Implementing shared decision making in the NHS: lessons from the MAGIC programme.

Shared decision making requires a shift in attitudes at all levels but can become part of routine practice with the right support, say

Pain relief in labour: a qualitative study to determine how to support women to make decisions about pain relief in labour.

Background: Engagement in decision making is a key priority of modern healthcare. Women are encouraged to make decisions about pain relief in labour in the ante-natal period based upon their expectations of what labour pain will be like. Many women find this planning difficult.

More in hope than expectation: a systematic review of women's expectations and experience of pain relief in labour.

Background: Childbirth is one of the most painful events that a woman is likely to experience, the multi-dimensional aspect and intensity of which far exceeds disease conditions. A woman's lack of knowledge about the risks and benefits of the various methods of pain relief can heighten anxiety. Women are increasingly expected, and are expecting, to participate in decisions about their healthcare.

Trends in the cause of late fetal death, 1982-2000.

Background: Progress in reducing late fetal deaths has slowed in recent years, despite changes in intrapartum and antepartum care.

Objectives: To describe recent trends in cause-specific fetal death rates.

Design: Retrospective cohort study.

Multiple neonatal deaths due to a homoplasmic mitochondrial DNA mutation.

Mutations of mitochondrial DNA (mtDNA) are an important cause of genetic disease. We describe a family with an unusual homoplasmic mutation that resulted in six neonatal deaths and one surviving child with Leigh syndrome. The mother is clinically normal, but a severe biochemical and molecular genetic defect was present in both a fatally affected child and the mother.