I find this interesting around transfer times and our medical colleague's perceptions. Over the years I have also been concerned around women 'transferring' from home when in 'active' rather than 'early' labour. This has led to the subsequent births by the roadside or in car parks that the press are so fond of but which are not places of safety. The logic to me has always been to me if in 'active' labour stay put and call a midwife to the home and then 'transfer' if required. Rather than 'call a midwife' it has become 'call the hospital' who invariably seem to say 'come in'.
something else for the mix...
best wishes
Jenny

Dr Jenny Hall
Senior Midwifery Lecturer
Faculty of Health and Social Sciences
Bournemouth University

Find me on twitter at hallmum5
________________________________________
From: A forum for discussion on midwifery and reproductive health research. [[log in to unmask]] On Behalf Of Louise Silverton [[log in to unmask]]
Sent: 09 December 2014 11:50
To: [log in to unmask]
Subject: Re: NICE intrapartum guidance

Ah, how long is a piece of string?

The key issue is having transport mechanisms in place and ensuring that there are no delays in being seen on arrival at the obstetric unit. birthplace found that women transferring from home had quicker decision to transfer to being seen in the OU times than those from FMUs. Ambulance control seems to regard an FMU as a place of safety, they do not always prioritise these calls so it is vital that if there is an FMU in an area, they must prioritise calls for transfer.

It is also worth looking at reasons for transfer. Few of these could be regarded as urgent as they related to slow progress for example. As you will have seen from some letters in the press, our medical colleagues feel more supportive of alongside midwifery units than freestanding ones or home birth due to the issue of transfer. What is not said is that for a woman labouring at home her transfer to an OU for slow progress is no different from a similar woman travelling there with her partner in early labour. It is still a transfer.  Should women spend the the last trimester in an OU to avoid the need to transfer? This is the corollary of some medical views as is assuming that care in hospital is safe but there is a question mark of other places for birth.

Anecdotal experience tells me that delays in transfer relate to the following:
1 timely decisions to transfer
2 having transfer mechanisms set up in advance with ambulance service
3 speedy assessment on arrival in OU

Our colleagues in alongside units also experience delays with transfer due to lack of space in the OU (esp if transfer not urgent) or delays in being seen by an obstetrician after transfer.

Hope this helps

Louise

Sent from my iPad

> On 9 Dec 2014, at 05:27, "Pauley Tara (HINCHINGBROOKE HEALTH CARE NHS TRUST)" <[log in to unmask]> wrote:
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> A question has been raised on the Facebook group "Research Midwives" page.
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> Can anyone aid in responding to Karen's question about "timely access"?
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