Postnatal Care E-Book

Heather Winter, Christine Macarthur, Debra Bick

Description

This title is now out of print. A new edition with e-book is available under ISBN 9780702041174.

This practical handbook presents evidence-based guidelines for the identification and management of postnatal health needs. It reviews the evidence on the physical and psychological postpartum health problems experienced by women, and the primary management of these, and facilitates individualised care. The ten guidelines were developed by experts in postpartum health as part of a large randomised controlled trial and were peer reviewed by nationally acknowledged experts in each subject area. The guidelines were designed for use by midwives and incorporate criteria for referral, but will also be useful for other health professionals and for women. Leaflets presenting a summary of recommended management are held in a pocket inside the back cover, for ease of regular use.

An essential reference for those involved with caring for women after childbirth; scientific evidence on management clearly reviewed, assessed and summarised in 'what to do' sections; each guideline is structured around one symptom area, incorporating definitions, prevalence estimates, risk factors and management, including referral; Lift-out leaflets on 'What to Do' are enclosed for easy use in clinical practice.

Sujets

• Perinatal
• Women's Health
• Medical
• Médecine
• Nursing
• Maternity

Informations

• Publié par: Churchill Livingstone
• Date de parution: 22 août 2008
• Nombre de lectures: 1
• EAN13: 9780702037832
• Langue: English

Extrait

Table of Contents

Cover image
Front matter
Dedication
Copyright
Preface
Introduction
Chapter 1. Endometritis and abnormal blood loss
Chapter 2. Perineal pain and dyspareunia
Chapter 3. Caesarean section wound care and pain relief
Chapter 4. Breastfeeding issues
Chapter 5. Urinary problems
Chapter 6. Bowel problems
Chapter 7. Depression and other psychological morbidity
Chapter 8. Fatigue
Chapter 9. Backache
Chapter 10. Headache
Appendix 1. Search strategy for second edition
Appendix 2. Symptom checklist
Subject index
Front matter
Postnatal Care
For Elsevier:
Commissioning Editor: Mairi McCubbin
Development Editor: Sheila Black
Project Manager: Elouise Ball
Designer: Erik Bigland

Postnatal Care

Evidence and Guidelines for Management
SECOND EDITION
Debra Bick BA MMedSci RGN RM , Professor of Midwifery and Women's Health, Centre for Research in Midwifery and Childbirth, Faculty of Health and Human Sciences, Thames Valley University, London, UK
Christine MacArthur PhD , Professor of Maternal and Child Epidemiology, Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham, UK
Heather Winter MD FRCOG MFPHM , Senior Clinical Lecturer in Public Health and Epidemiology, Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham, UK
With contributions from
Kathy de Mott and Gill Ritchie,
National Collaborating Centre for Primary Care, Royal College of General Practitioners
Dedication
In Memoriam
Dr Heather Winter very sadly died, aged 48, just after the final chapters for this book were finished. Heather had an important role in the production of this book and was pivotal in the research on postnatal care to which it was linked. Heather was qualified as an Obstetrician and Gynaecologist and a Public Health Doctor. She was a Senior Clinical Lecturer in Public Health and Epidemiology at Birmingham University, in which capacity she was an excellent teacher and researcher. Her main aim in life was to live and work in ways that could make a difference to the lives of others. In addition to her research on maternity care, she made major contributions in the areas of gynaecological cancer and in reduction of perinatal and maternal mortality in the developing world. Her contribution will be hugely missed by many.
Copyright

An imprint of Elsevier Limited
© Elsevier Limited 2009. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier's Rights Department: phone: [phone] (US) or ([phone] (UK); fax: [phone]; email: [e-mail] . You may also complete your request on-line via the Elsevier website at www.elsevier.com/permissions .
First published 2002
This edition 2009
ISBN 978-0-443-10400-8
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress

Notice

Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Authors assume any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book.
The Publisher


Printed in China
Preface
Debra Bick and Christine MacArthur

London and Birmingham, 2008
The evidence base and guidelines which form the main part of this book were originally developed as part of the IMPaCT (Implementing Midwifery-led Postnatal Care Trial) study ( MacArthur et al., 2002 and MacArthur et al., 2003 ). The guidelines were developed as part of the new model of care, the main objective of which was to improve women's physical and psychological health after birth, through the systematic identification and management of their postpartum health problems. Postnatal midwifery care continued to be universally implemented as part of the new model. These guidelines were part of the new care package used by community midwives in the study to provide best evidence of effective management. As such, they were extensively reviewed and tested.
For the second edition, in order to ensure consistency with recently published guidance for postnatal care in England and Wales from the National Institute for Health and Clinical Excellence (NICE 2006) , systematic reviews undertaken by the NICE guideline development team at the National Collaborating Centre for Primary Care (NCC-PC) have informed the update of evidence with respect to the identification and management of included health problems and symptoms. The guidelines were devised for use by practising midwives and assume a prior level of knowledge applicable to their training and experience, but will also be useful for other groups, such as midwifery and health visitor students, health visitors, family doctors and obstetricians, as well as women themselves. Although originally prepared for UK postnatal practice, the evidence presented is international and the guidelines are relevant to community-based care after childbirth in other countries in the developed world.

Acknowledgements
This book was written in collaboration with the National Collaborating Centre for Primary Care. Dr Kathy de Mott and Gill Ritchie developed and implemented the search strategies for the systematic reviews which have informed the second edition.
Christine Henderson devised the original format of the accompanying leaflet sections for each guideline.

References

MacArthur, C; Winter, H; Bick, DE; et al. , Effects of redesigned community postnatal care on women's health 4 months after birth: a cluster randomised controlled trial , Lancet 359 ( 2002 ) 378 – 385 .
MacArthur, C; Winter, HR; Bick, DE; et al. , Redesigning postnatal care; a randomised controlled trial of protocol based, midwifery led care focused on individual women's physical and psychological health needs . ( 2003 ) NHS Research and Development, NCC HTA , Southampton .
National Institute for Health and Clinical Excellence (NICE) , Postnatal care: routine postnatal care of women and their babies. Nice Clinical Guideline 37 . ( 2006 ) .
Introduction
The content of this book was originally derived from work undertaken for the IMPaCT study, a large cluster randomised controlled trial, funded by the NHS Research and Development Health Technology Assessment Programme, which compared a new model of midwifery-led postnatal care with current care ( MacArthur et al., 2002 and MacArthur et al., 2003 ). The background to the IMPaCT study was informed by the recommendations of two major reports which sought to influence the direction of the maternity services in the 1990s: Changing Childbirth , the report of the Expert Committee on Maternity Care ( Department of Health 1993 ), and the House of Commons Select Committee Report on the maternity services ( House of Commons Health Committee 1992 ), and evidence from studies of maternal morbidity. These studies consistently found that women did not volunteer information about their health problems, but would provide information if they were asked ( Bick and MacArthur, 1995 , Brown and Lumley, 1998 , Glazener et al., 1995 and MacArthur et al., 1991 ). It was postulated that much morbidity remained unidentified because care continued to focus on routine observations and examinations, and that early discharge from midwifery care at around 10–14 days, together with a final postnatal consultation with the family doctor at 6 weeks, left insufficient time to adequately ascertain and manage women's health needs.
The new model of care which was developed, implemented and evaluated within the IMPaCT study required midwives to plan selective visits based on women's individual needs until 28 days rather than the usual 10–14 days. Symptom checklists were used to systematically identify health problems around the 10th and 28th days, and at a final consultation at around 10–12 weeks, which replaced the 6–8-week check with the family doctor. The Edinburgh Postnatal Depression Scale was also administered by the midwives at 28 days and 10–12 weeks to identify women who may have depression. The emphasis of the new model of care was on the identification and appropriate and timely management, including support and reassurance, of individual physical and psychological health needs. The evidence-based guidelines were developed to help achieve this. The results of the IMPaCT study showed that universal implementation of midwifery-led postnatal care, tailored to me