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Continuity of midwifery care, and caseload care in particular, is associated with a vast and varied array of improved outcomes for mothers and their families, including reduced intervention, reduced need for analgesia in labour, reduced preterm birth, and improved satisfaction with the birth experience. Caseload models of care may also increase midwives' satisfaction with their role and, contrary to what is often thought, may result in an improved work-life balance, and reduced burnout when compared to models of standard care. This article discusses how caseload midwifery might result in both women and midwives becoming more empowered and autonomous, and may facilitate a redirection of midwifery philosophy back to promoting and protecting normal birth.

Gestational diabetes affects 5-7% of all pregnancies and has an effect on care during pregnancy, as well as on outcomes for both mother and fetus. Its prevalence is rising, along with the background prevalence of obesity and type 2 diabetes. This is not surprising, considering that they are intertwined in a cycle whereby having one condition increases the risk of having the other, and that they can all be passed down through the generations. This article will discuss the pathophysiology of gestational diabetes, as well as methods of screening, diagnosis, and intervention; increased knowledge and optimisation of which have the potential to slow the amplifying intergenerational cycle of these conditions.

Jaundice in the newborn is usually normal. It is caused by the breakdown of red blood cells, which, as a result of newborn transitional physiology, results in the build-up of bilirubin in the infant's circulation. Bilirubin can be toxic, however, particularly in the brain, where its presence can result in death, or devastating long-term neurological damage. This article reviews factors that might result in the excessive production or build-up of bilirubin, as well as those that might predispose an infant to neurotoxicity.

Pre-eclampsia is a pregnancy-specific disorder that can significantly alter maternal physiology and result in a considerable threat to maternal and fetal health. Although many of the mechanisms involved in its pathophysiology have been elucidated, significant knowledge gaps remain. Perhaps as a result, there is no known treatment for the condition, and birth is the only known cure. The optimal timing of birth can present a difficult decision in the face of maternal or fetal demise; therefore maternal and fetal condition must be monitored and stabilised with the aim of prolonging pregnancy until this time is evident, or until birth becomes necessary. Intervention involves screening pregnant women with the aim of initiating aspirin prophylaxis for those deemed to be at increased risk. This article discusses the pathophysiological mechanisms involved in pre-eclampsia, factors that may impact on pathophysiology, controversies around screening, and the mechanism of aspirin prophylaxis.

Postpartum haemorrhage is a leading cause of maternal morbidity and mortality worldwide. A common aetiology is uterine atony, which can often be related to the intrapartum management of labour; but an increasingly common cause is abnormally adherent placentation, which is occurring more often due to rising caesarean rates. While intervention can increase the risk of postpartum haemorrhage, it also has its place in its prevention. Hopefully, a balance can be found to improve outcomes both in the short- and long-term.

Domestic abuse and mental health disorders are particularly dangerous during the perinatal period, due to their effects on both the mother and the developing fetus. Furthermore, domestic violence and mental health appear to be linked, which can result in these issues being passed down through generations. In order for health professionals to respond efficaciously, pre-registration and ongoing training is needed on how to ask, respond, provide support and refer women on to appropriate supportive agencies. High-quality research is also needed to improve outcomes.