Conceptualizing induction as a liminal state may enhance understanding of women's feelings and promote a more woman-centered approach to care. Thorough preparation for induction, including an explanation of possible delays is fundamental to enabling women to form realistic expectations. Care providers need to consider whether women undergoing induction are receiving adequate support, analgesia, and comfort aids conducive to the promotion of physiological labor and the reduction of anxiety.

This paper presents the results of a qualitative study into student midwives' perception of the Objective Structured Clinical Examination (OSCE). The study was conducted at the University of Hertfordshire in the summer of 2005 as part of the author's Masters Degree in teaching and learning. Ten volunteers from a sample cohort of 23 students were surveyed through the medium of semi-structured interviews. The findings show that OSCE is generally perceived by student midwives to be an acceptable, valid and fair means of assessing clinical skills in simulation. However, several aspects were highlighted for criticism, in particular the artificiality of the situation, poor equipment and unsatisfactory administration, all of which contributed to student anxiety. Many suggestions for improvement were offered, such as allowing interaction with assessors during workstations and having flexible time limits to complete each station. On balance, the author concludes that the student perception of OSCE is encouraging enough to justify its continued use.

Background Induction of labour is one of the most frequent interventions in pregnancy. While it is not always unwelcome, it is associated with increased labour pain and further interventions. Evidence from earlier studies suggests that induction is often commenced without full discussion and information, which questions the validity of women's consent. This study aimed to add depth and context to existing knowledge by exploring how first-time mothers acquire information about induction and give consent to the procedure. Method A qualitative study into women's experiences of induction was undertaken, comprising 21 women, who were interviewed 3-6 weeks after giving birth following induction. Findings Information from midwives and antenatal classes was minimal, with family and friends cited as key informants. Midwives presented induction as the preferred option, and alternative care plans, or the relative risks of induction versus continued pregnancy, were rarely discussed. Women reported that midwives often appeared rushed, with little time for discussion. Conclusions Providers of maternity care need to devise more flexible ways of working to create time and opportunities for midwives to discuss induction in detail with women and to promote fully informed decision-making.

Objectives  To determine the number of Approved Education Intuitions (AEIs) offering training in the Newborn Physical Examination (NIPE) as part of pre-registration midwifery programmes  To explore the reasons for including the NIPE and the experiences of those AEIs which have implemented it. Design In early 2015, all Lead Midwives for Education (LMEs) in the United Kingdom were sent a link to an on-line questionnaire which aimed to assess the scope and practice of NIPE education in programmes of pre-registration midwifery education. Key findings 68.9% of all AEIs completed the questionnaire. 25% of those that responded stated that NIPE training is included in in their pre-registration midwifery programmes; one AEI included NIPE in the shortened midwifery programme and the remainder as part of the three year programme. 37.5% of respondents reported they were planning to implement the NIPE within the next 2-5 years and 30% reported they had no plans to do so. Rationales for including the NIPE were broadly summarised as follows: NIPE skills are consistent with the philosophy of midwifery, training midwives to undertake the NIPE meets service needs and also provides a responsive maternity service. Some AEIs reported very positive experiences, identifying benefits for practice partners, commissioners, students and service-users. Others reported challenges, particularly in relation to resources and student support in practice. Conclusions Despite previous recommendations to expand NIPE training into the undergraduate curriculum, few AEIs are currently providing this. Although barriers doubtless exist, the success of the few institutions which have incorporated NIPE into their curricula is evidence that this is not only possible, but has proven benefits.

Objectives: To determine compliance with recommended standards for the newborn and infant physical examination (NIPE), identify which professionals were performing the NIPE and determine standards for screening and management of babies at risk of developmental dysplasia of the hip (DDH) or congenital heart disease (CHD). Design: In autumn 2014, an online questionnaire was sent to all heads of midwifery in the UK. Key findings: Completed questionnaires were returned from 64.3% (n=99/154) of targeted NHS Trusts. The main professionals performing the NIPE were paediatricians, midwives and neonatal practitioners. 95% of responding Trusts employed midwives qualified to perform the NIPE, with 13.7% of midwives employed in the UK NIPE-qualified. Midwives performed over 50% of NIPEs in more than 20% of Trusts where babies were born in the consultant-led delivery suite, and 70% of Trusts where babies were born in a midwifery-led setting. All respondents believed the optimum time for the NIPE was before 72 hours, and all but one Trust usually achieved this. Overall, nearly 80% of respondents rated the value of NIPE as a screening tool as ‘good’ or ‘excellent’. Conclusions: Despite evidence for the safety and cost-effectiveness of midwives examining the newborn, plus previous recommendations for expanding NIPE training, the number of NIPE-qualified midwives remains low. Considerable variation was found between Trusts for screening for DDH and CHD. Implications for practice: The few midwives with NIPE training are examining far more babies than those in their caseload, which undermines the principles of continuity of care. There is scope for improvement in the quality and consistency of information to parents and follow-up processes. There is a need for the development of more robust guidelines for practice and improved screening for neonates.