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Thanks Christine,

I was just thinking that there might be observational studies where
transfer time is related to outcomes for all that has occured in the last
few years.
I know in the national maternal morbidity work that I was part of here
delayed transfer was a factor in poor outcomes but we are talking numbers
of hours. Also there is some Australian research where Born Before Arrival
(BBA) is a measurement proxy but again very long distances there. These BBA
data are around just getting to ANY maternity facility not transfers.

I have found a lot of the things you might want to study here in NZ eg
transfer time and BBA aren't routinely collected in national datasets.

Fascinating conversation - thank you

Pauline

On Tue, Oct 22, 2019 at 11:59 AM McCourt, Christine <
[log in to unmask]> wrote:

> Pauline - to my knowledge no, and it would be a rather challenging thing
> to research.
>
>
>
> The Birthplace data are the most detailed I can think of without searching
> systematically, but our findings showed particularly good outcomes from
> freestanding midwifery units and the distance/travel time to hospital was
> higher than that for home births.
>
> We were not able to assess the actual time to get to hospital but the time
> to being assessed in hospital, as the data available didn’t allow the
> distinction to be made – how long women waited on arrival before being
> seen.
>
> The median overall transfer time, including time spent arranging transfer,
> waiting for the ambulance to arrive, travel time and any wait before first
> assessment in the OU, was 60 minutes for transfers from FMUs and 49 minutes
> for transfers from home.
>
>
>
> It seems likely that time to be seen on arrival in a well-functioning
> system would be related to urgency of reason for transfer.  In two cases of
> urgent transfer from FMU observed directly in the Birthplace qualitative
> case studies, the OU staff were ready to receive and take on care straight
> away having been briefed by a midwife by telephone. This is no doubt a
> benefit of having an integrated maternity system under the NHS, as compared
> with experiences in some countries.
>
>
>
> The key source with details on transfers from Birthplace is this follow-on
> analysis paper:
>
>
>
> Rachel E Rowe, John Townend, Peter Brocklehurst, Marian Knight, Alison
> Macfarlane, Christine McCourt, Mary Newburn, Maggie Redshaw, Jane Sandall,
> Louise Silverton and Jennifer Hollowell. Duration and urgency of transfer
> in births planned at home and in freestanding midwifery units in national
> prospective cohort study. BMC Pregnancy and Childbirth 2013, 13:224
> http://www.biomedcentral.com/1471-2393/13/224
>
>
>
>
>
>
>
>
>
> On 21/10/2019, 19:54, "A forum for discussion on midwifery and
> reproductive health research. on behalf of Pauline Dawson" <
> [log in to unmask] on behalf of [log in to unmask]>
> wrote:
>
>
>
>     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.
>
>
>
>
>
>     This is great data!
>
>
>
>     Further to my email though I don't think anyone has found an optimal
> time?
>
>     Am I wrong??
>
>
>
>     Pauline
>
>
>
>     -----Original Message-----
>
>     From: A forum for discussion on midwifery and reproductive health
> research.
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