The majority of first-aid presentations during the M2006 were of low acuity and treatment resulted in return of patrons to the event, with only a small number requiring ambulance transport to hospital.

The umbilical cord is the only communication between the fetus and the placenta and, not surprisingly, lesions or conditions affecting it may have detrimental effects in both. One important feature of the umbilical cord is its coiling index (UCI), with hypo- and hypercoiling being associated with fetal thrombotic vasculopathy, intolerance of labor, intrauterine growth restriction, cord stricture, thrombosis of cord and chorionic blood vessels, and fetal demise. It is essential that every placenta report include the UCI. The UCI could also be assessed prenatally, but there is currently no way of accurately assessing the entire length of the umbilical cord. The aim of this study was to compare UCI measured in a segment of cord 10 cm long (UCI-10) and over its total length (UCI-T). One hundred fifty consecutive placenta reports in which both measurements were recorded were retrieved from the files and analyzed. Gestational age ranged from 16 to 42 weeks, with a mean of 33.67 ± 5.96 weeks and a median of 36 weeks. Mean UCI-10 was 0.4360 ± 0.2625 coils/cm and mean UCI-T was 0.3530 ± 0.2022 coils/cm; the difference between these measurements was highly statistically significant (P < 0.0001). Counting the number of umbilical cord coils in 10 cm led to an overestimation of the UCI-T by 23.5%; it can be concluded, therefore, that the latter should be used.

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Midwives have always been seen as the ‘guardians of normality’ (Rosser and Anderson, 1998) yet increasingly the limits for normality are changing. This paper explores the concepts of ‘normality’ and ‘usualness’ in the context of the midwifery role. The issues surrounding normality have been well researched yet their application to what is ‘usual’ in practice is harder to define. The skills and knowledge demanded by our consumers and colleagues have demonstrated the ability to adapt and be flexible across a variety of traditional definitions. There are many midwives pioneering ‘normal but not the usual’ within specific practice issues. What is ‘normal and usual’ for midwifery conduct is unclear and this article lists matters that demonstrate these in terms of the service provided. These areas of care are often ‘normal but not the usual’ yet they are the essence of what is termed midwifery care.