Current Midwifery Practice Can Improve Outcomes For...

As a midwifery student, the author has worked with two women, within the Continuity of Care Experience, who have been induced for post-term pregnancy. Reflections have been written about the care these women received and are located in the authors Continuity of Care Experience reflective journals under the pseudonyms RO’B and EE. The purpose of this portfolio is to explore current midwifery practice in relation to this event which can turn an uncomplicated pregnancy into a complex labour and birth. Current literature will be reviewed to determine best practice in care provision for woman who are post-term and a recommendation will be made on how midwifery practice can improve outcomes for women whose pregnancies progress past term. For†¦show more content†¦Induction of labour involves one or more of the following interventions to artificially initiate labour: amniotomy, insertion of prostaglandins and intravenous oxytocin (Rimmer, 2014). Expectant management requir es waiting for labour to initiate spontaneously however it is recommended that this method is coupled with increased fetal surveillance via cardiotocography and ultrasound monitoring (Wennerholm et al., 2009; Oros et al., 2012; Heimstad et al., 2007; Queensland Health, 2011). IOL is always indicated where maternal and/or fetal health is compromised by continuing the pregnancy (Queensland Health, 2011; Thorogood Donaldson, 2010). Five articles were identified to determine best practice in care provision between IOL and expectant management in relation to post-term pregnancy. These articles were a mixture of trials and reviews published between 2006 and 2012. The results of these five articles were surprisingly varied. Oros et al. (2012) claimed that both options are equally risky as IOL reduces the number of babies being born small for gestational age but increases risk of birth by caesarean section, particularly for failed induction, and therefore increases length of hospital stay. Heimstad et al. (2007) maintained that no difference was found between IOL and expectant management in relation to neonatal morbidity or mode of birth. Glantz (2010) argued that the