Despite research which highlights parents' increased anxiety and risk of attachment issues with the pregnancy that follows a perinatal loss, there is often little understanding that bereaved families may need different care in their subsequent pregnancies. This book explores the lived experience of pregnancy and parenting after a perinatal loss. Meeting the Needs of Parents Pregnant and Parenting After Perinatal Loss develops a helpful framework, which integrates continuing bonds and attachment theories, to support prenatal parenting at each stage of pregnancy. Giving insight into how a parent's world view of a pregnancy may have changed following a loss, readers are provided with tools to assist parents on their journey. The book discusses each stage of a pregnancy, as well as labor and the postpartum period, before examining subjects such as multi-fetal pregnancies, reluctant terminations, use of support groups, and the experiences of fathers and other children in the family. The chapters include up-to-date research findings, vignettes from parents reflecting on their own experiences and recommendations for practice. Written for researchers, students and professionals from a range of health, social welfare and early years education backgrounds, this text outlines what we know about supporting bereaved families encountering the challenges of a subsequent pregnancy.

Maria Anderson trained as an NHS nurse and went on to become a midwife, a job she has adored for over twenty years. After fainting whilst attending her first three births, Maria went from nervous trainee to assured midwife and in her brilliant memoir she recounts the highs and lows of life inside the maternity unit. From frantic fathers and breaking her hand during a traumatic home birth, to witnessing the delivery of quads and the ultimate devastation of assisting the delivery of a stillborn baby, Maria has had an extraordinary career. Tales of a Midwife is a funny, poignant and heart-warming account of a devoted midwife.

Legal and ethical competence is a cornerstone of professional midwifery practice and an essential part of midwifery training. Law and Ethics for Midwifery is a unique and practical resource for student midwives. Written by an experienced midwifery lecturer, this text draws on a wide variety of real life case studies and focuses particularly on the core areas of accountability, autonomy and advocacy. Opening with two chapters providing overviews respectively of ethical theories and legislation, the book is then arranged thematically. These chapters have a common structure which includes case studies, relevant legislation, reflective activities and a summary, and they run across areas of concern from negligence through safeguarding to record-keeping. Grounded in midwifery practice, the text enables student midwives to consider and prepare for ethical and legal dilemmas they may face as midwives in clinical practice.

Legal and ethical competence is a cornerstone of professional midwifery practice and an essential part of midwifery training. Law and Ethics for Midwifery is a unique and practical resource for student midwives. Written by an experienced midwifery lecturer, this text draws on a wide variety of real life case studies and focuses particularly on the core areas of accountability, autonomy and advocacy. Opening with two chapters providing overviews respectively of ethical theories and legislation, the book is then arranged thematically. These chapters have a common structure which includes case studies, relevant legislation, reflective activities and a summary, and they run across areas of concern from negligence through safeguarding to record-keeping. Grounded in midwifery practice, the text enables student midwives to consider and prepare for ethical and legal dilemmas they may face as midwives in clinical practice.

Over the last hundred years, pregnancy and childbirth has become increasingly safe - yet it is still a site of risk, and a contested ground on which health professionals and pregnant women both face high costs of error. In this context, all those involved in managing pregnancy and birth are expected to identify and mitigate risk: pregnant women are subject to increasing surveillance to ensure the safety of the unborn foetus, and every aspect of childbearing is increasingly medicalised. This publication brings together fascinating social science research to explore the ways in which risk is both created and managed in pregnancy and childbirth. The introductory chapters reflect on the changing social context of childbirth, in particular the medicalisation of both pregnancy and childbirth with development of specialist practitioners, such as obstetricians and midwives who claim to have the knowledge, technology and skills to identify and manage the risks involved. The next three chapters that examine the ways in which women's behaviour during pregnancy is constructed as potentially risky -- for example smoking, drinking alcohol and taking drugs, and how these risks are monitored and mitigated. The final two parts of the book address the construction of and responses to both medicalisation and risk in childbirth. Altogether, it represents a valuable insight into the complex world of pregnancy, childbirth and risk. This book brings together editorials and articles originally published in special and open issues of Health, Risk and Society.

When hospital-trained midwife Penny Armstrong takes on a job delivering the babies of the Amish, she encounters a way of life deeply rooted in the earth. As she renews her respect for nature, she discovers an approach to giving birth which would change her life forever. A gripping first-hand account of Armstrong's journey from student midwife in Glasgow to running her own practice in rural Pennsylvania, A Midwife's Story is a life-affirming book that never fails to enlighten, inform and surprise. Honest and ultimately very moving, it is inspirational reading for everyone interested in the art and humanity of midwifery.

This workbook addresses the vital questions helpers, responders, and organizations have about self-care and its relationship to resilience and sustained effectiveness in the midst of daily exposure to trauma victims and or situations. Packed with activities, worksheets, and interactive learning tools, the text provides neuro-based and trauma-sensitive recommendations for improving the ways clinicians care for themselves. Each 'session' helps clinicians identify their personal self-care needs and arrive at an effective self-care plan that promotes resilience in the face of daily exposure to trauma-inducing situations and reduces the effects of compassion fatigue and burnout. Reducing Compassion Fatigue, Secondary Traumatic Stress, and Burnout is an essential workbook for any helper or organization looking to enhance compassionate care.

A midwife is responsible for recording the progress of labour on a partograph or partogram. The partograph helps caregivers detect whether labour is progressing normally or not, indicates when augmentation of labour is appropriate and assists in recognising potential problems before they occur. Each title covers one important topic, and has been written by a specialist in that field. The series follows a consistent format and covers issues such as key ethical and legal considerations, relevant legislation, case studies, and practical applications. These concise, accessible texts will be suitable for accreditation when continuing professional development becomes a requirement

The midwife's role is examined in the community and family-health context in this handbook on effective maternal and newborn care for midwives and other healthcare providers. The skills, competencies, and knowledge required to make informed decisions about neo- and postnatal care are covered, including anatomy and the physiology of reproduction, high-risk pregnancies, and labor and birth. Theoretical and practical issues illuminate a midwife's role in the prevention of illness in mothers and babies, with attention to the unique challenges of midwifery in developing nations. Insights from current research studies and critical questions about midwife practice will help those new to health care understand the unique challenges of this form of health-service delivery.

All cardiologists will be called on to assess and manage pregnant women, however the majority have had little or no training in the subject. In the same way, obstetricians assess women with cardiac conditions, and therefore require the knowledge to both refer patients with heart disease as well as to manage them through the pregnancy. However a recent enquiry into maternal deaths has highlighted that morbidity and mortality of women with heart disease in pregnancy has continued to increase over the last 15 years and substandard care has been identified in 40% of cases. Recommendations have been made that women with, or at risk of, heart disease are screened and counselled on the appropriate risks of undergoing a pregnancy, and as a result all physicians involved need a good understanding of the subject and access to the relevant information.
A concise handbook written for cardiology and obstetric trainees and consultants, as well as specialist nurses and midwives, Heart Disease in Pregnancy provides a detailed introduction to the physiological changes of pregnancy and gives practical advice on the management of women with heart disease who are pregnant or who are considering pregnancy. It also provides the relevant obstetric knowledge and processes needed for a cardiologist to successfully manage a pregnant woman.

Being an effective midwife requires a range of knowledge and skills, all of which are essential to provide competent and safe care to childbearing women and their infants. Midwifery Skills at a Glance offers an invaluable, straightforward guide for students and practitioners - offering readable, easily digestible information, supported with illustrations throughout to enhance application to practice. Clear and concise throughout, Midwifery Skills at a Glance covers a wide range of skills - exploring issues such as infection control, personal hygiene care, and safeguarding; assessment, examination and screening skills; how to care for the woman and neonate with complex needs; drug administration and pain relief. A comprehensive, highly visual guide to the skills essential for safe, effective, and compassionate midwifery practice Written by experts in their field Briefly describes each skill and provides clear illustrations -- making it an ideal companion in clinical practice Offers instruction on the safe use of a wide range of essential skills required to deliver safe, evidence-based maternity care Includes service user viewpoints and key points to help consolidate learning and reflect on the experience of receiving care Written with the student midwife in mind, Midwifery Skills at a Glance is equally invaluable for all others providing care, including Maternity Support Workers, mentors, registered midwives and medical students.

Are you supporting students in practice? This book provides an overview of the different approaches and summarises the key NMC Standards that you need to understand. You will follow the student's journey on placement starting from the preparation needed before they arrive through to the orientation, initial interview and planning of learning, plus how to provide feedback and ensure that your assessment is fair and objective. Some of the challenges you may face will be explored, along with approaches you can use to ensure successful outcomes. This is an indispensable handbook for: both new and experienced nurses seeking practical advice academic staff who prepare and support practice supervisors and assessors students undertaking modules on teaching and learning in practice Based on the NMC standards for student supervision and assessment Offers guidance and tips on supporting and assessing students on placements Presents sections on understanding you, supporting the student with additional needs, and using simulated learning Covers how to support students who are not making the progress expected Action points at the end of each chapter will help you consolidate your learning Part of the A Nurse's Survival Guide series. Now fully aligned to the latest NMC standards and competencies on supervision and assessment.

Considering its importance, the history of fetal health and mortality remains a neglected area. Medical historians have tended to focus on maternal mortality and professional conflicts between midwives rather than on the unborn, while among the social scientists demographers and epidemiologists have until recently devoted most of their attention to infants and children.
Death before Birth redresses this imbalance, redirecting attention to the fetus. A study of fetal health from the seventeenth century to the present day, it is the first book to offer an historical perspective on the subject and to combine both medical history and epidemiological and demographic research, using long-term and comparative perspectives, including a strong international comparative element, across both Europe and North America. The book not only provides an account of how fetal health and the risks facing the unborn (miscarriages, abortions, stillbirths etc) have changed, it also offers an interpretation of the causes, one that focuses on the role of obstetrics and the epidemiology of maternal infections.
Along the way, it pays detailed attention to a host of related themes, such as varying cultural practices in the recognition of stillbirths; the age pattern of mortality risk between conception and live birth; comparative trends in late-fetal mortality and their causes; fetal mortality and obstetric care during the eighteenth, nineteenth, and twentieth centuries; and the contrasting approaches of the pathologists and "social epidemiologists" to the causes of fetal death. The book concludes with a study of the "fetus as patient," focusing on issues surrounding the legalization of abortion in many Western countries and the public health challenges of persistently high mortality in less developed countries.

Providing in-depth information on natural remedies that midwives, doulas, GPs and other health professionals can use to advise and inform their clients, this reference guide focuses on safety in their application. The book brings together herbal medicine, homeopathy, essential oils, flower remedies and traditional remedies from other cultures, and applies them directly to pregnancy, childbirth and the postnatal period. Containing an alphabetical listing of 220 remedies covering common uses, contraindications and precautions, adverse effects and interactions, Using Natural Remedies Safely in Pregnancy and Childbirth is a vital resource for healthcare professionals working in conventional maternity care who wish to learn about the safe application of natural remedies.

The Objective Structured Clinical Examination (OSCE) was developed for all undergraduate nursing programmes, with the aim of emphasising the need for nursing students to be competent in clinical skills, to assess clinical reasoning skills and as a means of standardizing the assessment process. This practical, easy to read and interactive study guide helps nursing and midwifery students at all levels to maximise their chances of success with OSCEs. It features case studies, quick quizzes, recap and recall summaries and an OSCE preparation plan; all of which help to prepare the student for the examination. Hints and tips on what to expect during the examination and pointers on what the examiner will be looking for, together with a comprehensive chapter on personal learning will help to guide the student through the process and maximise their chances of success! "Very readable with useful tips and information for students" Cath Hill, Keele University "I found the book extremely relevant from the students' perspective, reader friendly and well structured. Quizzes and activities excellent." - Liz Day, Senior Lecturer, Nursing and Health Care Practice, University of Derby "A useful and easily digested text on this important assessment strategy", Ms. Karen Lumsden, Faculty of Nursing and Applied Clinical Studies, Canterbury Christchurch University"Useful for students as they prepare... Easy to read and understand." Kirsty Wedgbury, Faculty of Health and Community Care, Birmingham City University

For acupuncturists and birth professionals, this book explains how yin/yang and other principles of Chinese medicine can improve birth experiences as well as outcomes. Acupuncture and Chinese medicine can shift and support the physical and emotional journey of birth and provide nonpharmacologic treatment approaches for commonly occurring disorders of labor such as malposition, asynclitism, slow cervical dilatation and inadequate contractions, as well as postpartum and post C-section care. Accessible and engaging, the book includes an overview of Chinese medicine for women's health; information on what happens before, during and after birth from both a biomedical and Chinese medical perspective;and a toolkit of treatment strategies for birth work. The techniques described include acupressure, Tui Na (Chinese medical bodywork), needling, auricular acupressure and electrostimulation.

Midwifery: The Basics provides an engaging and authentic insight into the midwife’s world. It explores the role of the midwife as a clinician and professional, showing how midwives can support women both to achieve a healthy full-term pregnancy and a smooth transition to motherhood.

This book begins with a discussion of the context of birth and parenthood, placing midwifery in its broader social context. Topics covered include:

the midwife as an autonomous professional;

becoming a midwife;

pre-conceptual and antenatal care;

intrapartum care;

postnatal care; and

the specialist midwife.

Midwifery: The Basics uses the voices of mothers, fathers and midwives to illustrate the complex world of becoming, being and supporting parents. This is an essential introduction for students at undergraduate and A-Level who are approaching midwifery for the first time.

Table of Contents

1. The context of birth

2. The roles of the midwife

3. Midwifery: An evolutionary tale

4. Becoming a midwife

5. Pre-conceptual and antenatal care

6. Labour and birth care

7. Postnatal care

8. Midwife as specialist

‘A vital, heartfelt read for anyone navigating the rough seas of infertility and pregnancy loss’ – Leah Hazard, author of Hard Pushed An insightful, moving memoir, capturing life working as a midwife in a busy NHS hospital at the same time as dealing with experiences of infertility, IVF and loss. As a young married couple, Sophie Martin and her husband spent years trying to conceive. They went through several rounds of IVF, at great expense, and even travelled overseas for treatment, never quite knowing whether they would one day have a family. Alongside this, Sophie was working hard at a job she loved: looking after expectant mothers and newborn babies as a midwife in a busy hospital, where the patients’ daily new additions were a constant reminder of Sophie’s own setbacks in pursuit of motherhood. The Infertile Midwife is a deeply personal, moving account of chasing something that you want so desperately. It also offers a much-needed look at how society treats infertility – from the language we use to the small talk we make – and the ways in which we can all do more to make things better for hopeful parents. With great warmth and honesty, Sophie shares her experiences of the bursts of hope and moments of great loss, but also the humour, love and joy that can be found in even the darkest places.

Examination of the Newborn ist ein Muss fur Studenten und Fachkrafte, die mit der Untersuchung von Neugeborenen betraut sind. Die 3. Auflage dieses evidenzbasierten Praktikerbuchs spiegelt die aktuellen britischen Gesundheitsstandards fur die Untersuchung von Sauglingen wider und gibt Lesern die erforderliche Hilfestellung, um auf Familien zugeschnittene, hochwertige Pflegeleistungen in Einklang mit geltenden nationalen Richtlinien erbringen zu koennen. Jedes Kapitel bezieht sich auf die einschlagigen Standards und stellt damit Good Practice im Krankenhaus und bei niedergelassenen AErzten und Gesundheitspersonal vor. Diese vollstandig uberarbeitete Auflage beinhaltet die fur einschlagige Prufungen relevanten aktuellen Leitlinien im Bereich Ausbildung und Pflege, auch aktuelle Informationen zu den neuen Nursing and Midwifery Council (NMC)-Standards. Neue und erweiterte Themen beziehen sich auf Anamnese und Untersuchung von Neugeborenen, Fragestellungen rund um den Beruf der Hebamme, den Einsatz von Pulsoximetern und die wichtige Mutter-Kind-Bindung wahrend einer Untersuchung. Dieses Buch ist ein wertvoller Leitfaden fur die Untersuchung von Neugeborenen und - spiegelt die aktuellen Standards klinischer Praxis des britischen National Screening Committee (UK NCS) wider. - umfasst Betrage von Experten aus einer Vielzahl von Disziplinen, die u. a. Untersuchungen des Herz-Kreislauf-Systems, der Haut, von Nacken und Augen beschreiben sowie auf Chromosomen- und Gendefekte, Verhaltensmuster von Neugeborenen und viele weitere Aspekte eingehen. - enthalt farbige Fotos und Illustrationen, klinische Fallstudien und Zugriff auf eine aktualisierte und erweiterte Website mit interaktiven Fragen, Checklisten, Links zu Videos und eine Fulle von Informationen rund um die Untersuchung von Neugeborenen. Examination of the Newborn ist ein unverzichtbares Referenzwerk fur angehende Pflegekrafte, Hebammen, Pflegepersonal auf Neugeborenenstationen, AErzte, Kinderarzte, Physiotherapeuten und Allgemeinmediziner.

Nurses, midwives and health visitors have a statutory duty to safeguard and promote the welfare of children and young people. In this clear and invaluable guide, Catherine Powell focuses on the practical aspects of safeguarding and how healthcare professionals should respond to safeguarding children concerns. Key features of the book include: * Setting out the roles and responsibilities of nurses, midwives and health visitors working in a range of settings, including those working primarily with adult clients * Realistic case scenarios of physical, emotional and sexual abuse and neglect, covering infants, toddlers, school-age children and adolescents * Explanations of inter-agency working and the roles of other key players such as children's social care, the police and education services * 'Markers of Good Practice' boxes highlighting lessons for practice. The book covers the full spectrum of safeguarding children work; from prevention and early help through to statutory intervention and serious case review. New for this expanded Second Edition are: * A new chapter on child sexual exploitation, and more consideration of risks for children online * More detail on the links between domestic violence and abuse and child maltreatment * New 'Child Perspective' boxes to encourage further thought about the voice and role of the child Safeguarding and Child Protection for Nurses, Midwives and Health Visitors 2e is an essential tool for students and will be invaluable for practicing healthcare staff who face an array of complex and sensitive issues in the field of safeguarding. "Dr Catherine Powell is the Institute of Health Visiting safeguarding expert, advising us on any national safeguarding issues or changes of policy. I am personally delighted that she has updated this important book. Safeguarding is the practice area that nurses, midwives and health visitors must not shy away from. It can however provide their greatest professional challenges as well as making them feel anxious about providing correct professional responses. This is a very well-structured and comprehensive book. The author very effectively brings safeguarding responsibilities to life with the use of case studies. The recurring features in the book are helpful and I very much like the inclusion of the child or young person's perspective boxes. For the inexperienced professional this can be forgotten when swamped with a complex situation. By keeping the child's perspective at the centre of all decision-making the right decisions are more likely to be made. Perhaps of particular value to learning will be the chapter on child death and serious case reviews, something professionals seek to avoid ever being involved in, but sometimes find themselves having to face. It is therefore important to learn from these reviews of what went wrong, a breakdown in professional communication so often being a feature. This chapter explains how a serious case review is carried out and allows the reader to understand how they might be asked to contribute to the process. To have a book such as this to use as a professional companion, not only to refer to and check facts, or underpin decision making, but also to expand professional knowledge, will lead to improved safeguarding practices, prompt, appropriate interventions, and better outcomes for children and families. Safeguarding is of course everyone's business and others needing to refresh or update their skills in this area will also find the information included of great value." Dr Cheryll Adams, Director, Institute of Health Visiting, UK "This is a very readable and practical book which achieves its aim to raise awareness about good safeguarding and child protection practice. The book is intended to prepare nursing, midwifery and specialist community public health nursing students and those 'returning to practice', but it will also be of use to more experienced practitioners who work with children, young people and their families, wanting to update their learning in the field. The book clearly reflects the author's expertise and knowledge in safeguarding and child protection practice. It contains a wealth of extremely useful information presented in an easily accessible fashion. The range of case examples, practice points and new for this second edition, a 'child's perspective' box, brings the text to life and focuses the reader's attention on practice needing to be 'child-centred'. This is an excellent book, which I thoroughly recommend." Jane V. Appleton, Professor in Primary and Community Care, Faculty of Health and Life Sciences at Oxford Brookes University, UK "All nurses have a duty to inform and alert appropriate personnel if they suspect a child has been abused, and to know where they can seek expert advice and support if they have concerns. This comprehensive text providing the link between legislation, policy, research and practice will enable students and practitioners to expand their knowledge and understanding of the key issues involved in safeguarding children and young people." Fiona Smith, Professional Lead for Children and Young People's Nursing, Royal College of Nursing, UK

This concise guide offers a comprehensive step-by-step framework for midwifery students to learn about all aspects of the newborn infant physical examination (NIPE), a screening assessment completed on all babies between 6 and 72 hours of age.

The Student Guide to the Newborn Infant Physical Examination encourages the reader to approach the examination in a system-based format, with case studies and practice tips to support learning.

The book offers:

• Evidence-based, well-illustrated assessment tools, which take into account the national screening committee standards, and is written by authors with both academic and clinical experience;

• A clear direction on how to perform the NIPE in practice while exploring the wider context of screening in healthcare today;

• Coverage of the changing role of the midwife, and the importance of understanding the whole context of the mother’s care, health promotion and starting the practitioner-parent conversation.

The Student Guide to the Newborn Infant Physical Examination is a core text for all pre-registration midwifery students and a useful resource for qualified midwives, neonatal nurses and practice nurses.

Table of Contents

Introduction

1. The newborn infant physical examination

Tracey Jones

2. The changing role of the practitioner caring for the newborn

Tracey Jones

3. Communication skills in healthcare

Tracey Jones

4. Maternal factors that influence fetal development

Carol Mashhadi

5. Why the maternal history is important for the NIPE practitioner in performing a safe and thorough examination

Kim Wilcock

6. The physical examination: a step-by-step approach

Tracey Jones

6A. Examination of the head, including the ears, neck, eyes and neurological (tone)

Melanie Carpenter and Michelle Scott

6B. Cardiovascular examination of the newborn infant

Jonathan Hurst

6C. Examination of the respiratory system and the chest

Michelle Scott

6D. Examination of the newborn abdomen and genitalia

Natalie Fairhurst

6E. The skeletal examination

Sarah Paterson

6F. Examination of the skin

Natalie Anders and Alison Cooke

7. Congenital abnormalities

Joanna Cookson

8. Overview of the NIPE and appropriate and timely referral pathways

Anne Lomax and Claire Evans

9. Clinical competence and professional responsibility

Christopher Lube and Tracey Jones

10. The second examination

Tracey Jones

Index

This textbook is written in line with the Council of International Neonatal Nurses, Inc. (COINN) vision for global unity for neonatal nursing. The core values and goals of COINN are based on excellence and advocacy for high quality newborn care, as well as respecting diversity by integrating cultural norms and values among the care of newborns and their families. The book promotes neonatal nursing as a global speciality through evidence, research, and education of neonatal nurses; and offers key examples of the millennium goals and global outcomes, as well as variations in outcomes for babies. The first part focuses on global perspectives of neonatal nursing from different continents aligning with the World Health Organizations' global regions: (The Americas -USA, Canada and South America-, Western Pacific region -Australia and New Zealand-, European region -UK and Europe-, African region, South-East Asia and Eastern Mediterranean region. For each region, education and competencies, challenges and opportunities, research and evidence-based practice (EBP) as well as practice regulations are described. The second part elaborates on key topics for neonatal nursing across the globe, such as the continuity of neonatal care in the community, patient and family centered care in neonatal settings, sleep and brain development, the fundamental care needs of the neonate and family and global perspectives on hypothermia, hypoglycaemia and hypoxia. Written in a formal academic but reader style, using key literature and evidence, this textbook enables an understanding from a large audience with academic levels and experience, both staff and students, bedside nurses, advanced practice nurses, midwifes and allied professionals. In addition, first person story based reflective narrative are interspersed throughout the book to capture the perspectives of nurses, staff and parents, in the form of vignettes. This textbook is aimed at neonatal nurses across the world as well as current and aspiring students in this field.

The acclaimed quick-reference guide to performing and interpreting emergency ultrasound exams More than 400 ultrasound images! Spanning all body systems typically evaluated by ultrasound, this succinct, find-it-now pocket atlas allows you to instantly compare and contrast your real-time images with those appearing in the book. You will also find valuable how-to guidance on essentials such as probe placement, patient positioning, and proper settings - along with anatomical drawings that help you visualize affected organs. Featuring concise, bulleted text, and more than 400 ultrasound images and dozens of line drawings, Emergency Ultrasound, Second Edition is specifically designed to be used at the bedside in an emergency care setting. Coverage includes: * Clinical Considerations * Clinical Indications * Anatomic Considerations * Technique and Normal Findings * Tips to Improve Imaging Acquisition * Common and Emergency Abnormalities * Pitfalls

This important book makes the case for placing maternity care in the community. It has been written by a multidisciplinary group. The first section considers the role and function of the participants in community-based maternity care; the woman, the midwife, and the GP. The second section discusses four major contemporary issues: the radically changing social background, the economics of care, audit, and education of the carers. Next the major clinical challenges in maternity care are tackled: how to reduce the differences in morbidity and mortality which are associated with differences in age, social class and ethnicity; the care of disadvantaged groups; prematurity and low birth weight and their prevention; technology used in childbirth; and the fetal origins of adult disease. Finally, all aspects of the clinical care carried out by Gps and midwives are covered. The editors hope that after reading this book midwives, Gps, and obstetricians should find the theory underpinning their work has been sharply defined and that their work will be more effective and evidence-based. The editors, a GP and a midwife, anticipate the resolution of the current tensions between midwife, GP, and obstetrician and look forward to a responsive, effective and sensitive service for mothers and babies in the next millennium.