Improving continence service standards within midwifery.
Within west Essex, any woman that has difficulty in passing urine or problems controlling her bladder in the immediate postnatal period is referred to the Continence Advisory Service (CAS) and liaison takes place with the midwife, or with the woman if she is at home. A small working party from midwifery and the CAS has developed, introduced and reviewed guidelines and standards for bladder management during and following labour. These are based on informing women of the importance of regular bladder emptying, especially if they have had epidural analgesia. Regular bladder emptying is by normal voiding or intermittent catheterization, if necessary. The contact with the CAS enables women sustaining anal sphincter trauma to have a better understanding of the injury and the ways in which problems can be treated or prevented. It provides continuity of contact with the same practitioners, and a suitable environment to discuss a potentially embarrassing subject. In-house education of all healthcare professionals involved with women who are planning or have had babies has resulted in the early detection of women with voiding difficulties, and has led to an improved and efficient service.