Patricia Lindsay RN, RM, MSc, PGCEA, DHC Registered Midwife.Carmel Bagness MA, RN, RM, ADM, PGCEA Professional Lead for Midwifery & Women’s Health Royal College of Nursing London, UK.Ian Peate OBE FRCN, EN(G), RGN, DipN (Lond), RNT, BEd (Hons), MA (Lond) LLM Editor in Chief British Journal of Nursing Visiting Professor of Nursing St George’s University of London and Kingston University London Head of School School of Health Studies Gibraltar.

• Contributors viiiForeword xiPreface xiiPart 1 The basics of care 1Chapter 1: Infection control1 Infection prevention and control 22 Hand hygiene 43 Infectious diseases in pregnancy 64 Modes of transmission 85 Asepsis and sepsis 10Chapter 2: Health and safety at work6 Moving and handling 127 The control of substances hazardous to health 148 Safety in the working environment 169 Sharps injuries 1810 Working safely in the community 20Chapter 3: Personal hygiene care11 Personal hygiene care for women 2212 Perineal and vulval hygiene; use of bedpans and commodes 2413 Pressure area care 26Chapter 4: Quality and patient safety in maternity care14 Risk management, liability and avoidable harm 2815 Types of incident, incident reporting, record keeping and duty of candour 3016 Audit and quality assurance in maternity care 32Chapter 5: Safeguarding17 Safeguarding vulnerable women 3418 Safeguarding of children: key issues 3619 Female genital mutilation 38Part 2 Assessment, examination, screening and care of the woman and baby 41Chapter 6: Assessment of the woman20 ‘Booking’: the initial consultation with the midwife 4221 The antenatal appointment: physical and psychological assessment of the woman in pregnancy 4422 Abdominal examination in pregnancy 4623 Physical and emotional assessment after birth 48Chapter 7: Care of the woman in labour24 Assessing the woman in labour 5025 Abdominal examination in labour 5226 Vaginal examinations in labour 5427 Positions in labour and birth 5628 Supporting and caring for women in labour 5829 Supporting and caring for the partner 6030 Care of the perineum in labour including episiotomy and suturing 6231 Examination of the placenta and membranes 6432 Urinary catheterisation 66Chapter 8: The fetus in pregnancy and labour33 Assessing fetal wellbeing in pregnancy and labour 6834 Monitoring the fetal heart in pregnancy and labour 70Chapter 9: Assessment and examination of the neonate35 The Apgar score 7236 The midwife’s examination of the baby at birth including identification of the neonate 7437 Appearance and characteristics of the well term neonate 7638 Overall daily assessment of the term neonate including vital signs and bladder and bowel function 7839 Newborn and infant physical examination 8040 The term, preterm and growth-restricted baby 82Chapter 10: Caring for the newborn41 Providing daily hygiene for the neonate including changing a nappy 8442 Bathing the newborn 8643 Breastfeeding 8844 Formula feeding 9045 Other feeding methods 9246 Neonatal blood screening (‘heel prick’) 94Chapter 11: Blood sampling and cannulation47 Maternal venepuncture, including glucose tolerance testing 9648 Cord blood and neonatal capillary blood sampling 9849 Venous cannulation of the woman 100Chapter 12: Taking and testing other body samples50 Urinalysis 10251 Specimen collection – stool specimen 10452 Taking a wound swab 10653 Use of a vaginal speculum and taking a vaginal swab 108Part 3 The woman or neonate with different needs 111Chapter 13: Induction/stimulation of labour54 Membrane sweep 11255 Insertion of vaginal prostaglandin E2 11456 Artificial rupture of membranes 116Chapter 14: Care skills for the woman with complex needs57 Recognising the deteriorating woman 11858 CVP, Spo2 and ECGs 12059 Fluid balance monitoring 12260 Peak flow measurement in the woman 12461 MEOWS, AVPU, GCS and SBAR 12662 Care of the deceased 128Chapter 15: Care skills for the baby with complex needs63 Recognising deterioration in the neonate 13064 Neonatal jaundice 13265 Hypoglycaemia 13466 Hypothermia 136Chapter 16: Wound care67 Wound assessment 13868 Wound dressings and drains 14069 Wound closures 142Chapter 17: Prevention of venous thromboembolism70 Assessment of venous thromboembolism risk and prevention of deep vein thrombosis in childbirth 14471 Application and use of compression stockings 146Part 4 Drug administration in midwifery 149Chapter 18: Routes of administration72 Drug administration, handling and storage 15073 Administration by injection to the woman 15274 Intravenous administration of drugs 15475 Medicine administration by oral, rectal, vaginal, topical and inhalation routes 15676 Neonatal drug administration 15877 Immunisation 160Chapter 19:Pain relief78 Regional analgesia 16279 Non-pharmacological methods of pain relief 16480 Transfusion of blood and blood products 16681 Anti-D: preventing rhesus isoimmunisation 168Appendices 170Key references and further reading 172Glossary 182Index 184

Patricia Lindsay RN, RM, MSc, PGCEA, DHC Registered Midwife.Carmel Bagness MA, RN, RM, ADM, PGCEA Professional Lead for Midwifery & Women’s Health Royal College of Nursing London, UK.Ian Peate OBE FRCN, EN(G), RGN, DipN (Lond), RNT, BEd (Hons), MA (Lond) LLM Editor in Chief British Journal of Nursing Visiting Professor of Nursing St George’s University of London and Kingston University London Head of School School of Health Studies Gibraltar.

• Contributors viiiForeword xiPreface xiiPart 1 The basics of care 1Chapter 1: Infection control1 Infection prevention and control 22 Hand hygiene 43 Infectious diseases in pregnancy 64 Modes of transmission 85 Asepsis and sepsis 10Chapter 2: Health and safety at work6 Moving and handling 127 The control of substances hazardous to health 148 Safety in the working environment 169 Sharps injuries 1810 Working safely in the community 20Chapter 3: Personal hygiene care11 Personal hygiene care for women 2212 Perineal and vulval hygiene; use of bedpans and commodes 2413 Pressure area care 26Chapter 4: Quality and patient safety in maternity care14 Risk management, liability and avoidable harm 2815 Types of incident, incident reporting, record keeping and duty of candour 3016 Audit and quality assurance in maternity care 32Chapter 5: Safeguarding17 Safeguarding vulnerable women 3418 Safeguarding of children: key issues 3619 Female genital mutilation 38Part 2 Assessment, examination, screening and care of the woman and baby 41Chapter 6: Assessment of the woman20 ‘Booking’: the initial consultation with the midwife 4221 The antenatal appointment: physical and psychological assessment of the woman in pregnancy 4422 Abdominal examination in pregnancy 4623 Physical and emotional assessment after birth 48Chapter 7: Care of the woman in labour24 Assessing the woman in labour 5025 Abdominal examination in labour 5226 Vaginal examinations in labour 5427 Positions in labour and birth 5628 Supporting and caring for women in labour 5829 Supporting and caring for the partner 6030 Care of the perineum in labour including episiotomy and suturing 6231 Examination of the placenta and membranes 6432 Urinary catheterisation 66Chapter 8: The fetus in pregnancy and labour33 Assessing fetal wellbeing in pregnancy and labour 6834 Monitoring the fetal heart in pregnancy and labour 70Chapter 9: Assessment and examination of the neonate35 The Apgar score 7236 The midwife’s examination of the baby at birth including identification of the neonate 7437 Appearance and characteristics of the well term neonate 7638 Overall daily assessment of the term neonate including vital signs and bladder and bowel function 7839 Newborn and infant physical examination 8040 The term, preterm and growth-restricted baby 82Chapter 10: Caring for the newborn41 Providing daily hygiene for the neonate including changing a nappy 8442 Bathing the newborn 8643 Breastfeeding 8844 Formula feeding 9045 Other feeding methods 9246 Neonatal blood screening (‘heel prick’) 94Chapter 11: Blood sampling and cannulation47 Maternal venepuncture, including glucose tolerance testing 9648 Cord blood and neonatal capillary blood sampling 9849 Venous cannulation of the woman 100Chapter 12: Taking and testing other body samples50 Urinalysis 10251 Specimen collection – stool specimen 10452 Taking a wound swab 10653 Use of a vaginal speculum and taking a vaginal swab 108Part 3 The woman or neonate with different needs 111Chapter 13: Induction/stimulation of labour54 Membrane sweep 11255 Insertion of vaginal prostaglandin E2 11456 Artificial rupture of membranes 116Chapter 14: Care skills for the woman with complex needs57 Recognising the deteriorating woman 11858 CVP, Spo2 and ECGs 12059 Fluid balance monitoring 12260 Peak flow measurement in the woman 12461 MEOWS, AVPU, GCS and SBAR 12662 Care of the deceased 128Chapter 15: Care skills for the baby with complex needs63 Recognising deterioration in the neonate 13064 Neonatal jaundice 13265 Hypoglycaemia 13466 Hypothermia 136Chapter 16: Wound care67 Wound assessment 13868 Wound dressings and drains 14069 Wound closures 142Chapter 17: Prevention of venous thromboembolism70 Assessment of venous thromboembolism risk and prevention of deep vein thrombosis in childbirth 14471 Application and use of compression stockings 146Part 4 Drug administration in midwifery 149Chapter 18: Routes of administration72 Drug administration, handling and storage 15073 Administration by injection to the woman 15274 Intravenous administration of drugs 15475 Medicine administration by oral, rectal, vaginal, topical and inhalation routes 15676 Neonatal drug administration 15877 Immunisation 160Chapter 19:Pain relief78 Regional analgesia 16279 Non-pharmacological methods of pain relief 16480 Transfusion of blood and blood products 16681 Anti-D: preventing rhesus isoimmunisation 168Appendices 170Key references and further reading 172Glossary 182Index 184

Patricia Lindsay RN, RM, MSc, PGCEA, DHC Registered Midwife.Carmel Bagness MA, RN, RM, ADM, PGCEA Professional Lead for Midwifery & Women’s Health Royal College of Nursing London, UK.Ian Peate OBE FRCN, EN(G), RGN, DipN (Lond), RNT, BEd (Hons), MA (Lond) LLM Editor in Chief British Journal of Nursing Visiting Professor of Nursing St George’s University of London and Kingston University London Head of School School of Health Studies Gibraltar.

• Contributors viiiForeword xiPreface xiiPart 1 The basics of care 1Chapter 1: Infection control1 Infection prevention and control 22 Hand hygiene 43 Infectious diseases in pregnancy 64 Modes of transmission 85 Asepsis and sepsis 10Chapter 2: Health and safety at work6 Moving and handling 127 The control of substances hazardous to health 148 Safety in the working environment 169 Sharps injuries 1810 Working safely in the community 20Chapter 3: Personal hygiene care11 Personal hygiene care for women 2212 Perineal and vulval hygiene; use of bedpans and commodes 2413 Pressure area care 26Chapter 4: Quality and patient safety in maternity care14 Risk management, liability and avoidable harm 2815 Types of incident, incident reporting, record keeping and duty of candour 3016 Audit and quality assurance in maternity care 32Chapter 5: Safeguarding17 Safeguarding vulnerable women 3418 Safeguarding of children: key issues 3619 Female genital mutilation 38Part 2 Assessment, examination, screening and care of the woman and baby 41Chapter 6: Assessment of the woman20 ‘Booking’: the initial consultation with the midwife 4221 The antenatal appointment: physical and psychological assessment of the woman in pregnancy 4422 Abdominal examination in pregnancy 4623 Physical and emotional assessment after birth 48Chapter 7: Care of the woman in labour24 Assessing the woman in labour 5025 Abdominal examination in labour 5226 Vaginal examinations in labour 5427 Positions in labour and birth 5628 Supporting and caring for women in labour 5829 Supporting and caring for the partner 6030 Care of the perineum in labour including episiotomy and suturing 6231 Examination of the placenta and membranes 6432 Urinary catheterisation 66Chapter 8: The fetus in pregnancy and labour33 Assessing fetal wellbeing in pregnancy and labour 6834 Monitoring the fetal heart in pregnancy and labour 70Chapter 9: Assessment and examination of the neonate35 The Apgar score 7236 The midwife’s examination of the baby at birth including identification of the neonate 7437 Appearance and characteristics of the well term neonate 7638 Overall daily assessment of the term neonate including vital signs and bladder and bowel function 7839 Newborn and infant physical examination 8040 The term, preterm and growth-restricted baby 82Chapter 10: Caring for the newborn41 Providing daily hygiene for the neonate including changing a nappy 8442 Bathing the newborn 8643 Breastfeeding 8844 Formula feeding 9045 Other feeding methods 9246 Neonatal blood screening (‘heel prick’) 94Chapter 11: Blood sampling and cannulation47 Maternal venepuncture, including glucose tolerance testing 9648 Cord blood and neonatal capillary blood sampling 9849 Venous cannulation of the woman 100Chapter 12: Taking and testing other body samples50 Urinalysis 10251 Specimen collection – stool specimen 10452 Taking a wound swab 10653 Use of a vaginal speculum and taking a vaginal swab 108Part 3 The woman or neonate with different needs 111Chapter 13: Induction/stimulation of labour54 Membrane sweep 11255 Insertion of vaginal prostaglandin E2 11456 Artificial rupture of membranes 116Chapter 14: Care skills for the woman with complex needs57 Recognising the deteriorating woman 11858 CVP, Spo2 and ECGs 12059 Fluid balance monitoring 12260 Peak flow measurement in the woman 12461 MEOWS, AVPU, GCS and SBAR 12662 Care of the deceased 128Chapter 15: Care skills for the baby with complex needs63 Recognising deterioration in the neonate 13064 Neonatal jaundice 13265 Hypoglycaemia 13466 Hypothermia 136Chapter 16: Wound care67 Wound assessment 13868 Wound dressings and drains 14069 Wound closures 142Chapter 17: Prevention of venous thromboembolism70 Assessment of venous thromboembolism risk and prevention of deep vein thrombosis in childbirth 14471 Application and use of compression stockings 146Part 4 Drug administration in midwifery 149Chapter 18: Routes of administration72 Drug administration, handling and storage 15073 Administration by injection to the woman 15274 Intravenous administration of drugs 15475 Medicine administration by oral, rectal, vaginal, topical and inhalation routes 15676 Neonatal drug administration 15877 Immunisation 160Chapter 19:Pain relief78 Regional analgesia 16279 Non-pharmacological methods of pain relief 16480 Transfusion of blood and blood products 16681 Anti-D: preventing rhesus isoimmunisation 168Appendices 170Key references and further reading 172Glossary 182Index 184