Midwife-Led Units in the UK
Following an enquiry about midwife-led units:
I would suggest that your group campaigns for a stand-alone midwifery unit along the lines of the Edgware Birth Centre. The vast majority of those midwifery units which are within, or close to, large obstetric units end up offering a diluted form of obstetric care (obstetrics with a smiley face). They do not work and published studies to date show that they don’t work.
Give me a ring if you would like to discuss this, 01753-652781 (or contact via the AIMS site).
There is a Midwifery-Led unit at Heatherwood Hospital in Ascot. It became midwifery-led in 1995 as a result of the Special Care Unit being closed and 24hr paediatric cover being withdrawn. If there had not been a strong enough public feeling about having the midwifery-led unit there, the hospital would not have continued to have a maternity unit.
Aberdeen has had a midwife-led unit since 1990. It is situated adjacent to the consultant-led labour ward within the main maternity unit. Midwives provide intrapartum care for women considered to be ‘at low obstetric risk’.
I was involved in the evaluation carried out in 1992-1993 and would be happy to answer any questions about that.
Centre for Advanced Studies in Nursing
University of Aberdeen
At West Wales Hospital – we do midwife led care. The numbers vary between teams from 10% of caseload to 63%! The main problem is when we refer for an obstetric opinion and even if everything Ok the docs aren’t keen on ‘allowing’!!! the women to come back to MLC! Some of our Docs got very worried about MLC thought there would be a seperate unit!!! Still need to sort out some probs but if you wanted to talk to anyone any of the team midwives would be pleased to chat!
We have had Midwifery-led Care (MLC) in Gwent for a few years now. The number of MLC women varies between teams..and midwives within the teams! I haven’t come across too many problems with our consultants…and 1 in particular I have found very helpful.
A case in point…the women are meant to be “low risk” (we have a whole load of criteria to follow), and home births would ‘obviously’ be low risk and therefore MLC. However, there was a woman who was G5P4, who wouldn’t be considered MLC due to her parity but wanted a home birth. So to do things ‘by the book’, I sent to her to his booking clinic with a covering note..to which he replied with a letter stating that the woman was aware of the risks of home birth, so he was happy to transfer her to MLC, and also happy to see her again if it was needed.
Another of our criteria is that the woman should have a medical, therefore we send them to their GP. This led to one GP panicking that there was a sudden increase in home births until the concept of MLC was explained again to him!!
BIRTH CENTRE INTEREST GROUP
Information about setting up birth centres, and networking opportunities for people working in them.
Birth Centre Interest Group, C/o 34 Oxford Road, Littlemore, Oxford OX4 4PE.
The Wessex Maternity Centre is a private birth centre. Website:
A Midwife-led Service Evolves By Diane Guiver. From Midwifery Matters, an article about St Mary’s Maternity Unit, in Melton Mowbray.
AH updated 20 July 2000