Topic 34
The Society and College of Radiographers has issued a statement discouraging partners and other relatives from using mobile phones or video cameras to record ultrasound examinations of pregnant mothers.
It says that the filming can affect the concentration of the sonographer and during the examination he or she may be distracted and miss vital observations, it can also extend the length of time the ultrasound examination takes.
In your experience, has relatives filming the ultrasound examination distracted you and others from the job at hand?
Join in the discussion should relatives be allowed to film the ultrasound examination
Topic 33
In the government's White Paper
Equity and excellence: liberating the NHS, much of the primary care Trusts' budgets will fall under the control of GP consortia. However, will this give GPs too much power?
Join in the discussion on GPs in charge of NHS purse strings
Topic 32
This week NICE released new guidelines recommending that midwives monitor the carbon monoxide levels of pregnant women to see whether they smoke.
Do you think subjecting them to this breath test is a helpful way to encourage pregnant women to stop smoking? Or do you feel that the intervention will only just make women feel more guilty and not entirely trusted to be truthful about their smoking habit?
Join in the discussion on carbon monoxide testing of pregnant women
Topic 31
To what extent should midwives be involved in child protection?
Join in the discussion on child protection
Topic 30
There is a growing body of evidence calling for pregnant women, particularly women with darker pigmentation, to receive higher doses of vitamin D supplements.
Higher doses have been linked to cutting the risk of preterm birth, reducing the risk of complications and helping fetal growth.
What do you think? Are we placing too much emphasis on the importance of vitamin D, particularly when too much can cause vitamin D toxicity, characterised by such symptoms as nausea, constipation and kidney stones?
Join in the discussion on vitamin D and pregnancy
Topic 29
Following an increased number of women diagnosed with breech presentation in established labour, a unit is considering scanning all nulliparous women on admission to confirm presentation.
Do you know of any other Trusts considering a similar move? Should midwives and obstetricians receive more training to identify breech presentations prior to labour?
Join in the discussion on breech presentation
Topic 28
A recent review in
BJOG: An International Journal of Obstetrics and Gynaecology concluded that there was 'little convincing evidence' that acupuncture helped diminish the pain of childbirth.
Do you think this means that acupuncture has no role to play in a woman's pain relief?
Join in the discussion on acupuncture in childbirth
Topic 27
Are midwives over-reliant on CTGs at the expense of their core midwifery skills such as auscultation and palpation?
Join in the discussion on too dependent on CTGs?
Topic 26
An RCM member has asked:
What are the experiences of direct-entry midwives practising in atypical roles such as family planning and health visiting in maintaining their midwifery registration? What constitutes midwifery practice in order to fulfil PREP requirements seems to depend on the view of the individual’s supervisor of midwives and local supervising authority. Do you think there should be guidelines so that all midwives in this position are treated equally? (
*Please note this topic is now closed*)
Join in the discussion on midwives in atypical roles
Topic 25
As the general election draws near, which political party do you think will do its best for the NHS?
Join in the discussion on the general election
Topic 24
If a pregnant woman is suspected of drinking heavily, should she be asked to take a blood test, which could confirm or deny this, as one north London hospital has introduced? Is this being too judgmental and condemnatory? Perhaps the issue should be more about educating the woman about unit consumption?
Join in the discussion on testing for drink
Topic 23
A woman who claims that medical staff left her premature baby to die because he was born at less that 22 weeks has attracted a number of headlines in the media. Sarah Capewell is campaigning for every baby, whatever their age, to be treated by doctors and for parents to be given information to make their own informed choice about whether the child should be treated in a neonatal intensive care unit.
At the moment the Nuffield Council on Bioethics and the British Association of Perinatal Medicine have guidelines saying that babies born below 22 weeks' gestation should not be resuscitated.
Do you think these guidelines need to be revised, particularly in light of continuing advances in treating premature babies?
Join in the discussion on treating babies born before 22 weeks
Topic 22
Do you work in a midwifery-led unit, either alongside or standalone? If so, what is your staff skills mix?
A fellow member is interested in hearing how other units are staffed.
Join in the discussion on staff skills mix
Topic 21
One of the subjects debated at the recent RCM student conference was on whether fathers should be present at childbirth. The prevailing view is that fathers provide vital support for mothers, but some say they should be banned from the delivery suite as their presence causes a longer, more difficult birth.
Have you generally found fathers' presence a help or a hindrance?
Join in the discussion on fathers at birth
Topic 20
Alistair Darling has announced a 1% pay cap on public sector Workers for two years from 2011, if labour is still in government. Has this announcement affected the way you will vote in the next general election, or do you feel these measures are justified given the dire state of public finances?
Join in the discussion on the pay cap
Topic 19
Scotland plans to introduce a midwife to maternity support worker ratio of 60:40.
What do you think the optimum ratio should be?
Join in the discussion on midwife to maternity support worker ratios
Topic 18
A member wrote: I have recently become ward manager on a 32-bedded post/antenatal ward. The ward is very busy and is often running at capacity. The buzzers are constantly ringing, the women are totally dependent on the staff and take no responsibility for themselves or their babies – it is like they are in hospital so need to behave as if they are ill and require nursing. I appreciate that women who have had operative deliveries need to recover, and we do give them extra care, but encourage them to be self-caring, because they can go home after 24 hours. Are there any progressive postnatal wards that promote self-caring with the support of staff, rather than dependence? Any ideas?
Join in the discussion on postnatal care
Topic 17
A recent BMJ study sparked off a renewed debate on the link between cot deaths and co-sleeping. Would you advise parents not to sleep with their babies under any circumstances?
Join in the discussion on cot deaths and co-sleeping
Topic 16
The headline grabbing news that an Indonesian woman gave birth to an astonishing 19lb 2oz baby was quickly followed up with the report that a woman in Glasgow had given birth to a 13lb 13oz baby the heaviest ever recorded in Scotland. Both women were suffering from diabetes, do these two stories highlight the need for better management of diabetes in pregnancy?
Join in the discussion on diabetes in pregnancy
Topic 15
In a recent survey of 1500 nurses, a third said that they would decline vaccination against swine flu, citing concerns about the safety of the vaccine and the fact that the illness seemed very mild in the majority of cases.
Would you have any qualms about receiving the swine flu jab? Indeed, do you as a frontline member of the NHS feel morally obliged to be vaccinated against the virus?
Join in the discussion on the swine flu vaccination
Topic 14
In a recent survey of 1500 nurses, a third said that they would decline vaccination against swine flu, citing concerns about the safety of the vaccine and the fact that the illness seemed very mild in the majority of cases.
Would you have any qualms about receiving the swine flu jab? Indeed, do you as a frontline member of the NHS feel morally obliged to be vaccinated against the virus?
Join in the discussion on Contingency plans for swine flu
Topic 13
What has been your experience of doulas? Do they make your job as midwife easier or has there been instances where they have proved more of a hindrance than a help?
Join in the discussion on Doulas
Topic 12
Midwives at Southend University Hospital NHS Trust are having their competencies evaluated, in order to ensure good practice when caring for women with epidural infusions. This follows a national patient safety alert.
Do you have competencies where you work and, if so, what do you have to do to be deemed competent?
Join in the discussion on Epidural competencies
Topic 11
At its recent conference the health trade union Unison called for a ban on British National Party (BNP) members from nursing and urged the NMC to support its motion.
Do you support this move or do you believe midwives and nurses' political affiliations should be left out of any debate about professionalism?
Join in the discussion on BNP Membership
Topic 10
The ‘appalling failings’ in care identified in a Healthcare Commission report of Staffordshire Hospital underline the consequences of inadequate training and low staffing levels.
Do you fear that the effects of midwife shortages might cause a similar deterioration in standards of care at your hospital?
Join in the discussion on the effects of staffing shortages
Topic 9
Recent reports in the media have suggested that the number of cases of Erb’s palsy – a form of arm paralysis caused by shoulder dystocia presentation – is rising.
Do you think midwives receive sufficient training in the rotational technique to tackle shoulder dystocia?
Join in the discussion on shoulder dystocia
Topic 8
NHS North East Essex is offering pregnant women £100 worth of food vouchers if they stop smoking.
A woman will receive £20 when she has stopped smoking for a week, a further £40 when she has stopped for four weeks and another £40 when she has stopped for a year. Whether they have stopped smoking will be determined by carbon monoxide testing.
Is this the way to target entrenched smokers or is highlighting the health benefits the direction to take? Maybe we just have to accept some people will never give up, no matter what incentive is provided?
Join in the discussion on smoking in pregnancy
Topic 7
Healthcare unions have expressed disappointment at the NHS Pay Review Body's decision not to ask the government to reopen the three-year pay deal.
The review body points out that the labour market has rapidly weakened, with the unemployment rate rising. Thus, in this more uncertain climate the NHS is appearing a more attractive employer.
What do you think? Are midwives buckling under the pressure of the credit crunch or should they just be happy to have a job and that they are guaranteed some sort of pay rise in 2009?
Join in the discussion on the pay deal
Topic 6
Half of the 164 student midwives surveyed recently by researchers from the University of Ulster had either witnessed or experienced bullying. Furthermore, nearly a third of them had been bullied by more than one person.
What do you think? Is bullying in midwifery becoming more prevalent and driving people out of the profession at a time when recruitment and retention is a growing problem?
Join in the discussion on Bullying
Topic 5
Domestic abuse is associated with many negative outcomes in pregnancy such as premature birth, low birth weight, fetal injury and fetal death. However, abuse does not just have to be physical, a psychologically controlling partner that appears to make all the decisions for the pregnant women can be just as harmful.
How do you cope with the domineering partner? Should midwives do more to help these beleaguered women find their voice?
Join in the discussion on domestic abuse
Topic 4
A new report states that for every three Down’s syndrome babies prevented from being born, two healthy babies will be miscarried because of the methods used to detect the condition.
In the report, in Down Syndrome Research and Practice, the authors call for an overhaul of the current screening policy and estimate that in detecting and preventing the birth of 600 Down’s babies, 400 healthy fetuses are lost.
They add that about 5% to 10% of women receive a high-risk result because the initial screening threshold is set wide. They are then encouraged to undergo the more invasive high-risk procedures, amniocentesis and chorionic villus sampling.
Do you agree with the authors that the government needs a rethink on its policy of offering genetic screening to all pregnant women? Are too many women placed in the ‘high risk’ category and encouraged to undergo more invasive tests?
Do you think its ethical to screen for genetic indicators of mental ability and, if so, what level justifies termination of pregnancy? Or do you think such ethical quandaries are a private matter and should not impinge on a midwife’s professional life?
Join in the discussion on Screening for Down's syndrome
Topic 3
In light of the World Health Organization’s (WHO) predictions of more than 700m people becoming obese by 2015, what should be done to assist midwives in dealing with the challenges that this will undoubtedly bring?
The WHO projects that by 2015, approximately 2.3bn adults will be overweight and more than 700m will be obese. This means that more and more pregnant women will present to midwives as obese (that is with a BMI of 30 or more). Studies have shown that obese women are at greater risk of developing complications of pregnancy such as pre-eclampsia and gestational diabetes. But what needs to happen to alleviate the pressures midwives will face? Is the National Institute for Health and Clinical Excellence remiss in not as yet drawing up guidelines addressing the issue?
Join in the discussion on the challenge of obesity
Topic 2
A recent review by the Healthcare Commission into maternity services in England found that 28% of doctors and 58% of midwives surveyed felt that the two groups did not have shared goals.
The chairman of the Commission, Sir Ian Kennedy, was subsequently quoted as saying that the 'tribal allegiances' that set doctors and midwives against each other had to end.
So, do we need to break down these allegiances and endeavour to work better with doctors? Do you think that professional loyalty can sometimes adversely affect the service that women receive? Share your views online.
Join the discussion on whether midwives work well together
Topic 1
The RCM Council recently recommended that members reject the three-year pay offer negotiated by health departments, NHS Employers, RCN and Unison. The College wants members to accept the NHS Pay Review Body recommendation of an increase of 2.75% on pay and allowances for one year only.
The College's position is explained in the following Midwives magazine article: 'RCM says 'no' to locked-in pay cuts'
Do you think this is the right path to take? We would welcome your views on the pay offer and our response. We would also like to hear what you think about midwifery pay in general.
Join the discussion on midwives' pay
