The new Dutch selection criteria have now been published and I will file
them on the midwifery-research list web site following translation.
Jane Sandall
Edwin van Teijlingen wrote:
>
> Dear Andrew,
>
> I am not sure which country you are living, but last year there was an
> article called 'Review and assessment of selection criteria used when
> booking pregnant women at different places of birth' (Campbell, British
> Journal of Obstetrics & Gynaecology vol. 106, June 1999). In this survey a
> wide range of selection criteria for place of birth were identified. These
> criteria vary widely between trusts as previously expected. One interesting
> finding is that none of the 128 different individual criteria was mentioned
> by all 22 trusts in Campbell's study.
>
> I wrote a letter in reply to this article highlighting the Dutch selection
> criteria:
>
> "The Dutch criteria are mentioned by one of Campbell's trusts as evidence,
> but these are not further explained. Selection for place of delivery of the
> pregnant woman is an important part of the basic philosophy of obstetrics in
> the Netherlands. Their criteria are interesting, not because they add yet
> another set of criteria, but because of the way they are established. The
> process of establishing the Dutch criteria (the so-called Kloosterman list)
> has been described in detail by Professor Treffers. The selection process
> in the Netherlands addresses two basic issues: (a) Who should provide
> maternity care for the woman in question?; and (b) Where should the delivery
> take place? There are four areas of decision making, relating to the
> following questions:
> 1. What are the nature and the seriousness of possible complication(s)
> involving increased risk?
> 2. What are the possibilities of preventing the occurrence of
> complication(s)?
> 3. What is the likelihood that any complication(s) which may occur will be
> promptly recognised?
> 4. What are the possibilities of adequate intervention in the event of
> complication(s)?
> In the light of these strategic questions, optimum referral policies for the
> whole of the Netherlands were accepted by the Medical Insurance Board, based
> on 124 selection criteria.
> These selection criteria are subdivided into four categories:
> 1. risk factors before the pregnancy, namely medical history (covering
> neurological disorders, medical disorders, gynaecological disorders and
> miscellaneous) and obstetrical history;
> 2. abnormalities originating during the antenatal period;
> 3. abnormalities during labour and delivery; and
> 4. abnormalities in the postnatal period.
> For illustration, if a woman's obstetric history includes one previous
> premature delivery in weeks 35 to 37, the recommended birth attendant is the
> midwife or GP, and a home birth or a short-stay hospital delivery (=DOMINO
> in UK) is recommended. However, if one premature delivery has taken place
> at 34 weeks or earlier the recommended birth attendant is the midwife or GP
> in consultation with obstetrician and the place of birth could be home or
> hospital, depending on consultation. An example of having the obstetrician
> as the recommended birth attendant and a hospital birth would be a previous
> caesarean section. This example highlights the clear selection criteria for
> both birth attendant and place of birth.
> Campbell suggests that "what is required ideally is a systematic review of
> the evidence", but recognises that this would be difficult. We would
> suggest that a first step might be to collect all selection criteria from
> all UK trusts and develop a national draft guideline based on common
> criteria. Some criteria could be based on research evidence and some on
> best practice, as long as all criteria remain under constant discussion and
> are updated as new evidence emerges.
>
> References
> 1. Teijlingen van E., Bryar R., Selection guidelines for place of birth,
> Modern Midwife, 6, 1996: 24-27.
> 2. Eskes M, Alten van D, Review and assessment of maternity services in the
> Netherlands, In: The Future of the Maternity Services. G. Chamberlain, N.
> Patel (eds.) London: RCOG Press, 1994: 37.
> 3. Treffers P.E., Selection as the basis of obstetric care in the
> Netherlands, In: E. Abraham-Van der Mark (ed.), Successful Home Birth and
> Midwifery: the Dutch Model, Westport: Bergin & Garvey, 1993.
>
> What this indicates is that there is a confusion across the Uk as to which
> guidelines for home births should be used. Hope this is of use to you.
>
> PS. My letter was published earlier this year: Teijlingen van E. (2000) '
> Review and assessment of selection criteria used when booking pregnant women
> at different places of birth' (letter) British Journal of Obstetrics &
> Gynaecology, 107: 298
>
> Edwin R. van Teijlingen
> Department of Public Health & Dugald Baird Centre for Research on
> Women's Health
> University of Aberdeen
> Aberdeen AB25 2ZD
> Tel. +(44)-1224-552491
> Fax. +(44)-1224-662994
>
> E-mail address: [log in to unmask]
>
> Web address http://www.abdn.ac.uk/public_health/phstaff/phevt.htmi
>
> -----Original Message-----
> From: [log in to unmask]
> [mailto:[log in to unmask]]On Behalf Of Andrew
> Symon
> Sent: 08 April 2000 12:14
> To: [log in to unmask]
> Subject: Home birth guidelines
>
> I have a colleague who is thinking of devising a protocol / check list for
> women who request a home birth. Does any member of the list know if anyone
> is using something along these lines? An information leaflet or similar
> might be what we're looking for. The crux is ensuring that all women
> requesting a home birth are given the same information, regardless of which
> midwife they see, and that consent is informed.
> Many thanks
> Andrew Symon
--
Dr Jane Sandall
Reader in Midwifery
Dept. Midwifery
City University
London, E1 2EA
Tel: 0171 505 5871
Fax: 0171 505 5866
[log in to unmask]
http://www.city.ac.uk/barts/midwiferyintro.htm
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|
