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Trixie
It’s worth having a look at how care is provided in Wales as a model that works well. I can’t point you to a publication on this but Billie Hunter or Marie Lewis probably could.
Also, do look at the CMU studies from Scotland.
Regarding place of birth and rurality, as said earlier, the majority of freestanding midwifery units were in fact in rural areas like this. Also – re continuity - take a look at the follow-up AMU
study report as although this was mainly focused on AMU organisation and experience, we discussed how a number of services were developing integrated community or caseload and MU midwifery staffing - still with core MU staff but with caseload or community
team midwives having the MU as a base and providing cover for home births and back up for MU births – that kind of thing.
Link here: Bit.ly/amustudy
Or http://www.journalslibrary.nihr.ac.uk/hsdr/volume-2/issue-7
The main report of the MU study, led by Denis Walsh will be coming out soon. This looked at issues affecting uptake of MUs in England since the new guidelines were produced. As a sub-study to this
project, we did an analysis of media reporting on closure of FMUs, as a number had closed in the period prior to the study. The aim was in part of learn more about prevailing discourse in relation to these units and how this might be affecting uptake or closures.
We found a significant lack of awareness or reporting of the evidence – clinically or economically and media reporting was dominated by press release written by agencies that were proposing closure. Dissenting voices focused on the community impact and with
some discussion about the risks to women of giving birth en-route to hospital, but these voices (mainly women and politicians) were cast in a less powerful position. You can find the paper via this link:
In the earlier Birthplace Organisational Case Studies we found that in our more rural case study areas, the rates of unplanned home birth were higher than those of planned homebirth owing to distance
to get to hospital (a kind of transfer that tends not to get counted as women have to do it themselves). This is not the case in all areas though – there are some excellent models too. Some of the issues in relation to providing an adequate service to support
home birth were published here:
McCourt C, Rance S, Rayment J, Sandall J.
Organisational Strategies And Midwives' Readiness To Provide Care For Out Of Hospital Births: An Analysis From The Birthplace Organisational Case Studies. Midwifery, Special Issue: Place of Birth, 2012.
http://dx.doi.org/10.1016/j.midw.2012.07.004
I think some areas have improved their organization to support home birth since then, especially through caseload or homebirth teams, but in many areas I don’t see signs of improvement and
that is reflected in the most recent National Maternity and Perinatal Audit.
Christine McCourt
Professor of Maternal Health & Centre Lead
Centre for Maternal & Child Health Research
City, University of London
1 Myddelton Street
London EC1R 1UW
Tel: 0207 040 5863
Mob: 0791 235 1476
Twitter: @ProfMcCourt
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From: "[log in to unmask]" <[log in to unmask]> on behalf of Trixie McAree <[log in to unmask]>
Reply to: "[log in to unmask]" <[log in to unmask]>, Trixie McAree <[log in to unmask]>
Date: Tuesday, 22 October 2019 at 12:16
To: "[log in to unmask]" <[log in to unmask]>
Subject: Re: distance to hospital
CAUTION: This email originated from outside of the organisation. Do not click links or open
attachments unless you recognise the sender and believe the content to be safe.
I would be very interested to hear about work done for rural communities, I am frequently asked about are there quantifiable additional risks for them. This is in regard to CoC in England, Cornwall, Devon, Lincolnshire versus working London
or Birmingham where it takes an hour to travel a mile (not quite) due to traffic.
Are there any definitive facts for me to talk about, or papers to refer to?
Thanks
Trixie
Professor Trixie McAree
Professor of Midwifery and Maternal Health
City South Campus
Birmingham City University
B15 3TN
0121 3316196
Birmingham Womens and Childrens NHS Foundation Trust
Mobil: 07894802961
Https://orchid.org/0000-0001-7845-2195
On 22 Oct 2019, at 09:51, Pauline Dawson <[log in to unmask]> wrote:
