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Midwifery

Treating pain during pregnancy and breast feeding

16 Apr, 17 | by josmith

This week’s EBN Twitter Chat on Weds 19th April at 8-9pm UK time will focus on pain during pregnancy, how important and difficult is to treat pain during pregnancy and breast feeding.

The Twitter Chat will be hosted by Dr Massimo Allegri, Assistant Professor in Anesthesia Intensive Care and Pain Medicine at the University of Parma (Italy),@allegri_massimo. Participating in the Twitter chat requires a Twitter account; if you do not already have one you can create an account at www.twitter.com. Once you have an account contributing is straightforward, You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ and add #ebnjc (the EBN chat hash tag) at the end of your tweet, this allows everyone taking part to view your tweets.

The Pain Department of University Hospital of Parma is one of the biggest pain clinic in Italy and it is the most important research centre about acute ad chronic pain in Italy and one of the most important in Europe.

Furthermore, next year a new PhD Position in Pain will be settled up together with Alborg University and Prof Lars Arendt Nielsen about chronic pain and central sensitization. Furthermore, University of Parma organizes one of the most important translational pain meeting in the world: SIMPAR (www.simpar-pain.com).

Pain affects 20% of adult population worsening not only quality of life, but also outcome of patients who refer it. Unfortunately, pain continues to being undertreated and under-recognized. Chronic pain is not just a symptom but it is a real disease that needs an accurate diagnosis and appropriate therapy against the pain generator pathophysiology.

This problem is even more important during pregnancy and breastfeeding. The fear to give drugs that can hurt foetus/neonate can drive the physician to a “wait and see” approach that cannot solve the problem to the mother. Furthermore, during pregnancy there are several physiological changes that can worsen previous pain or generate new one. Finally, all the drugs are obviously off label and it is difficult to know exactly their real toxicity.

On Wednesday 19th April during the twitter chat we will continue the conversation to consider how to drive the therapy for patients during pregnancy and breastfeeding. We will discuss all together which multidisciplinary approach could be useful and how important is to diagnose the right pathophysiological mechanism that triggers the acute or chronic pain:

  • Which are the classifications of the drugs that could drive clinicians to use the drugs to alleviate pain?
  • When is more harmful to use some specific drugs?
  • Which concerns do we have to consider when we give a drug to a breastfeeding mother?
  • How to perform the right pathophysiological diagnosis?
  • Do we have to stop some drugs if the women would like to become pregnant

Please join us to discuss this important medical, nursing and public health challenge.

References

1 Coluzzi F, Valensise H, Sacco M, Allegri M Chronic pain management in pregnancy and lactation. Minerva Anestesiol. 2014 Feb;80(2):211-24.

2  Narayan B, Nelson-Piercy C. Medical problems in pregnancy. Clin Med (Lond). 2016 Dec;16(Suppl 6):s110-s116.

3 Tepper D. Pregnancy and lactation–migraine management. Headache. 2015 Apr;55(4):607-8.

Caesarean section increases risk of preterm birth in subsequent pregnancy

12 Apr, 17 | by josmith

Professor Allison Shorten

Center for Interprofessional Education and Simulation, University of Alabama at Birmingham

Prevention of preterm birth remains an important priority for international perinatal research. Identification of risk factors is important for development of effective preterm birth prevention strategies. One of our latest EBN commentaries, by international experts Laura Visser, Marjon A de Boer and Ben W Mol, presents an interesting discussion of recent research by Wong and Wilks (2016), which highlights a relationship between caesarean section and preterm birth in subsequent pregnancies. As the quest to identify risk factors for preterm birth continues, our commentators note that large observational studies are needed to determine the pathophysiology and possible causal relationships between the risk factors identified (Caesarean section, new tobacco use, short interpregnancy interval) and preterm birth. Caesarean section rates remain high and are increasing in many countries around the globe, making it important to examine relationships between Caesarean section and problems that may arise in subsequent pregnancies. Read more about this interesting case control study and recommendations for future research and clinical management.

 

Reference:

Wong LF, Wilkes J, Korgenski K, et al. Risk factors associated with preterm birth after a prior term delivery. BJOG 2016;123:17728.

Read EBN cimmentary :

http://ebn.bmj.com/content/20/2/42

The #hellomynameis campaign reaches its 3rd anniversary

28 Feb, 16 | by josmith

This weeks ENB twitter chat on Wednesday the 2nd of March between 8-9pm(GMT) UK will be hosted by Kate Granger a doctor, but also a terminally ill cancer patient. and founder of the #hellomynameis campaign, and will focus on the importance of healthcare workers introducing themselves to patients. Participating in the twitter chat requires a Twitter account; if you do not already have one you can create an account at www.twitter.com. Once you have an account contributing is straightforward – follow the discussion by searching links to #ebnjc or @EBNursingBMJ, or better still, create a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ and add #ebnjc (the EBN chat hash tag) at the end of your tweet, this allows everyone taking part to view your tweets.

Hello, my name is Kate Granger and I’m the founder of the #hellomynameis campaign, which will reach its third anniversary in August 2016.  Three years of tireless work trying to spread one simple message across the globe. Three years of trying to improve the experience for other patients all facing their own health problems. A straightforward premise that any healthcare worker who approaches a patient should first introduce themselves, with the innovative use of social media to spread the message.

more…

Dignity From the First Breath

18 Dec, 15 | by Gary Mitchell, Associate Editor

It’s week three of our #ebnjc December blog series which celebrates the inspiring contributions that nurses and midwives make across a variety of settings. 

Thus far we have celebrated children’s nursing with blogs from Jayne Pentin, Kirsten Huby & Marcus Wootton, as well as learning disability nursing with blogs from Professor Ruth Northway, Jonathan Beebee & Amy Wixey.

This week our #ebnjc blog series focused on midwifery and we have already shared blogs from Louise Silverton CBE & Gina Novick.  Today we are delighted to bring you a blog from Lynsey Wilgaus, a student midwife from Queen’s University Belfast, on the topic of dignity.

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Click Here to Read Lynsey’s Guest Blog

Continuity of Midwife Carer

14 Dec, 15 | by Gary Mitchell, Associate Editor

It’s week three of our #ebnjc December blog series which celebrates the inspiring contributions that nurses and midwives make across a variety of settings. 

Thus far we have celebrated children’s nursing with blogs from Jayne Pentin, Kirsten Huby & Marcus Wootton, as well as learning disability nursing with blogs from Professor Ruth Northway, Jonathan Beebee & Amy Wixey.

This week our #ebnjc blog series focuses on midwifery and we are delighted to share our first guest blog from Louise Silverton CBE, Director of the Royal College of Midwives.

royal-college-of-midwives

Click Here to Read Louise Silverton’s Blog

Lauren’s Student Nursing Experience

31 Aug, 15 | by Gary Mitchell, Associate Editor

On Wednesday 2nd September (8pm-9pm UK time) @EBNursingBMJ is co-hosting a twitter chat on student nursing and midwifery with @RCNStudents 

To celebrate the contributions our student nurses/midwives make – we are sharing blogs of their experiences in practice.  Today’s blog is from Lauren James a second year student nurse from Birmingham City University

blog photo (2)

Hello! I’m Lauren. I am 20 years old, and just about to start my second year of paediatric nursing at Birmingham City University. My road to nursing is pretty normal, I decided I wanted to nurse due to having a number of illnesses growing up, also most of my family are in some sort of medical profession. For me there was no question to which field of nursing I wanted to do. I have always loved being around and caring for children. I have 4 siblings and they all have been such a massive influence on me and how I wanted to make every child better and help every child when they felt their worst. I also went to Africa and saw the children and visited a few African hospitals, it broke my heart – I couldn’t bare to listen to cries of pain without wanting to cuddle them and make it all better for the children, their parents and carers.

I started my nursing journey last September. I was accepted into BCU after thinking I’d majorly messed up the interview. I moved cities from a little farmer town to Birmingham (a massive shock) and had to adjust to living in halls away from my family, boyfriend and friends. The main thing for me this year was my confidence. I threw myself into university life, tried to make sure I had a good circle of ‘uni’ friends and got on with working.  This year I’ve completed two placements on top of my academic work. I’ve been placed in a medical observation ward and then a surgical ward – both in a children’s hospital.

This year has taught me more about myself than I could have possibly learnt in ten years on my own. As much as I tried you can’t do everything. If I wasn’t revising or learning for tests, I was doing assignments, or preparing for practical’s, ironing my uniform or sorting out how I was going to spend time with my friends whilst working 13 hour shifts… at one point it just got way too much and I had to step back and say actually tonight I’m not going to spend 6 hours reading I’m going to go see my friend then do it tomorrow. IT WORKED!

I have to say, and I wish someone had told me, NOTHING will prepare you for that first day walking into a ward in a uniform. No matter what colour your uniform is – patients assume you are a qualified nurse of some sort. It is terrifying to say the least! I didn’t want to do anything wrong, and even the slightest thing I didn’t know or did wrong I beat myself up about… and really I shouldn’t have. It’s so easy to forget when you are on ward for 10 weeks and you aren’t qualified! You have so much to learn but you never really stop learning anyway.

This year has really taught me just how blessed I am. This year not only have I been touched by every patient I have been in contact with but their families are going to be imprinted on my life forever. Working in the field of paediatrics really touches the heart of so many people, you see these children who are poorly and you know they deserve your 100% best effort to help them and their families.

When I started this journey I thought that just meant the best medical care. I had to have as much knowledge as possible, I must be the best at every assignment and exam but no, actually most patients and their family don’t really care what grade or classification that you have, they want you to be empathetic, be with them and explain what is going on.

At points it meant being there for parents whilst they explain to their child about an operation they must have and the complications that may occur, to just comforting a child that hadn’t stayed in hospital before. It’s important to remember it’s not just the children we work for, the parents sometimes need you more than the child does. Countless times I have spent time with parents who are waiting for their child to come out of theatre and there has been a complication, we don’t know why or what has happened and all we can do is talk about the weather until we get the call  to go and see their child.

I know this blog is different to the other ones that have been written on EBN over the last few days, but I’m so thankful for what I’ve learnt and the people who have been there for me this year and I really wanted to be ‘that person’ for even one new starter this year. This year has been hard, and yes I know the next two are going to be even harder, but I’m lucky. I have an incredible family who love me unconditionally and always have my back. I have friends both at home and in Birmingham who understand I can’t be a normal university student, but that meeting for breakfast at 8am IS totally normal after a night shift. My cohort is filled with such amazing people who I really wouldn’t change for the world – there have been people who have left to do other things but still are the most amazing people and forever will be part of my nursing life. I have a boyfriend who loves me and listens when I come home crying about a patients journey that’s touched me. Mostly however, I have my patients. Those who have touched my heart in a way that I will never forget and those I haven’t met yet. WE are all in this together. Every paediatric nurse is in the same boat and at time it feels lonely, but reach out – you’ll be surprised how many people are there ready to catch you! You can do this, We can do this!

Lauren James

@Twenty_Thirty2

Stephen’s Student Nursing Experience

28 Aug, 15 | by Gary Mitchell, Associate Editor

On Wednesday 2nd September (8pm-9pm UK time) @EBNursingBMJ is co-hosting a twitter chat on student nursing and midwifery with @RCNStudents 

To celebrate the contributions our student nurses/midwives make – we are sharing blogs of their experiences in practice.  Today’s blog is from Stephen McKenna, a first year student nurse from the Queen’s University of Belfast.

Stephen3

Life Changing. Changing Lives.

Nursing was always a bit of a pipe dream, something I should have pursued a long time ago. Sometimes however, all you need is a push in the right direction and before you know it you’re a third of the way through a Nursing degree.

Heading back to the land of academia at 30 might not sound that daunting, but when you’ve been out of the loop for so long you start to question your sanity. Not normally a shrinking violet, I quickly became one on my first day. It didn’t help that there were only 12 males in a class of 370; that alone was pretty intimidating. If RCN statistics are anything to go by I better get used to working in a female dominated profession. By the end of the week the males in the class, perhaps through a sense of macho pride, had managed to commander an upper section of the lecture theatre, which we retained for the rest of the year. An unofficial ‘boy zone’ where lads could be lads and masculinity prevailed!

People say a Nursing degree is one of the toughest courses out there and if I’m honest they’re right. My first 6 weeks were a baptism of fire. They don’t call it ‘front-loaded learning’ for nothing! The topics are dished out raw for you to take away and digest. For me it was about keeping my head down and getting to grips with the basics. I quickly learned that I needed to be organized in order to stay on top of the demands. As much as study was important I also needed an excuse to get away from the books. With this in mind I joined the Rowing Club. At first the whole work/university/life balance thing was going fine, but then first placement kicked in and things were about to change.

Any nursing student will tell you that after 6 weeks in university they can’t wait to get the heck out of the place and onto their placement. Most of us have a deluded belief that we’ll have a bit more time to ourselves. Everyone’s placement experience is different though. We’ve all heard the horror stories of demonic Ward Sisters, absentee mentors and places you’re all but ignored. Thankfully my first placement was not like this and I learned a lot very quickly. On a busy surgical ward I saw a variety of complex conditions and procedures. You can read all the books under the sun, but in reality placement is where you learn the most. There were of course some sad cases. I found knowing someone was dying before they did a hard burden to carry. Dealing with death and dying is an intense experience. It’s hard to know what to say to a relative when a loved one dies, but in time I’m sure I’ll learn.

Juggling placement and part time work is a fine art. Unfortunately like everything in life; you can’t have it all. Something had to give. That something was the rowing. I couldn’t sustain the training required and by February I was already falling behind. After a lot of thought I decided it was time to hang the oars up for good. It’s fair to say everything in life is a trade-off. You give up one thing to get another and you can’t have it all. If I’m honest I was no Steve Redgrave anyway and a less demanding sport would have made more sense!

Before you know it 6 weeks of placement are up and you’re excited to get back to university, despite wishing 6 weeks previously you could escape it! University offers the chance to catch up with friends and have a bit of craic – something you don’t get much of on the wards for obvious reasons. The work continued to come in thick and fast in second semester. Social life became a distant memory.

Stephen2

Placement 2 was Health Visiting. I wasn’t really sure what to expect, but got my eyes well opened when I went into the community. They say you don’t know what goes on behind closed doors and that’s very true. I saw it all; deprivation, loneliness, neglect and domestic violence. Of course there is the pleasant side too. Brand new babies and happy homes to make you smile. It was an enjoyable placement, but health visiting isn’t for me – there are just some things a man doesn’t need to know about!

Final semester meant exams and essays. It was a pretty intense time, but I was determined to succeed – I’d made it this far and wasn’t going to fall at the final hurdle. I put a lot of work into revision and entered exams quietly confident. Thankfully the revision paid off and results were good.

The words ‘care home’ strike the fear of God into us Nursing Students. We imagine them as fusty old places with a bad reputation. An image not helped by the likes of the Winterbourne scandal. When I heard my final placement of year one was in a care home I was slightly dubious. Thankfully, I can report that good places still exist and this was one of them. Based in an Intermediate Care setting I found myself part of a fantastic team who really cared for the people they looked after. I had a brilliant mentor and learned a lot. In the end I left with a changed perception of care homes and was sad to leave the wonderful nursing staff and residents whom I had become so attached to.

Stephen1

With a year under my belt I am excited for what the next two will bring. Despite constantly being called ‘Doctor’ and asked why I’m not studying medicine, I am convinced Nursing is my calling. Determined to make the most of every opportunity I am already planning my elective in a developing country, where I hope to experience a back to basics approach to care, while embracing another culture.

 

Stephen McKenna | Adult Nursing Student |Queen’s University Belfast

Katie’s Student Nursing Experience

27 Aug, 15 | by Gary Mitchell, Associate Editor

On Wednesday 2nd September (8pm-9pm UK time) @EBNursingBMJ is co-hosting a twitter chat on student nursing and midwifery with @RCNStudents 

 

To celebrate the contributions our student nurses/midwives make – we are sharing blogs of their experiences in practice.  Today’s blog is from Katie Eckert, a third year student nurse from the University of Derby

Katie STDN

Before I started nursing I was a security officer who occasionally completed an Open University course to keep me busy. Matt, my husband, always told me “you would make a good nurse” and I would laugh the statement off. Don’t tell him but little did I know a couple of years on I would be following his advice and be about to commence my third year of studying. Although I had done Health Care Assistant work for a year before starting my course I still had no idea what to expect. University was very much the same as the Open University course apart from the fact that I actually went to a University for lectures. In the first year we learnt a lot of the “basics” in nursing around clinical skill and the government bodies that we needed to be aware of etc.   Until our first placements were announced I hadn’t really given it much thought. I had been allocated a local district nursing team for my first year which both excited me and scared me. So my first day came and with my uniform perfectly pressed and shoes polished I found myself ushered into a small office in a clinic full of nurses in royal blue. I sat in the corner and watched trying to take as much as I could in so I could impress my new mentor. When the office cleared we focused on my paperwork that I needed to get signed off. This included an interview to identify goals. Then she said “Why do you want to be a nurse?” Now I had prepared answers for the obvious questions like, “Where do you live?” “Have you any children?” “What year of study are you in?” but this totally threw me. I couldn’t sit there and say “Because my husband thought I might be good at it” so I quickly responded with “I want to help people”. To this day I haven’t got a clue if she believed me or not as she simply carried on with the paperwork. The truth was, of course I wanted to help people, but at the same time I really wasn’t sure. I never dreamed I would get onto the nursing course so when I did it was a bit of a whirlwind and I hadn’t sat back and thought about how I felt about it all.

During my second year I have continued to develop my clinical skills and learn a lot more about myself and how I manage situations on a busy Emergency Management Unit in a local trust. I am sure you can appreciate the new fear I felt when I learnt that this would be my second placement, what a jump from district nursing to emergency nursing. During this year I have faced many challenges, from the increasing difficulty of University work, to the higher expectations of my clinical skills as a second year student nurse. However, it has not put me off progressing into third year. If anything I have a huge desire to see where third year takes me.

If my first year mentor was to ask me the same question again now that I have completed 2 years of study, with the experiences I now have, I wouldn’t give the same answer. Of course I want to help people – but I have learnt that being a nurse is much more than that. I want to fulfil my desire to learn so as I can help positively change people’s lives. I want to develop as an individual and challenge myself on a daily basis. Now in my third year of nursing I am realising that Nursing is more than a career choice – it’s a way of life for me and my husband, who I have to say has been very supportive. This journey is far from over and I am thoroughly enjoying the challenges it is throwing at me and can’t wait to see where the journey will take me once I finish my degree next year.

Katie Eckert StN @KatieEckertStN

Anna’s Student Nursing Experience

26 Aug, 15 | by Gary Mitchell, Associate Editor

On Wednesday 2nd September (8pm-9pm UK time) @EBNursingBMJ is co-hosting a twitter chat on student nursing and midwifery with @RCNStudents 

To celebrate the contributions our student nurses/midwives make – we are sharing blogs of their experiences in practice.  Today’s blog is from Anna Jones, a second year student nurse on the children’s branch, from the University of Leeds 

Anna Jones

My name is Anna Jones and I am a second year student nurse. I am studying at the University of Leeds and my branch is children’s nursing. I am currently on my summer annual leave and I have to say, I’m enjoying every minute! As much as I enjoy my course, it’s a relief to have a break! To say that second year has been difficult would be an understatement. Continual deadlines whilst working on placement all year has been exhausting, but a challenge I am proud to say that I have overcome. Being a student nurse brings many challenges every day. Whether it’s completing an assignment, frantically trying to get a certain skill signed off or ironing your uniform after a twelve and a half hour shift ready for another the next day. What I would give for my own fairy god mother!

However, these challenges do not compare to the ones many patients encounter daily and I am forever putting my own life into perspective to realise how truly lucky myself and many others are to have good health. Working within the field of paediatrics is incredibly rewarding and a joy to meet and care for so many courageous children and families. The strength and resilience they have to face each day is remarkable and gives me the motivation to deliver the best care I can, because my patient’s deserve nothing less.

Like I mentioned, this year has been a tough one – I thought first year was difficult but nothing can prepare you for the jump to second year. I first worked on a day case surgical ward which I loved. Whilst the no nights and weekends were a bonus, meeting so many children and families every shift was a delight. I was able to accompany patients throughout their short stay in hospital, from their admission and the journey to the anaesthetic room to bringing them back to the ward and saying goodbye as they were discharged. Although this was a short experience for patients and their families, do not underestimate the fear and anxieties that are experienced and how valuable the role of nurses are to lend a comforting smile and words of encouragement as children prepare for their surgery.

Being a children’s nurse means delivering the upmost care to that patient, but also ensuring family centred care is encapsulated within practice because they are also on this journey, experiencing a vast range of emotions. Comforting a parent who was crying as their child had been anaesthetised and taken to surgery, having only known them for a few hours seems a bit of an awkward situation. But when you are in that role, that caring role of a nurse, you pat them on the back, lend them a shoulder to cry on or even give them a hug, all with no hesitation. Because if you cannot show that level of compassion and empathy, how can you truly fulfil your role as a nurse?

The rest of my placements this year have been based in the community, one of which was health visiting. Students often have mixed reactions about health visiting but for me it was very different to life on the ward! 9am starts was one of the best perks, an extra two hours in bed was bliss! Working 9-5 Monday to Friday was also a very different routine, and one which I actually found more tiring than 3 long days on a ward. Community placements were slightly more relaxed compared to the busy pace of a ward, but do not doubt the workload. One baby is born every forty seconds in the UK, and each one needs a health visitor. But I enjoyed the placement and an area of health care I would certainly consider further along in my career. Another placement within the community was based at a SILC school. These are Specialist Inclusive Learning Centres for children with special needs. This was a special placement for several reasons; meeting children with specialist and complex needs was so valuable as a student nurse. To see the small yet significant impact you were making on these children was endearing and a valuable learning experience for future practice. The school was also where my grandma had nursed for 20 years; I had quite literally stepped into her shoes! As you can see, nursing runs in the family…

I found that working in the community was a valuable experience to ascertain the care that is delivered outside of the hospital setting. It was also important to become aware of all the services available for children and families to ensure that you are working as part of a wider team to ensure that the care you deliver is holistic within the context of that patient. I realise I sound like I’m writing an essay but it is so important to deliver effective, person centred care. To put my job into perspective, I always try to imagine if it was my younger sister or brother being cared for which gives me the drive to deliver the care that my patients deserve. If my parents or grandparents had to go into hospital, I would want the best level of care delivered to them, as would everyone. This is why the notion of ‘person centred care’ should resonate throughout the nursing workforce and an aspect I will channel within my career. At the beginning of my nursing programme I discovered a quote by Maya Angelou that encapsulates this well within the context of nursing:

‘People will forget what you said, people will forget what you did, but people will never forget how you made them feel.’

I have one more placement of my second year, 4 weeks on a respiratory ward which I begin in a few weeks time. It’s been nice to relax and have some time off but I am looking forward to being thrown back into the whirlwind that is nursing. I will then continue straight into third year. My final year. With so many assignments and placements, qualifying has always seemed like a lifetime away, but now it’s only 60 weeks away (to be precise!) Am I apprehensive? Yes. I can already feel the huge weight that is third year beginning to rest on my shoulders with the prospect of dissertation and applying for jobs. Am I ready? Sometimes I’m not so sure, but I’ve got this far so there is definitely no turning back now! Am I excited with what the next few years will bring? Absolutely.

Anna Jones @AnnaJones6

A Birth Partner Checklist

12 Aug, 15 | by josmith

Steve Hogarth, Senior Lecturer Midwifery, University of Huddersfield

Having a baby in the UK is the safest it has ever been. However, women and babies are still being exposed to substantial and sometimes multiple avoidable harms, during labour and birth. Human factors, working culture, communication and teamwork are key themes associated with avoidable harm in maternity care. The success of the WHO surgical checklist in reducing harm and improving team work and communication in operating theatres is a model which is transferable to labour and birth.

Our response was to create a safety checklist to be used in collaboration with women and their birth partners. The project aimed to improve communication between the midwives/other clinical staff and the birth partners, meaning that in effect the development of the checklist will be personal and potentially empowering for mothers and partners during labour and birth to ensure that basic care is delivered reliably and safely.

In March 2013, we generated ideas for the birth partner checklist, which included focus groups. The purpose of these groups was to generate ideas from healthcare professionals for the content and potential themes that could be incorporated into the checklist. We used the NICE Intra partum Birth Guidelines (2007) as a reference to help inform some of the suggestions.

Midwife extract: ‘After today’s session I will go away and have a look at my parent craft input and probably tweak the parent craft presentation to look at it a lot more from a birthing partner’s point of view and hopefully get them to be a little bit thought provoking and involve them more in the process of labour.” Another Midwife, said: “I did not what to expect but it has all been extremely positive and it is nice to hear that there could be some extremely improved changes to how we care.’

In May and June 2013 we undertook interviews with new parents Parent (1) highlighted that ‘having a checklist in labour would be very helpful, knowing what will happen and what to do if there is a problem would really help’. Parent (3), said ‘I always like to know what is going on and if I have a checklist this would help me to have an understanding of when thing need.

The evaluation of the project were mixed response from both health professionals and birth partners, with the qualitative part of the evaluation took the form of a thematic analysis of the responses. Salford_SHINE_AW

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