Transcript Slide 1

Community & Homebirth
Conference
Friday, 15th November 2013
Mossley Mill, Newtownabbey
Planning Ahead:
Guidelines and Best Practice
Bid McKeown, Lead Midwife Community and Public Health and SOM
Work email: [email protected]
Home Birth Guideline
Is it:
 a policy?
 a protocol?
 operational guidance
 standard operating procedure?
Guidelines should include (1)
 Evidence
Base
 Reflect National Guidelines
 Roles and responsibility
 Scope and limitations
 Information for woman
Guidelines should include (2)
Criteria - assessment
 Organising & attending
 Transfer of care
 Skills for Home Birth
 Equipment, phone numbers
 Medicines supplies, pharmacy,
transport (gases)
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Governance 1
Communication
 On-call Team > Parents
 Community Midwifery Team Leader
 On-call Home Birth Team Rota and contact
details – distance/response time
 Hospital for Transfer switchboard / CDS
 Ambulance Control – distance/response
time
Governance 2
 Documentation
 Birth
Plan
 Care Plan
Complex Case Management Plan
Remember – mother’s instinct for the safety and survival
of herself and her baby
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Community Midwifery Team Leader
Lead MW > HOM
Supervision of Midwives >LSAMO
Obstetrician, GP
Trust Clinical Risk Midwife > Risk Register
 Know your Policies/Guidelines
 Good planning e.g. check equipment, medical gases – transport,
safe storage
 Familiarisation visits – relationships, birthing room
Lessons learned
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Reflection > learning
What went well for parents?
What went well for staff?
Did you do everything you could?
What would you do differently next time?
Share the learning
Focus groups
Review guidelines
Consider regional guideline?
Further recommended reading 1
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Armstrong P, Feldman S (2006) A Wise Birth: Bringing together the Best of Natural Childbirth & Modern Medicine. Pinter & Martin
Ltd. London.
Bainbridge, J (2010) Australian Researchers Claim Home Birth Increases Risk of Babies Dying. BJM, February 2010, Vol 18, No
2, page 111.
Campbell R, Macfarlane AJ. (1994) Where to be born? The debate and the evidence. Second edition. Oxford, National Perinatal
Epidemiology Unit.
Dahlen, H et al (2010) The Novice Birthing: Theorising First Time Mothers’ Experiences of Birth at Home and in Hospital in
Australia. Midwifery (2010) 26. 53-63 www.elsevier.com/locate/midw .
Dick-Read G (2004) Childbirth without Fear: The principles and practices of natural birth. London: Pinter & Martin.
Downe S (2004) Normal Childbirth: evidence and debate. Edinburgh: Elsevier.
Downe, S and Gyte, G (2007) Hospital is the Best Place for All Women to Give Birth. BJM, March 2007, Vol 5, No 3, page 157
Gyte, G and Dodwell, M (2007) Safety of Planned Home Birth: NCT review of evidence. New Digest. (40)
Lavender T. Chapple J (2005) How women choose where to give birth. Practising Midwife. 8(7):10-5.
Lindgren, H. et al (2010) Perceptions of Risk and Risk Management Among 735 Women Who Opted For a Home Birth. Midwifery
(2010) 26. 163-172 www.elsevier.com/locate/midw .
Longworth L. Ratcliffe J. Boulton M (2001) Investigating women's preferences for intrapartum care: home versus hospital births.
Health and Social Care in the Community. 9(6): 404-13.
Madi BC. Crow R (2003) A qualitative study of information about available options for childbirth venue and pregnant women's
preference for a place of delivery. Midwifery. 19(4):328-36.
McClean J. Turnbull DA. McGinley MC. Lunan CB (1999) Professional issues. Can childbirth be changed? -- offering women a
choice. British Journal of Midwifery. 7(10): 622-6.
McKeown, B, Wallace, V (2012) Guidelines to Support Homebirths. Chapter 3 in Steen, M (editor) Supporting Women to Give
Birth at Home. London: Routledge.
National Perinatal Epidemiology Unit (2011) Prospective cohort study of planned place of birth.
https://npeu.ox.uk/birthplace/component-studies
Further recommended reading 2
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NHS Litigation Authority (2010) Clinical Negligence Scheme for Trusts : Maternity Clinical Risk Management Standards, Version
1, 2010/2011. Cheshire: DVH Healthcare UK. www.nhsla.com
Olsen (1997) Meta-analysis of the safety of Homebirth. Birth. 21:1 4-13.
RCM, RCOG, NCT (2007) Making Normal Birth a Reality. www.appg-maternity.org.uk/resources/N.
Sweet, M (2010) Science and Headlines in The Home Birth War. BMJ, 27 February 2010, Vol 340, page 455
Weston N (2006) Homebirth: A Practical Guide. (4th edition), Pinter & Martin Ltd. London.
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Guidelines:
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DOH (2004) National Service Framework for Children, Young People and Maternity Services. Standard 11: Maternity Services
www.dh.gov.uk
DOH (2006) Our Health, our care, our say: a new direction for community services www.dh.gov.uk
DOH (2007) Maternity matters: choice, access and continuity of care in a safe service
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyDH_073312.
DOH (2007) Making it better for mother and baby. DH February 2007.
http://www.dh.gov.uk/PublicationsAndStatistics/Publications
NCT (2001) Home Birth in the UK, Nationals Childbirth Trust. London www.nct.org.uk
NICE (2007) Intrapartum Care: Management & delivery of care to women in Labour. London: National Institute for Health &
Clinical Excellence.
NMC (2005) Report of issues arising from a document review to support recommendations for guidance for homebirth. Written by
Julia Magill-Cuerdin for NMC Midwifery Committee. http://www.nmc-uk.org/aFrameDisplay.aspx?DocumentID=1981
NMC (2008) The Code: Standards of Conduct Performance and Ethics for Nurses and Midwives. London NMC.
NMC Circular (2006) Midwives and homebirth Circular 8 http://www.nmc.uk.org/aFrameDisplay.aspx?DocumentID=1472
NMC (2012) Midwives Rules and Standards. London: NMC.
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