By Helen Baston; Jennifer Hall

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Discuss place of birth Women need to be aware of the options available about place of birth before they can make a decision about what might be best for them. Place of birth is a complicated issue and many factors need to be considered before a fully informed decision can be made. The booking visit is an ideal opportunity to raise the issue, to let the woman know that she has a choice, but not necessarily the right time to seek a definitive decision. In some services, for example the Albany Group Practice (Reid 2002) women are not asked to make a decision until they go into labour.

They need support to give up and there are many local initiatives designed to provide advice and encouragement. Access to services depends on the midwife identifying the need for support and using her interpersonal skills to discuss the topic in a non-judgmental manner. The midwife needs to be aware of her own feelings with regard to women who smoke. ’ either by the tone of her voice or the look on her face, it may be very difficult to repair the damage. It is important not to push information on a woman who does not want to give up smoking; however, it is prudent to assess if the woman is aware of the dangers to both herself and the developing fetus, and to correct misinformation.

42 Swordfish, marlin and shark These fish should not be eaten due to their high methylmercury content, which could affect the nervous system of the developing fetus (Food Standards Agency 2008a). There is evidence to suggest that women who consume a low seafood diet are more at risk of premature labour (Olsen & Secher 2002) although further evidence is required from randomized controlled trials to support these findings. Professionals should always be aware of the impact of their advice. Enkin et al (2000:41) suggest caution and state: efforts to encourage women to eat well during pregnancy, however well intentioned, often include explicit statements that women can reduce their risk of having a pre-term infant through attention to their diet and other lifestyle issues.

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