Community & Homebirth Conference Friday, 15th November 2013 Mossley Mill, Newtownabbey

1. Community & Homebirth ConferenceFriday, 15th November 2013Mossley Mill, Newtownabbey Planning Ahead: Guidelines and Best Practice Bid McKeown, Lead Midwife Community and Public Health and SOM Work email: brigid.mckeown@northerntrust.hscni.net

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) 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

10. Further recommended reading 2 • 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. • Guidelines: • 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.