A midwifery lecturer once described something that I think is very pertinent to those who enjoy reading books, even possibly having a passion for them in absolutely needing to own them.
She said that she would find herself in a bookshop and look at all the titles around her, much like a child in a sweet shop, overwhelmed with the need to make a choice. But choose she would, usually several, and take her prizes home where the reality would hit her. This was that just glazing over the cover and skimming the contents did not constitute the academic pursuit of learning and that she was required to read and understand the words, rather than just glance over them, if her purchases were to be of any value.
I think this is very similar to the extensive choices we have these days with regard to the internet and downloadable resources, where we are overcome with information in various lengths and a huge range of visual presentation. So, here you have an opportunity to look inside the March issue of the Digest at just one article which we hope will tempt you to look further.
Risks and responsibilities arising from prenatal ultrasound by Judy Slome Cohain (MIDIRS Midwifery Digest 22(1):39-43, March 2012)
The author of this article is a self-employed midwife who practices in Israel and has done so for many years. Judy has written for the Digest on a number of occasions and has in the past raised issues about midwifery care that are controversial and challenging to the often status quo framework of more institutionalized maternity care. In this article, Judy focuses on the placenta and its involvement in the many screening tests available to assess fetal well-being throughout pregnancy as well as afterwards. She links this information with the use of ultrasound, and although some of the tests described are not common in the UK, I think the basic philosophy of screening is generalizable whatever the location for care and this is really the issue being raised.
The article takes the various opportunities for screening, whether these are routine or as a follow up to some potential abnormality, and reviews the effectiveness of these tests. It is clear that ultrasound has value but this is not in all areas and Judy explores this information in terms of concern about fetal growth and the fetal environment and what is really known about the placenta and its function.
Although the use of ultrasound enables us to have more information about intrauterine conditions, it is not really until the placenta is delivered that any mix and match can be made, if at all, between the predicted conditions, the actual placental condition and how either of these affected the fetus. This is perhaps quite a complex and novel area for midwives where we have been schooled in various approaches to assess fetal well-being as well as placental appearance after it is expelled, and I think Judy makes an interesting case that we should know more about it, and that there is a need to join up the dots between screening and basic physiology so that we are using technology to the maximum benefit with the minimum risk of harm.
Contributor: Sally Marchant, Editor, MIDIRS Midwifery Digest
Photo Credit: zen0 – fotolia.com
Subscribe to MIDIRS Midwifery Digest and receive 136 pages of in-depth articles, reviews and news that allow you to reflect in detail on both theory and practice. Costing as little as £11.50 for students and £15.75 for professionals per quarter, MIDIRS Midwifery Digest represents ridiculously good value for money – subscribe today.