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Excellent response Soo - please can I use this example Soo and Laura? Very best wishes Sheena www.sheenabyrom.com > On 14 Nov 2018, at 20:47, Trixie McAree <[log in to unmask]> wrote: > > Great argument! > Trixie > > -----Original Message----- > From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Soo Downe > Sent: 14 November 2018 09:39 > To: [log in to unmask] > Subject: Re: Debates on the ‘uselessness’ and costs of having MLU and homebirth in ongoing Italian Congress > > I would say: > > 1. all women in hospital have had to transfer from home to hospital, often in strong labour, but no-one seems to worry about this - if we wanted minimum transfers in labour, we would have 100% home birth, with women only being transferred when they really needed the hospital 2. there are units with much lower transfer rates, still with safe outcomes, so if we want to reduce transfers lets look at these units, and use their guidelines - lets not work on the basis of units where the guidelines are so restrictive, without any benefit to mothers and babies. > 3. If there really is a need for 40% transfer (which is unlikely) this still means that 60% of women are able to have their baby as they want to in a BC. This is much higher than the % of healthy women who manage to have the kind of birth they originally wanted in hospital - so what is the problem? Indeed, if we want to maximise the chance for women to have physiological births, even with a 40% transfer rate, BCs beat hospitals every time > > All the best > > Soo > > > -----Original Message----- > From: A forum for discussion on midwifery and reproductive health research. <[log in to unmask]> On Behalf Of Laura Iannuzzi > Sent: 14 November 2018 09:07 > To: [log in to unmask] > Subject: Debates on the ‘uselessness’ and costs of having MLU and homebirth in ongoing Italian Congress > > Dear all > I am attending the pre congress courses of the BIRTH Congress in Venice and I ll be speaking this afternoon of our experience in the Margherita birth centre in The Italian context The doctor who was chairing the course this morning in his presentation posed the question of what is the benefit of having MLUs if women in large part need to be transferred (he mentioned the 40% transfer rate for nulliparous in the birthplace study) and access to obstetric led unit with consequent trauma for women and costs for the system and ‘risks’ related to emergency (homebirth was not even considered to be an option being ‘risky’ - and he used US based literature ) So he was posing question on the issue of transfers > > I am trying to slightly change my presentation trying to address this question (that express a very common cultural standpoint in some context, that encourages midwife led care in labour ward but not midwife led care in midwife led units or home) > > For sure in my mind are coming reflection such as ; > - yes it might be quite a challenge the theme of transfer for both women/ family and midwives > - what is provided is not only intrapartum care > - the more you protect physiology the less u need to transfer > - the theme of women’s choice > - the fact that transfers are mainly not due to emergency reason but more ‘tranquil’ situation such as slow progress of labour > - what about the costs of unnecessary interventions ? Are we sure that they are lower than the costs of transfers > - health is more than a intact Perineum and so on > > > But as even if thoughly posed this is an interesting are of debate, I d like to know if possibile from you what would you argue, what points would you make to answer ? > This could be of massive help > Thanks! > Laura > > Laura Iannuzzi > PhD, MSc, PgCert, BMId, RM > Lead midwife physiological pregnancy path and Margherita birth centre Careggi university hospital Italy > > > > Inviato da iPhone > ######################################################################## > > To unsubscribe from the MIDWIFERY-RESEARCH list, click the following link: > https://www.jiscmail.ac.uk/cgi-bin/webadmin?SUBED1=MIDWIFERY-RESEARCH&A=1 > [University of Central Lancashire] > Please consider the environment before printing > > ######################################################################## > > To unsubscribe from the MIDWIFERY-RESEARCH list, click the following link: > https://www.jiscmail.ac.uk/cgi-bin/webadmin?SUBED1=MIDWIFERY-RESEARCH&A=1 > > ######################################################################## > > To unsubscribe from the MIDWIFERY-RESEARCH list, click the following link: > https://www.jiscmail.ac.uk/cgi-bin/webadmin?SUBED1=MIDWIFERY-RESEARCH&A=1 ######################################################################## To unsubscribe from the MIDWIFERY-RESEARCH list, click the following link: https://www.jiscmail.ac.uk/cgi-bin/webadmin?SUBED1=MIDWIFERY-RESEARCH&A=1