Index Page numbers appearing in bold refer to figures and page numbers appearing in italic refer to tables. Active birth 12-13 Amniotomy, see Membranes, artificial rupture Analgesia in delivery chair trial 301-2,302 psychological 91-2 Antenatal care, responsibility for 209 Antenatal class, attendance 114 Antenatal perceptions 18-19,20-21, 22,23-5 Antenatal stress, methodological weak research 65 Antepartum Hospital Stressors Inventory (AHSI) 67-8,70-71 data collection 69,70 Anxiety about family 73, 74 Association of Radical Midwives (ARM) 260,270-71,275,278 Baby feelings about 75 newborn, demands 127 Blood loss assessment 311-12 in delivery chair 303, 305 estimations 314,315 Bolam Report 264 Boredom 81, 84 Brandt-Andrews technique 310-11 Breast feeding 143 Breast feeding counsellors 122 Breathing exercises 92 Breathing techniques 109 Briggs Report 1972 267,269 Caesarian delivery birth perception 318-19 data collection methods 317 emergency 315-16 experimental groups 316 women's reactions 315-22 Cardiff integrated antenatal care system 85 Central Midwives Board (CMB) 177-8,185 training regulation 262-4,268-9 Central Midwives Board for Scotland 121,181,241 Guidelines for the Extension of Training 234 Child care arrangements 73-4 Childcare facilities 183 Choice, right of 13-14 Clinical Grading Review 186, 190 views on 217-18 College of Midwives 177 Communication 65,67,78-81,79, 80 Communication with health professionals, stress 77
326 Index Community midwives advice 136-8 daily visits 127-30 women's reports of care 132-3, 133 see also Midwife Confidence and employment practice 253-5 Consciousness-raising 43-4 Consultant decision 14-15 Consultant - midwife interactions 10-11 Contact, problems making 42-3 Control in labour 92-3,111-16 Controlled cord traction (CCT) 311-14 method 314 Cord traction 310-11 Cortisol, and dysphoria 170 Crying in maternity blues 154, 158, 164-7 Delivery chair 300-10 Hillan's controlled trial 301-4 midwives' and doctors' opinions 306 rapidity of birth 304 Romney's trial 304-9 women's view 307 Delivery outcome in Romney's study 306,308-9,308 Derby midwifery school 277 Distraction from labour pain 107 District hospitals, staffing structures 6-11 Domino schemes 124 Double Identifiers 251-2 EEC Midwifery Directives 269-70 Electronic fetal monitoring 308 Emotions, stress 76-7 Employment decision changes in training 251-2,252 factors influencing 250-51,251 Endorphins 170-71 English National Board 185,260-61, 268,278 Continuing education and training 181 Careers Advisory Centre (ENBCAC) 275 Teaching and Assessing in Clinical Practice 287 Entonox 102,104, 105, 106-7 Environment and postnatal care 126 Environment stress 78 Epidural analgesia and delivery mode in delivery chair 304 Episiotomy decision 211 Ethos of unit 12,27 Family, hospitalization effect 73,82 Family status stress 77 Feeding method 135-6, /36 Flexible hours 183 Food provision in hospital 85 General Health Questionnaire 150 GP trainees 9 Health status stress 78 Health visiting 250 Health Visitors Association 188 High risk pregnancy 64 outpatient care 85 Hospital, discharge time and midwives' care 133-5,134 Hospital confinement rise 123 Hospital life, experience of 71-2 Hospital Stress Rating Scale 67 Hospitalization 64-86 effect on children 74 effect on partner 74 potential problem rating 72 sample characteristics 71 study design and methods 66 House of Commons Health Committee on the Maternity Services 83,322 Social Services Committee 5 Idiosyncratic strategies 109-11 Imagery in labour pain 108-9 In-service education opportunities 213-15 satisfaction 214
Index 327 Information giving 65,78-81,79,80, 84 Institute of Manpower Studies 187, 278 Intra-uterine growth retardation (IUGR) 71 Job sharing 183 Kings College, Nursing Research Unit 175 Know Your Midwife scheme 60 Labour active management 180 third stage, CCT 312-15,313,314 Labour and delivery care, responsibility 209-12 Labour induction, in delivery chair 302 Labour pain analgesic effects 101-7 assessment by midwives 101 assessment comparison 102 coping strategies and levels 110,115 use and levels J08 data analysis 99 factors affecting 91-3 intensity 99-101 level comparison 101 multidimensional nature 94 underestimation 105-6 see also Pain Lamaze-type breathing techniques 92,109 Legalliability 15-17 Likert scale 67, 78 Locus of control (LOC) 111 Low birthweight (LBW) 31 McGill Pain Questionnaire (MPQ) 94-100 Maternal mortality 124 Maternity blues study 147-74 aims and methods 149-55 assessment 154 data analysis 154-5 data collection 152-3,153 experience of 'blues' 158-9 homesickness and crying 165-6 incidence 155,157 manifestation 154, 158 participant recruitment 150, 152 patterns of symptoms 159-63 physical causes 164-5 study population 155,156 symptoms and crying 164 timing 155 tiredness and crying 165, 169 Maternity Care Plans 18 Maternity services, satisfaction with 65 Maternity Services Advisory Committee 125 Medical control, postnatal 126 Membrane rupture decision 210-11 Membranes artificial rupture 293-300 advantages 294 controlled trial 299-300 explanation and consent 295-9,295,297 methods 294-5 policy 298-9,298 reasons 296,297 MIDIRS 182 Midwife/woman relationship 116 Midwifery confidence 253-5,254 confidence in practice of 253 moving in and out of 204,207-8 practice implications 83-6 practising factors 252-3 reasons forleaving 219-21 service conditions 183,215-18, 216 skills underuse 181 staff retention 256-7 Midwifery education direct entry 260-90 questionnaire survey 273-4 potential applicants 274-6 response rates 274 resources 287-8
328 Index Midwifery education contd non-nurse, historical perspectives 262-71 post-registration 175,181-2,233 extension evaluation 234-57 findings 243-4 respondents profile 244-5, 246,247,248 response rates 241-2,242, 243 pre-registration 261 Midwifery Registration and Higher Certificate 269 Midwifery Research Database 182 Midwifery schools, entry intention interviews 276-8,277 Midwifery training aggregate level analysis 185 cross-sectional surveys 184-5 employment intention changes 251-2,252 individual level analysis 185 longitudinal panel design advantages 185 reasons for 247-8,248 Midwives Acts 121, 124,266 care continuity erosion 122 career intentions at qualification 195-6,196,204,205 career path summaries 182-3 career patterns structure 176 careers after qualification 196-200, /97, 198-9,202-3,204 Careers project aims and methods 187-8,190 career summary after qualification 206 data handling and analysis 191-2 data representativeness 190-91 future research directions 226-7 longitudinal panel design 200 main findings 221,222-5,226 questionnaire response rates 189 units of analysis 193-4 clinical skills development 178 differences between 51-3 educational programme requirements 284-7 future requirements 280-81 home visits 121 Information and Resource Service 278 job satisfaction versus overload 53-9 life aspects 179,208 new event response 186 postnatal relationship break 46-8 professional development. continuing 2l3-15 recall inaccuracy 185-6 recruitment and selection 281-4 registration educational routes 177-9 relationship with consultants 10-11 relationship with SH 0 9-10 remuneration 257 responsibility division with clinicians 179-81, 208-l3, 210, 211 and satisfaction 213 role 257 rules 127, 142,265 support and feedback 215 tasks and decisions 8 training 177-9 working with family responsibilities 183-4,218-19 see also Community midwives; Student midwives Minimum support package 32 Mood liability 148 Motherhood, meaning of 125 National Maternity Service 264 Negotiating access 68 Newcastle Community Midwifery Care Project 41 Notification of Intention to Practise 236-7 Nurses Midwives and Health Visitors Act
Index 329 1979 269 training 177 Nursing records 128 OPCS surveys 143 Pain affective components 94-5 assessment 93-6 time in relation to delivery 97 coping strategies 91, 93 use 98,107-11 evaluative components 94-5 experimental 92 normalization 109 sensory components 94-5 stress 94 see also Labour pain Pain Ranking Index (PRI) 95-6, 100, 105 Parentcraft information 78, 84 Peel Report 123 Perineal damage in delivery chair 303 Perrin Report 1978 234 Personal control 111 Pethidine 101-2, 103, 106-7 Physical factors in labour 105 Physical requirements 283 Placenta separation 310-11,313 Postnatal care assessment 125-6 by doctors 212 cohort characteristics 131-2 exploratory phase 128-9 interviews 128, 130 midwife's role 121-5 questionnaires 128, 130 responsibility 212-13 sample recruitment 129-30 depression 148 Postoperative patients in 'blues' study 152 Postpartum haemorrhage (PPH) 310-15 Pregnancy feelings about 74-5 intervention effectiveness 46 Present Pain Intensity ~PPI) scale 95 Primiparae, postnatal care 125 Primiparae and analgesia in Romney's study 305 Programme evaluation 235 Project 2000 1986 267, 269-70 Psychological factors in labour 105 Purposive samples for extension evaluation 237-8 Relaxation techniques 84, 107 Relaxation training 92 Replicability/reliability 238-9 Report of the Maternity Services Committee 1959 267 Research Ethics Committee 128 Research midwives experiences 34-61 job satisfaction 54-5 SSPO study as test 60 Reversal of affect 109 Royal College of Midwives (RCM) 188,260,269 Scottish National Board for Nursing, Midwifery and Health Visiting 241 Separation stress 76 Services available, information on 48-50 SHO-midwife interactions 9-10 Short Report 7, 124 Sleep, postnatal 126 Smoking behaviour 81 hospitalization effect 73 Social Readjustment Rating Scale 67 Social support, sticking to 44-6 Social Support and Pregnancy Outcome (SSPO) 30-34 characteristics by centre 33 characteristics of women 33 nature of intervention 52 randomization 37-8 recruitment 34-7 study design 32 timing and number of contacts 51 Social support provision 38-42 description 39
330 Index Special care baby unit (SCBU) 78,82, 131 Staff attitudes to direct entry students 288-9 control 112 trust in 112-16, II3, 114 Staffing levels, adequacy 215,217 Staffing structures methods 6-7 relationships 9-11 roles and responsibilities 7-8 Statistical Package for the Social Sciences (SPSS) 70 Stein's Daily Scoring System (SDSS) 150,151,152-5,158 response rates 153,154 Stocks Report 264,268 Stress in hospitalization 64-5,76 intensities 77 pain 94 Stress factors 67-8 Structured interview schedule 66-7 Student midwives employment intentions 248-50, 249 see also Midwives Surgery and dysphoria 167-8 Syntocinon infusion decision 210-12 Team midwifery schemes 123 Telemetry, home 85 Temperamental requirements 283 Total Pain Ranking Index 99 Training and Employment of Midwives 1929 264 Two-tier structure 28-9 UK Central Council: Post-registration education and practice project 181 Vaginal examination, explanation and consent 295 Validity assessment 239 Visual Analogue Scale (VAS) 96, 97-8,100-1 Winterton Report 83 Women characteristics comparison 100 childbirth experiences 26-7 labour pain assessment 99-101, 101 midwife's help assessment 138-41, 139 postnatal emotional needs 125 self-esteem 75-6,82 Women and Employment Study 183 Working Party on Midwives 1947 180