to integrate maternity and mental health care approaches. More collaborative frameworks of care are vital if health professionals are to adequately meet the needs of 'unhappy' women in the postnatal period.

Kerry Peart

Margaret Grigg

Postnatal Unhappiness: Who should direct support?

产后不快：谁应主导支持？

This paper presents a review of the literature that informed research undertaken to determine what features of childbirth have a positive effect on women's sense of self. The literature looked at control: of women or with women, trusting relationships, balancing self-empathy, self understanding through an instinctual response, altered concious states, childbirth and mother/baby relationships.

Jenny Parratt

The impact of Childbirth experiences on women's sense of self: A review of the literature

分娩经历对女性自我认知的影响：文献综述

Effective treatment for cognitive dysfunction after traumatic brain injury (TBI) is lacking in clinical practice. Increased brain-derived neurotrophic factor (BDNF) expression in cognitive circuits can significantly alleviate cognitive dysfunction in animal models of TBI. Selective 5-hydroxytryptamine receptor 6 (5-HT6R) agonists significantly increase BDNF expression and improve cognitive function. Therefore, we evaluated the protective effect of a highly selective 5-HT6R agonist, WAY-181187, on cognitive dysfunction after TBI. We established a controlled cortical impact model of moderate TBI in rats and performed drug intervention for five consecutive days. Rats had spatial reference memory impairment in the Morris water maze one and four weeks after TBI. BDNF expression in the medial prefrontal cortex (mPFC) and hippocampus decreased two and five weeks after TBI. Additionally, five weeks after TBI, decreases in neuronal dendritic spine density and the proportion of thin, mushroom-shaped dendritic spines and an increased proportion of stubby-type dendritic spines were observed. WAY-181187 administration (3 mg/kg) for five consecutive days after TBI significantly alleviated cognitive dysfunction at one and four weeks (P < 0.001 and P < 0.01), upregulated BDNF expression in the mPFC and hippocampus at two (P < 0.01 and P < 0.05) and five (P < 0.01 and P < 0.001) weeks and increased the dendritic spine density and the proportions of thin, mushroom-shaped dendrites in the mPFC (P < 0.05, P < 0.001 and P < 0.01) and hippocampus (P < 0.05, P < 0.001 and P < 0.05) at five weeks after TBI. Our results confirm that WAY-181187 administration (3 mg/kg) in the acute phase alleviated cognitive dysfunction after TBI, possibly by upregulating BDNF expression in the mPFC and hippocampus, enhancing neuroplasticity.

Alison Chandra

Midwifery in Victoria

维多利亚的助产术

Publication Information	Publisher: Australian College of Midwives，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2001，Proportion of original research papers: ，Self Citation Rate:， Gold OA Rate:

Australian journal of midwifery : professional journal of the Australian College of Midwives Incorporated

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Reasons for increased postnatal length of stay & women's perceptions of length of stay