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Nausea and vomiting in pregnancy (NVP) is a frequently occurring but often debilitating condition. The more severe form, hyperemesis gravidarum (HG) results in increased health care use and a reduced quality of life for sufferers. Management is inconsistent and results in multiple admissions and poor experience of the health care system. Women feel isolated, depressed and lonely and are often treated unsympathetically. Assessment of the severity of symptoms alongside alternative approaches which take into account the interaction between social, psychological and biological events should be considered. A combination of traditional and alternative remedies may be of benefit while ongoing information, advice, social, psychological and emotional support results in increased knowledge, reassurance and confidence which hopefully empowers and encourages women to carry out health promoting activities. This can be carried out in person or via telephone which is an economical and convenient option. Ultimately this should result in improved care and quality of life for sufferers. [ABSTRACT FROM AUTHOR]

The RCOG (2001) recommend external cephalic version (ECV) for breech presentation at term. When practised at term ECV has been shown to be safe and effective avoiding the associated risks of a vaginal breech delivery for the fetus and caesarean section for the mother. However, despite evidence of benefit, the provision of ECV varies due to lack of appropriately trained medical staff available to perform this procedure safely and effectively. This article describes the introduction of a midwife-led ECV service at the Royal Victoria Infirmary Newcastle and includes the preparation and rationale for expanding the midwife's role, the training undertaken and results of independent clinical practice. The authors report a midwife success rate of 43%, which is comparable to that of an experienced obstetrician. [ABSTRACT FROM AUTHOR]