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Planning Ahead: Guidelines and Best Practice

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1 Planning Ahead: Guidelines and Best Practice
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

2 Home Birth Guideline Is it: a policy? a protocol? operational guidance
standard operating procedure?

3 Guidelines should include (1)
Evidence Base Reflect National Guidelines Roles and responsibility Scope and limitations Information for woman

4 Guidelines should include (2)
Criteria - assessment Organising & attending Transfer of care Skills for Home Birth Equipment, phone numbers Medicines supplies, pharmacy, transport (gases)

5 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

6 Governance 2 Documentation Birth Plan Care Plan

7 Complex Case Management Plan
Remember – mother’s instinct for the safety and survival of herself and her baby 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

8 Lessons learned 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?

9 Further recommended reading 1
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) 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) 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): 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): 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): 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.

10 Further recommended reading 2
NHS Litigation Authority (2010) Clinical Negligence Scheme for Trusts : Maternity Clinical Risk Management Standards, Version 1, 2010/ Cheshire: DVH Healthcare UK. Olsen (1997) Meta-analysis of the safety of Homebirth. Birth. 21: RCM, RCOG, NCT (2007) Making Normal Birth a Reality. 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. Guidelines: DOH (2004) National Service Framework for Children, Young People and Maternity Services. Standard 11: Maternity Services DOH (2006) Our Health, our care, our say: a new direction for community services DOH (2007) Maternity matters: choice, access and continuity of care in a safe service DOH (2007) Making it better for mother and baby. DH February NCT (2001) Home Birth in the UK, Nationals Childbirth Trust. London 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. NMC (2008) The Code: Standards of Conduct Performance and Ethics for Nurses and Midwives. London NMC. NMC Circular (2006) Midwives and homebirth Circular 8 NMC (2012) Midwives Rules and Standards. London: NMC.


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