Planning birth in and admission to a midwife-led unit: development of a GAIN evidenced based guideline (Reprint)

Isobel Maria Healy, Patricia Gillen

Research output: Contribution to specialist publicationArticle

Abstract

Women with a straightforward pregnancy are encouraged to plan their birth in any of the following birth settings: home, freestanding midwifery unit, alongside midwifery unit or an obstetric unit (NICE, 2014). Most recently published maternity strategies internationally, within the United Kingdom (UK) and in particular, the Strategy for Maternity Care in Northern Ireland 2012-2018 (DHSSPS, 2012) place a strong emphasis on the normalisation of pregnancy and birth as a means of improving outcomes and experiences for mothers and babies. However, women and maternity care professionals require guidelines to assist them in their decision-making in planning their place of birth.
Aim: The aim of this paper is to outline the process involved in the development of evidence based guidelines for the admission to midwife-led units (MLUs) through collaboration with key maternity care stakeholders including: Heads of Midwifery, Midwives, Consultant Obstetricians, Consultant Anaesthetists from the HSC Trusts, a GP, Midwifery Advisor, a representative from the Public Health Agency, NI Practice and Education Council, a workplace union and service users from a range of women’s and parent groups.
Method:
Following approval from the GAIN (Guideline Audit and Implementation Network) Operational Committee to fund the project, requests for nominations to join the Guideline Development Group (GDG) were sent to the maternity care stakeholders and organisations, as well as women’s and parents groups across Northern Ireland (NI). In total, 35 individuals became members of the GDG participating on the Working or Steering group, with a small number of participants taking part in both groups (see table 6). The process included 12 meetings of the GDG between February 2014 and July 2015, with a specific remit to review and critically appraise relevant, up-to-date evidence relating to planning birth and the admission of a woman at the point of labour to either an Alongside Midwife-led Units (AMU) or Freestanding Midwife-led Unit (FMU). The criteria (see table 3) were informed by the evidence and expert opinion, and was made following robust inclusive discussion and challenge. Peer review was undertaken by two Professors of Midwifery, an Obstetrician and a Midwife Lecturer.
Outcomes: The process outcome was an evidenced-based guideline for admission to midwife-led units, including the specific criteria for planning birth within MLUs, Alongside midwife-led units and Freestanding midwife-led unit.
Implications for practice: The development of this evidenced-based guideline will enable women and maternity care professionals in their decision to plan birth in a midwife-led unit. Midwife-led units utilising this guideline may have an increased number of women accessing their services and therefore will require regular review to ensure adequate midwifery staffing levels.
Original languageEnglish
Pages26-32
Number of pages7
Volume27
No.1
Specialist publicationMIDIRS Midwifery Digest
Publication statusPublished - 26 Sep 2016

Keywords

  • Midwife-led care, Midwife-led units, admission criteria, straightforward pregnancy, low risk, evidence-based practice, normal labour and birth

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