Hi Sheena,
Please could you add my signature to this very positive response.
Best wishes,
Bernie Divall (see below for job title and base)
Dr Bernie Divall
Research Fellow in Maternity Care
School of Health Sciences
Division of Midwifery
Floor 12, Tower Building
University Park
University of Nottingham
Nottingham NG7 2RD
Tel: 0115-823-1200
Email: [log in to unmask]
www.about.me/berniedivall
From: A forum for discussion on midwifery and reproductive health
research. [mailto:[log in to unmask]] On Behalf Of SHEENA BYROM
Sent: 28 February 2016 14:13
To: [log in to unmask]
Subject: Re: New scientist - article REVISED DRAFT
Hi all,
Here is the amended latest draft ready to go to the New Scientist.
We would like the signatories to include a range of disciplines/researchers/policy makers if at all possible. For those willing to sign, please could you ask two or more others who are not midwives (fathers? obstetricians/ neonatologists?
epidemiologists? sociologists? bereaved parents?) to also sign?
I need the signatures by Tuesday, then we’ll send it to the New Scientist. We can add the content to a blog for wider sharing (and more signatures) after the journal has either rejected it or published the letter.
If you have signed (please check below), could you make sure I have all your details please? Just name, job title and base?
Response to New Scientist piece by Clare
Wilson, 25 February 2016
We are somewhat astonished that the New Scientist is citing Amy Tuteur, ex-obstetrician and US blogger, and the findings from one NHS Trust, as the only evidence base for their claims thatthe recommendations
of the recent NHS England Maternity Review will lead to ‘dead babies and damaged mothers’. This suggests that the New Scientist does not believe or accept the findings of a systematic review of 15 funded and published RCTs on the benefits of continuity of
midwifery led care including 17,674 women from 4 countries (Sandall et al, 2015). This Cochrane Collaboration review found that continuity of midwifery care reduces preterm birth and overall fetal and neonatal death.
It also fails to acknowledge the findings of high quality large scale scientific studies published in medical journals comparing the outcomes from planned out of hospital births with planned hospital births,
that identify no increase in perinatal mortality or severe morbidity (De Jonge et al 2009, Hutton et al 2015, Janssen et al 2009). The article ignores the National Institute of Health Research funded Birthplace in England study, which researched the risks
and benefits of giving birth in different settings in England, analysing detailed data on over 64,000 ‘low risk’ births. This included nearly 17,000 planned home births, 28,000 births in midwife-led units and nearly 20,000 obstetric unit births. The study
identified that there were no significant differences in adverse perinatal outcomes for babies born in midwife led units compared to obstetric units and in addition found significant benefits for the health of the mothers (Birthplace Collaborative Group 2011) .
The article completely avoids the most recent National Institute for Health and Clinical Excellence ( NICE) evidence-based guidance on intrapartum care for healthy women and babies (NICE, 2014, CG190), which makes strong evidence-based recommendations on
birth place and the benefits of physiological birth for the great majority of mothers and babies in the short and longer term.
The New Scientist will surely be aware that both NICE and the Cochrane Collaboration evidence-based guidelines follow a rigorous and inclusive review, consultation and decision-making system to ensure that guidelines
reflect best clinical evidence. Does the New Scientist therefore not believe any evidence produced by NICE and the Cochrane Collaboration, given that the maternity services review was based on exactly the same standards as all the relevant NICE and Cochrane
reviews?
Amy Tuteur is based in the USA, where there is a very different maternity system and much higher rates of maternal mortality and stillbirth than in the UK. She strongly opposes normal birth and midwife care. If we are really at a point when one personal opinion
from a blogger and one important but very specific element of findings from one single NHS Trust trumps years ofnational and international research, maybe we can save millions of pounds in future by not undertaking RCTs or guideline development, and just
organising policy and practice on the basis of the views of a few individuals and a few specific cases.
if the New Scientist does not believe the research underpinning the NHS England Maternity Review, it would be very helpful if they could provide evidence (not anecdote) of the dangers of the Review recommendations for designing maternity care so that mothers can have respectful,
kind maternity care centered on their values and needs, based on continuity of midwifery led care, as part of an integrated health system with seamless links to obstetric input and authentic teamwork.
References
De Jonge et al 2009 Perinatal mortality and morbidity in a nationwide cohort of 529688 low risk planned home and hospital births BJOG, 116(9):1177-84
Birthplace Collaborative Group et al 2011 Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study BMJ, 343 Open Access
Hutton et al 2015 Outcomes associated with planned place of birth among women with low-risk pregnancies CMAJ, . Dec 22, epub ahead of print
Janssen P et al 2009 Outcomes of planned home birth with registered midwives versus planned hospital birth with midwives or physicians CMAJ, 181, 6-7
NICE, 2014 Intrapartum care for healthy women and babies CG190. Available from: https://www.nice.org.uk/guidance/cg190. Accessed 28th February
2016
Sandall J et al 2015 ‘Midwife-Led continuity models versus other modes of care for childbearing women’, Cochrane Database Syst Rev. Sep 15;9:CD004667
Signed:
Professor Soo Downe OBE University of Central Lancashire UK
Dr Mary Ross-Davie Education Projects Manager Maternal and Child Health Glasgow UK
Sheena Byrom OBE, HFRCM, Midwife Consultant UK
Professor Christine McCourt Maternal & Child Health City University London UK
Tom McEwan MSc, PgDip (ANNP), BSc, RM. Lecturer in Midwifery (Maternal, Child & Family Health)
Dr. A. de Ruijter LLM, Chair of the Board, Clara Wichmann Foundation, strategic litigation for women’s rights
Dr Anke de Jonge xxx
Professor Jenny Gamble Discipline Head for Midwifery Griffith University Australia
Jenny Hall Senior Midwifery Lecturer Bournemouth University London UK
Lucia Rocca Lecturer in Midwifery City University London UK
Elizabeth Cluett Director of Programs for Family, Child and Psychosocial Health University of Southampton UK
Miranda Dodwell User representative and researcher, BirthChoiceUK
Professor Billie Hunter RCM Professor of Midwifery Cardiff University UK
Professor Mary Renfrew xxx
Ellen Blix xxxx
Zoe Vardavaki Birth Centre Midwife University College Hospital London UK
Yvonne McGrath Senior Midwife University College Hospital London UK
Sally Tracey xxx
Corine Verhoeven xxx
Susanne Besseling xxx
Dr Liz Darling Assistant Professor of Midwifery Laurentian University, Ontario, Canada
Alison McFarlane xxx
Louise Silverton CBE Director for Midwifery Royal College of Midwives London
Luisa Cescutti-Butler xxxx Bournemouth University UK
Caitlin Wilson Consultant Midwife Mid Yorkshire NHS Trust UK
Anna Byrom Senior Midwifery Lecturer University Central Lancashire UK
Megan Jackson Labour Ward Midwife University College Hospital London UK
Octavia Wiseman community midwife, Kings College Hospital Research Fellow, City University London UK
On 28 Feb 2016, at 11:48, Meghan Jackson <[log in to unmask]> wrote:
This is amazing!
I would love to sign.
Meghan Jackson
Labour Ward Midwife (UCLH)
On 28 Feb 2016 10:42, "Wilson Caitlin" <[log in to unmask]> wrote:
Hi
Looks great. I will sign
Warm Regards
Caitlin
Consultant Midwife
Sent from my iPad
On 26 Feb 2016, at 15:27, Louise Silverton <[log in to unmask]> wrote:
Excellent. Well done all
Louise
Louise Silverton CBE
Director for Midwifery
The Royal College of Midwives
15 Mansfield Street
London W1G 9NH
Tele: 0300 303 0444
Fax: 020 7312 3536
Web: www.rcm.org.uk
Facebook: www.facebook.com/MidwivesRCM
Twitter: www.twitter.com/MidwivesRCM
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From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Mary Ross-Davie
Sent: 26 February 2016 14:34
To: [log in to unmask]
Subject: Re: New scientist - article
Hi Billie, Mary and all
So, I made a few additions to Soo's great letter - just in terms of adding some references as requested - I have forwarded to Sheena to work her networking magic - but will also paste below so others can amend as they would like:
Response to New Scientist piece by Clare Wilson, 25 February 2016
We are somewhat astonished that the New Scientist is citing Amy Tueter, blogger, as the evidence base for their claims that natural birth is killing babies.
This suggests that the New Scientist does not believe or accept the findings of a systematic review of 15 funded and published RCTs on the benefits of continuity of midwifery led care including 17,674 women from 4countries (Sandall et al, 2015). This Cochrane review found that continuity of midwifery care reduces preterm birth and overall fetal and neonatal death.It fails to acknowledge the findings of high quality large scale studies comparing the outcomes from planned out of hospital births with planned hospital births, that identify no increase in perinatal mortality or severe morbidity (Janssen et al 2009, De Jonge et al 2009). The article ignores the National Perinatal Epidemiology Unit Birthplace study which researched the risks and benefits of giving birth in different settings in England, gathering detailed data on over 64,000 ‘low risk’ births. This included nearly 17,000 planned home births, 28,000 births in midwife-led units and nearly 20,000 obstetric unit births. The study identified that there were no significant differences in adverse perinatal outcomes for babies born in midwife led units compared to obstetric units (Hollowell et al 2011, Brocklehurst et al, 2011) The article fails to recognise the most recent National Institute for Health and Clinical Excellence ( NICE) guidance on intrapartum care for healthy women and babies (NICE, 2014, CG190), on birth place and the benefits of physiological birth for mother and baby in the short and longer term and the findings in the recent Lancet Stillbirth Series that very few babies die intrapartum in high income countries (even in the UK) (Froen et al 2016).
-Does the New Scientist therefore not believe any evidence produced by NICE and the Cochrane Collaboration, given that the maternity services review based on exactly the same standards as all the other NICE and Cochrane reviews?
If we are really at a point when a personal opinion from a blogger who is known to strongly oppose normal birth and midwife care, and the findings from one single Trust, trumps years of serious research, maybe we can save millions of pounds in future by not undertaking RCTS or guideline development, and just organising policy on the basis of the views of a few individuals and a few specific cases.
if the New Scientist does not think this is the way to determine policy in health care, it would be very helpful if they could provide the evidence base (beyond anecdote) that introducing a policy of maximising normal birth where possible, based on continuity of midwifery led care, and seamless links to obstetric support, will increase stillbirths for whole populations of womenReferences
Sandall J et al (2015) ‘Midwife-Led continuity models versus other modes of care for childbearing women’, Cochrane Library
Janssen P et al (2009) ‘ Outcomes of planned home birth with registered midwives versus planned hospital birth with midwives or physicians’, CMAJ, vol 181, 6-7
De Jonge A, 2009, ‘Perinatal moratlity and morbidity in a nationwide cohort of 529688 low risk planned home and hospital births’, BJOG, vol 116, 9
Brocklehurst, P, 2011, ‘Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birplace England national prospective cohort study’, BMJ, vol 343; see also www.npeu.ox.ac.uk/birthplace
NICE, 2014, ‘Intrapartum care for healthy women and babies’, CG190
Froen et al, 2016, ‘Endinb preventable stillbirth’, The Lancet stillbirth series
bwMary
Mary Ross-Davie
Dr Mary Ross-Davie
Education Projects Manager
Maternal and Child Health
3rd Floor, 2 Central Quay
89 Hydepark Street
Glasgow, G3 8BW
Tel: 0777 503 5536
0131 656 3399
See our latest learning resources at: www.knowledge.scot.nhs.uk/midwifery
Find out about our work at www.nes.scot.nhs.uk/maternitycare
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