Intrapartum Care – Communication Normal Birth Consensus Statement Mary Newburn Head of Policy Research

Intrapartum Care - communication Welcoming Informing Supporting Encouraging

Normal Birth Consensus Statement Who has developed it? What is it? Why is it needed? How should it be used?

Maternity Care Working Party Expert advisory body to the All-Party Group on Maternity The Royal College of Midwives The Royal College of Obstetricians and Gynaecologists Nursing and Midwifery Council The Healthcare Commission The Association for Improvements in the Maternity Services (AIMS) Independent Midwives Association RCM Consultant Midwives Forum Association of Radical Midwives BirthChoiceUK Birth Centre Network – UK NSPCC

A positive focus on normal birth Most healthy women can give birth with a minimum of medical procedures. Most women prefer to avoid interventions. Procedures that increase medical interventions to be avoided where possible, e.g.  continuous electronic fetal monitoring  epidural anaesthetic.

A positive focus on normal birth A straightforward birth makes it easier to establish breastfeeding helps get family life off to a good start and protects long-term health

Objective A standard definition for normal labour and birth to raise awareness that normal birth rates matter to facilitate better auditing to enable accurate comparisons to be made for similar women using different services and models of care.

Definition Birth “without induction, without the use of instruments, not by caesarean section and without general, spinal or epidural anaesthetic before or during delivery” episiotomy < 1%

How should it be used? We want all NHS Trusts and Boards across the UK to:  use this definition  collect and publish these annually.  The overall normal birth rate for England including home births, is estimated by BirthChoiceUK to be 48.1%, using Information Centre data

How should it be used? Recommendations for Maternity commissioners, providers and NHS Boards Set normal birth targets - realistic objective of 60% by 2010 Develop a strategy – signed off by clinical leads Active one-to-one midwifery support

How should it be used? Recommendations for Maternity commissioners, providers and NHS Boards antenatal courses  realistic expectations  practical skills: relaxation, massage, active positions access to birth pools, facilities, e.g. aromatherapy information about factors that make a normal birth more or less likely.

How should it be used? Recommendations for Government Set normal birth targets - realistic objective of 60% by 2010 Revise PbR tariffs Active one-to-one midwifery support Sponsor education and training Fund research on -facilitating normal birth -case-mix.

Normal Birth Consensus Statement Developed by stakeholders A tool to raise awareness, facilitate change and monitor performance Inform parents and professionals