Hi
I am the Practice Development MIdwife for Powys. We do not have a District 
General Hospital, we provide antenatal and postanatal care to approx £1400 
women per year and intrapartum care to around 300 low risk women who can 
choose to birth their babies in one of our six stand alone birth centres or 
at home. The high risk women receive antenatal and postnatal care from us 
but go out of county to one of the seven DGh's that we feed into.

We have 38 midwives in total providing 24/7 cover as Powys is so large 
geographically [approx 3 hours from one end to the other] the midwives are 
split into two teams- one north and one south for on call cover with three- 
four midwives on call for each team at any one time. These midwives will be 
provideding all care, antental, postnatal, breastfeeding support, parent ed 
etc. They are not just on call for intrapartum care. They work a caseloading 
type system. Each team has three stand alone birth centres set out across 
that half of the county, Powys is very rural and the cetnres are situated in 
the main market towns. We do not staff our buildings but instead midwives go 
to where the women are. I.e if a woman goes into labour she calls the on 
call midwife who will go to visit her at home and do a home labour 
assessment. The woman will then decide where she wishes to give birth either 
at home or in the birth centre. Our midwives carry all their own equipment 
in order to provide care wherever and whenever a woman requires it. The on 
call midwife will go with her to the birth centre, open the centre and 
provide intrapartum care. No other members of staff will be in the centre if 
it is out of hours [Other midwives may be working there doing antenatal 
clinics etc if it is in the normal working day time.]
When the on call midwife wishes support or second stage is immenent she 
calls the second on call midwife to come in and support her. This midwife 
will stay for as long as she is needed and returns home once things are 
settled. A midwife stays in the centre to care for the women until she 
wishes to go home. We have a 24 hour maximum postnatal stay policy.

I have also previously worked in another area with stand alone birth centres 
these were staffed 24/7 and allowed women to stay in for as many days as 
they wished postnately. We provided intrapartum care to approx 200 women per 
year.
I was the only midwife on duty working with a maternity support worker who 
would provide second cover for births. There would be a midwife working in 
the community during 9-5 hours and a midwife on call for home births during 
the night hours. These midwives would come in if I needed to leave the 
centre for a transfer to provide midwifery cover until I returned. This 
sytem worked just as well and my expereince of suppot workers is that whith 
the right training and clear role demercations they can be a safe pair of 
hands in an emergency.
Both systems work well but I acknoeldge that the midwives were providing 
care to a relatively small number of women and I am not sure how easy it 
would be with larger numbers.

I would be interrested in reading your findings when you have collated the 
data from across the different centers and models of staffing.
Best Wishes
Marie Lewis
Practice Development Midwife
Powys tHB

----- Original Message ----- 
From: "MIDWIFERY-RESEARCH automatic digest system" <[log in to unmask]>
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Sent: Tuesday, January 01, 2013 12:00 AM
Subject: MIDWIFERY-RESEARCH Digest - 29 Dec 2012 to 31 Dec 2012 (#2013-1)


There is 1 message totaling 569 lines in this issue.

Topics of the day:

  1. Midwifery Led Units

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Date:    Mon, 31 Dec 2012 10:10:36 +0000
From:    SHEENA BYROM <[log in to unmask]>
Subject: Re: Midwifery Led Units

Hi Sandra,

East Lancs Hospitals have three successful birth centres with two different 
staffing models. I have copied Anita Fleming into this reply, Head of 
Midwifery and hopefully she'll provide you with more information.

Good Luck!



With best wishes,

Sheena









My blog



On 26 Dec 2012, at 18:33, Ebanks Sandra 
<[log in to unmask]> wrote:

>
> HI Everyone
>
> I am keen to find out how MLU are staffed around the country?
> I am presently the team leader of a alongside birthing unit. We offer 
> three birthing rooms, one with a pool. We currently have two midwives on 
> shift, and no midwifery support person.
>
> Due to staff shortages across the maternity unit, it is proposed that it 
> is OK for a midwife to provide care to a labouring women alone with only a 
> midwifery support worker as support.
>
> If you could reply with how your alongside MLU are staffed?
> We currently have approximately 60 births a month with two midwives on 
> each shift.
>
> I look forward to your response.
>
> Best Wishes
> Sandra Ebanks RN RM SOM
> Team Leader for Willow Suite
>

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End of MIDWIFERY-RESEARCH Digest - 29 Dec 2012 to 31 Dec 2012 (#2013-1)
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