From MIDWIFERY MATTERS, Issue No.108, Spring 2006
The women-led homebirth group was set up in 2003 in order to inform and support women who wished to give birth at home. It is run by service users and has midwife input and support. The homebirth rate increased by 100% in 2004 and a group of midwives started a group in January 2005 to work in liaison with women to take the rising homebirth rate forward. This is a cost effective service that promotes the autonomy of midwifery practice. The NHS Plan states that: "The homebirth rate is a useful indicator of a service's responsiveness to women's choice".
Drivers for change
o Proposed reorganisation of maternity services at a local level.
o National Service Framework for Maternity Services.
o Government directives: 'Promoting Normal Birth'.
o Increasing medicalisation of childbirth.
o Increasing cost to Trust.
o Lack of choice for women/unaware of choices in childbirth.
o Fragmented/poor continuity of care.
o Poor job satisfaction for midwives.
o Negative birth experiences for women and families.
o Public health agenda - to increase breastfeeding rates and reduce incidence
of postnatal morbidity.
Aims
o To keep local women as the main focus for change.
o To inform/educate all service users about the provision and benefits of the
homebirth service.
o Emphasis on community-based care.
o Promote the autonomy of midwifery practice and the philosophy that childbirth
is a normal physiological process.
o The midwife as the lead professional for all 'low risk' women who wish this.
o To develop care options in partnership with service users.
o To increase the homebirth rate.
o To support and value women's choice.
Benefits - to service
o Cost effective - hospital birth costs approximately £850, homebirth
£430.
o Reduction of admissions to hospital/care given in home and community.
o Increased job satisfaction for midwives - midwifery skills developed.
o Reduction in complaints.
Benefits - to users
o Research has shown that in low risk women it is as safe to give birth at home.
o Continuity of care.
o One-to-one care and support in labour.
o Feel valued by carer and are empowered - involved in decision-making. Less
bad birth experience and postnatal depression.
o Are relaxed and more mobile in home environment, therefore labour is shorter.
o Require less analgesia.
o Less likely to have unnecessary intervention.
o Family fully involved and share in experience.
Currently
o Homebirth leaflet, information and support given to women interested in having
a homebirth.
o Women-led homebirth group meets in Wigan once a month.
o Homebirth evening led by midwives and women held every three months at Shevington
Clinic.
In the future
o Auditing the outcome of all women who request a home birth and researching
women's views.
o Informal education of PCT, GPs, medical staff and health workers about homebirths.
o Extending homebirth information evenings to all areas of the trust.
o Women-led homebirth group giving support to service user groups being set
up in Leigh and in other trusts. Sharing good practice.
o Development of 'Choices in Childbirth' leaflet to include homebirth information,
given to every woman who accesses maternity care.
o Formulation of homebirth guidelines.
o Ideally, caseload practice.
o Study day for midwives and women's group.
Updated LW October 3, 2006