• relationship with midwife is most influential factor in considering a home birth;
• home-from-home environment is the most influential factor in considering giving birth in a midwife-led unit
The recent maternity services consultation for Hull and the East Riding has backed local Clinical Commissioning Groups’ (CCGs) vision for maternity care. 92% of respondents agreed with the vision ‘to provide choice and certainty in respect of choice of place of birth and the delivery of safe, high quality services for local women and their partners’.
A total of 452 responses to the consultation were received; of these 391 (87%) were received online. 53% of the responses were from Hull residents and 47% from the East Riding of Yorkshire. A number of responses were received from the Polish community. 83% of respondents were parents or parents-to-be, 75% were aged 25 to 44 years and 94% were female.
Between July and October 2012 feedback was invited on Hull and East Riding of Yorkshire’s CCG’s plans to ensure local mums-to-be have access to a full range of birthplace options - from a home birth right through to hospital-based care from a consultant-led team.
Respondents rated a list of factors which would influence their decision to give birth at home, in a midwife-led unit or in a maternity-team led service.
Key findings from the survey showed:
- a good relationship with the midwife is the most influential factor in considering a home birth;
- a home-from-home environment is the most influential factor in considering giving birth in a midwife-led unit, followed by access to specialist services;
- the availability of specialist services is the most influential factor in considering giving birth in a maternity team-led service, followed by home-from-home environment;
- other key factors in considering where to give birth are staffing and support, personal experience, safety and quality of the facility;
- there was support for the development of a midwife-led unit located alongside the existing maternity unit at the Hull Women‘s and Children’s Hospital.
This is what people had to say:
‘I would always choose a home birth. The only factors changing this would be medical emergencies or availability of midwives, but I feel that this should be the first choice available to all women…’
‘The main factor for me was safety for my baby and myself. Therefore, would always choose hospital with medical team…’
‘I …believe that sometimes health care professionals, midwives etc need to realise that some parents are first time parents and this is all new to them.’
‘To be able to see the same midwife antenatal …… would influence me to want a home birth. To have to repeat the same conversations with different midwives is very frustrating.’
‘The main influence would be the surrounding environment. Giving birth can be stressful it would be helpful if the surroundings were as calm as possible in order to alleviate this.’
Dr Dan Roper, local GP and NHS Hull CCG lead for Maternity Services, said:
“It is clear that choosing where to give birth is a very individual and personal decision, and each mother-to-be should be able to access the right information to make the decision that is right for them.
“The feedback gathered through the consultation process will be valuable to us as clinical commissioners, providing a range of ideas to consider alongside developing clinically safe and cost effective maternity services.”
Dr Gina Palumbo, local GP and Chair of East Riding of Yorkshire CCG, said:
“We want to continue to make sure all women are involved in planning and making decisions about their maternity care, with their health professional.
“Some respondents said they wanted much more consistent information from health care professionals, particularly around pain relief and home births, to be able to make an informed choice. This insight will help us to work with our maternity care providers to ensure what they deliver meets the needs and expectations of people in our local area.”
The full consultation report recommends that key findings and comments are shared with current maternity service providers to support ongoing service improvement planning. The findings will be taken into consideration in the development and delivery of a Maternity Services Strategy for each Clinical Commissioning Group.
Please click here to read the report.
You can also keep up to date and see what others are saying via the Maternity Services Review facebook site: www.facebook.com/maternityservicesreview
- In line with the Department of Health’s ‘Maternity Matters’ (2007), women have the right to choose where they deliver their baby, and the consultation was prompted by recent changes in the options available locally, most notably the closure of the Jubilee Birth Centre.
- Further engagement with stakeholders will take place during the development phase of the Maternity Services Strategies.
Women who have been assessed by a midwife or obstetrician as being medically fit and have a normal pregnancy can choose to give birth in their own home. Mothers-to-be are supported by a midwife while they are in labour.
This type of unit or facility offers care to women who have been assessed by a midwife or obstetrician as being medically fit, have a normal pregnancy and are at low risk of developing complications. In this facility, all care and support for a woman and her birth partner is led by the midwife, with the woman being involved in all decisions made around her care.
Maternity Team-Led Unit
This type of unit offers the full range of maternity services including midwives, anaesthetists, consultant obstetricians and neonatologists who provide care to women and their babies during and immediately after labour and delivery. Women with underlying medical or pregnancy related problems and who are at risk of complications during labour and delivery will need medical supervision and/or intervention. Women who require induction of labour or a caesarean section will be cared for by these services, as will women who are expecting multiple births (twins, triplets, etc). This care is provided in a more hospital-like environment