My! No sooner than I have set up my blog, than the Establishment reacts! (only joking - know they were planning it all along;-))
Brighton and Hove PCT is contemplating setting up a midwife-led maternity unit next to the Royal Sussex County Hospital in Brighton (story link below). What an excellent idea, and one that marks a change in direction for the NHS, which only admitted last year that home birth was 'as safe as hospital birth'.
But, as I see it, one critically important link is missing from the proposal: the midwives. As I read the story, I fear that this proposal is NHS led, not midwife led.
Mothers and fathers-to-be need to form a relationship with a midwife from an early date, preferably during home visits. A new empathic process needs to replace the present system where the mother has to come into a hectic hospital and try to find out about birth from a handful of harassed NHS-led midwives, and is then rushed through a prepared script that has as much to do with hospital priorities and routines as with natural birthing.
The NHS initiative is to be applauded, even if it is prompted by the present need to save money. The consultant led approach is costly because almost one quarter end up in surgery as caesareans. Money saved from consultant led birthing could be spent on midwives.
If more midwives are not provided, the maternity unit might not be as effective as it should be - since the NHS production will take over and we will end up with a higher then necessary level of medical intervention (induction, epidural, caesarean).
If the NHS does not properly embrace natural birth and midwife led birthing, there is a danger that the new maternity unit will become an enlarged waiting room for the consultant led process of medical intervention and surgery.
One quarter of hospital births in the UK end up as caesarian sections, 2% of home births do so - for more see the Guide Page in this blog.
Midwife-led maternity unit for Brighton
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