A grim report. I am currently doing a piece of research exploring facilitators and barriers to the use of EBPs to support physiological labour and birth in two obstetrics units. Based on what I am observing the numbers in this report are not surprising.
Research is absolutely necessary but it takes a long time to do good work. Observation techniques during labour is sorely needed. Achieving sample sizes is a big challenge when you want to it amongst low risk labours because of intervention rates.
Tools are important and here there is some optimistic news - the study may result in a Tool that other researchers may be able to utilise.
Do get in touch if any of you are interested in such an approach. Happy to share my experience.
What we know is needed and yet to be widely mobilised is clinical expertise in practice to support implementation. Consultant midwives are doing good work implementing continuity models etc but are not spending enough time in practice and neither are senior midwives engaged in such work.
I think we are going to be sorely disappointed if we think continuity models and use of MLUs on its own are going to resolve the issues.
In house training is also of not of much use if it is not followed through into practice with continued reflection and assessment of skills gained.
Florence Darling
Sent from my iPhone
> On 13 Sep 2019, at 11:13, Macfarlane, Alison <[log in to unmask]> wrote:
>
> Great but worrying to see these data. We haven't had any data on this subject for a long time. We haven't had any from Maternity HES since it was taken over by HSCIC / NHS Digital.
>
> Two things look particularly worrying.
>
> 1. The differences are far wider than is compatible with random variation, indicating that differences reflect hospital policies.
>
> 2. Rates are low in so many small units, presumably midwife led?
>
> A statistical nit pick: Next time can you please start your vertical axes at zero, not 10 per cent.
>
> Thanks, Alison
>
>
>
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