Uterine induction after a single Caesarean section with ocytocic infusion and amniotomy where the cervix is favourable does not appear to entail any significant added risk in terms of maternal or foetal morbidity. Foley catheter induction is a reasonable option if the cervix is not ripe.
The amount of pain a woman experiences is influenced by many individual, physical, emotional and environmental factors. Some of these factors can be anticipated and controlled. It is important that, before the birth, a woman is aware of relaxation techniques and of all the forms of pain relief which are available before and during the birth. The midwife has an important role to play in informing the woman of the options available and devising a birth plan to suit the woman's needs. This article focuses on transcutaneous electrical nerve stimulation (TENS), where electrodes placed on the woman's back send out electrical signals, blocking pain and stimulating the production of endorphins. There are no known harmful side effects and studies have shown that it greatly reduces the need for pharmacological analgesia. Women should be made aware of all methods of pain relief available so they can make an infomed choice on what they believe will suit them.
Over half of UK nurses have considered leaving their current posts because of low pay and because they feel undervalued. These are the findings of a survey of 3500 nurses and midwives published in the Unison report Simply Slipping Away (Unison, 2002), which forms part of Unison's evidence to nurses' pay review body. Other reasons given for the discontent among nurses include an unfair grading system, unpaid overtime and lack of access to training. In addition, two-thirds of the nurses report frequent staff shortages and an increased workload, the latter mainly being as a result of Government targets.
Has the British public been victims of a media stunt? Recently I attended a briefing on severe acute respiratory syndrome (SARS) and its coverage by the media, which was held at City University, London. Panellists, who included Professor John Oxford, a virologist at the Queen Mary School of Medicine, London, representatives from the Communicable Disease Study Centre, healthcare professionals, and print and broadcast journalists, all pooh-poohed the idea that we are facing an uncontrolled outbreak similar to the 1918 ‘Spanish influenza’ epidemic that killed more than 50 million people.
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