BBC's Sian opens co-located birthing unit

BBC Breakfast presenter Sian Williams came straight from the studio to open Southend University Hospital’s natural birth unit last week.

Alongside the central delivery suite, the midwife-led co-located birth unit caters for those women expecting a straightforward birth who would still prefer to have their baby in hospital.

The idea is to create a more homely, less clinical, environment than the main delivery suite. Partners are encouraged to take an active role and are aided by the midwives and maternity support workers to achieve this. “The whole focus is on normality,” says community midwifery manager and public health co-ordinator, Antoinette Flynn. “When a woman is low risk, the midwives will now be able to offer a choice of either a home birth or to come to the co-located unit to have their baby.”

The four individual rooms in the unit have all the necessary equipment tucked away in drawers rather than on hospital trolleys. There is none of the usual hi-tech equipment – the emphasis is on making childbirth as natural and straightforward as possible. Some of the rooms do not even have a bed, but have alternative birthing couches. Antoinette explains: ”There are birthing stools and a pool; some women prefer to deliver in a supportive position and we have the necessary equipment to facilitate this. Our midwives encourage a more upright position and for the women to keep as mobile as possible.”

To aid this, the rooms are equipped with exercise balls to sit or rock on and other mobility equipment. The rooms even have a kitchen where the women or their partner can make tea and toast. Staff look after the mums throughout their experience and postnatally, offering support with infant feeding. Following the birth, women are normally discharged within four to six hours.

Jan encourages normality

Jan Butler was appointed as Consultant Midwife at Cambridge’s Rosie Hospital in April, and is one of only three in this role in the east of England.

Previously, Jan has been a Supervisor of Midwives and has played key roles in developing a midwife-led birthing unit and in a national research project on perineal suturing.

Jan told us “An important part of my remit is to work closely with the Head of Midwifery, Anna Shasha, in developing a culture of normalising birth, improving quality and safe care for mothers and their babies. It is also about working as a multidisciplinary team to reduce the C-section rate through positive leadership, which means supporting all our staff and a commitment to evidence-based practice.

Thanks to media and the internet, women are more informed about their options, and come armed with questions and expectations. For example, many healthy women who have had a normal, uncomplicated pregnancy may not have considered a home birth – we need to be giving them up-to-date evidence that supports normal birth rather than exposing themselves to unnecessary interventions.

I consider it a privilege to be the Consultant Midwife at the Rosie Hospital and look forward to being able to influence midwifery practice for women in my locality”.

Mums-to-be can contact a midwife direct

An innovative new service called Maternity Direct was launched in July giving pregnant women direct access to a midwife as soon as they know they are pregnant.

Basildon and Thurrock University Hospitals NHS Foundation Trust and NHS South West Essex have launched the scheme to give women direct access to maternity services as an alternative to going to their GP first.

Sue Grace, Matron for Community and Antenatal Clinic, said: “Women need to access maternity services within 7-8 weeks of becoming pregnant, so that they can be offered timely advice, be booked and have their first scan by 12 weeks. Maternity Direct will speed up the process and lead to earlier presentation for far more women than currently.”

Cathy Warwick, General Secretary of the Royal College of Midwives, launched the service and the rebirth of the Willow Suite, the midwife-led birthing unit (see below).

She said: "It is terribly important midwives celebrate their successes and I offer huge congratulations to you all. You have been under scrutiny as a unit, but that can be quite healthy if lots of good work emerges. I think you have been working fantastically well."

Midwives from Basildon Hospital are pictured above, with Cathy Warwick (right, cream jacket).

The Willow Suite

The midwife-led birthing unit at Basildon Hospital was developed as a home-from-home with midwives supporting women through a natural childbirth, offering natural pain relief including water, music and relaxation techniques, in an individual room where the woman can stay until she is ready to go home.

When the suite opened in March 2008, about 500 births per year were expected. Instead, in the past two years, the suite has been enormously popular with women and their families and more than 2,100 mothers have welcomed their babies into the world in the comfort of the suite.

Lynne Cook, Head of Midwifery, said: "As it is the launch of Maternity Direct, we wanted to take the opportunity to also celebrate the rebirth of the suite, and highlight all the amazing services it offers."

“The developments in the Maternity Unit have meant we have been able to attract more midwives to work for us. We have been able to recruit an additional 27 midwives in the past year. A good, experienced midwife means a mother feels she is in safe hands and has a better experience, while we are able to maintain the high standards we set ourselves.“

Neonatal unit recognised nationally

Many congratulations to the Neonatal Intensive Care Unit at the Norfolk & Norwich University NHS Foundation Trust who recently won a national award from the All-Party Parliamentary Group on Maternity (APPGM).

The unit wanted to ensure excellent palliative care for babies with life-limiting conditions, and a real choice for parents as to how and where their baby would be cared for.

A care pathway was developed from a neonatal intensive care unit to home or hospice and staff were then educated about hospice care and how to ensure rapid transfer for babies for end of life care.

Evidence indicates that quality of life for families is improved when babies are transferred to a hospice or home with this support, and more family members are able to be involved in the final days of the baby’s life.

Amanda Williamson, Nurse Manager at the Unit, said: “I was delighted to visit the Houses of Parliament on our team’s behalf to be presented with this prestigious award. I am very proud of the whole team and everyone who contributed to making this happen.”

Quick wins in East and North Herts

Following a study morning in July, East and North Herts Hospital maternity services have put into place two “quick wins” – a unit motto and birthing rooms which place the emphasis on normal birth. Birthing balls and mats replace visible medical equipment, and beds are pushed to the side of the rooms.

The unit looks forward to increasing the normal birth rate and to achieve their new motto of “The normal birth of healthy babies to healthy mothers"

The study morning, which was facilitated by the Institute for Innovation and Improvement, looked at “How to prevent the first LSCS" (Lower segment Caesarean Section). Thirty seven members of staff from a range of professional groups and settings looked at the culture of their organisation and how they would like their service to develop in the future. The Institute produced a report including areas to be addressed and the Trust is now working on its action plan. More information.

Success in cutting C-sections

Luton and Dunstable maternity unit is celebrating success in driving down its caesarean section rate.

In April 2009 it peaked at 31% but now averages at 22%, well below the national average. “Like all hospitals, we were concerned by the rising c-section rate,” says head of midwifery, Helen Lucas. “We are a level three neonatal unit and there was generally a perception among staff that this made us a ‘high risk’ unit.”

“In 2008, we started using the maternity dashboard to give us a month-by-month picture of the number of c-sections taking place. The following year, we employed a midwife to lead on the normalising agenda. Since that time, there has been a drive to change attitudes and behaviours. We are now seeing c-section rates coming down and normal deliveries, particularly VBAC (vaginal birth after Caesarean) rising significantly.”

Bright Gympoh, consultant and lead obstetrician adds “I am proud of the fantastic team we have built, and everyone is working together much better than they did a year ago. We have successfully implemented and maintained the daily review meeting and we now run a regular birth options clinic, which will soon be expanded to cover pre-natal care. It has been absolutely fantastic – this is a great place to work.”

Further details. This works forms part of the Department of Health’s High Impact Actions for nursing and midwifery.

Working together for families

March and Chatteris Children’s Centres in Cambridgeshire, run by Ormiston Children & Families Trust, host a variety of midwifery services and this one-stop shop approach is proving very popular with local mothers and staff.

Amanda Newman, the centre manager, says “Having the midwives working from the centres is like putting the missing piece in the jigsaw, it fits. It is of great benefit to the children's centre team to be able to call on the expertise of the midwives – who are able to signpost new parents to the range of support services we provide, such as Dads’ groups and Fizzical Families. This partnership approach ensures that we offer the very best services possible”.

Mum-to-be Leanne Fresher told us “I have found it easy to get an appointment on the day I need to and at a time which is convenient for me. The staff are always approachable and helpful and this contributes to the relaxed environment. I will be accessing the centre when my baby is born, to attend the many groups that are on offer to families”.

Sarah Rook, from the Hinchingbrooke midwifery team, adds “The centre is very welcoming and a nice environment to work in and this is reflected in the happiness of the women attending. With many of the follow on clinics such as Well Baby and Toddler Clinic running from the centre it allows the women to feel comfortable in the environment and know where they can attend for the next steps”

Pictured above: mum-to-be Sadie Foster at March Children’s Centre with Lesley Alexander, Team Leader, Fenland Midwives

If you would like more information, please contact Amanda.