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Martina Doolan CMTL Jacqueline Robinson CMTL

Martina Doolan CMTL Jacqueline Robinson CMTL. Home Birth Conference 15/11/13 The challenges that Home Birth can present . Why not Home Birth?. A Maternity Strategy for Northern Ireland (DHSSPS 2012) Changing Childbirth 1993 Delivering Choice 1994 The Code NMC 2008

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Martina Doolan CMTL Jacqueline Robinson CMTL

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  1. Martina Doolan CMTL Jacqueline Robinson CMTL

    Home Birth Conference 15/11/13 The challenges that Home Birth can present
  2. Why not Home Birth? A Maternity Strategy for Northern Ireland (DHSSPS 2012) Changing Childbirth 1993 Delivering Choice 1994 The Code NMC 2008 Midwives Rules and Standards 2012 NMC Circular Homebirth 03/2006 Ante natal care: Routine care of the healthy pregnant woman ( NICE 2010) Intrapartum care NICE Clinical Guideline 55 (NICE 2007) Birth Place Study (NPEU 2011) Promoting Normal Birth Campaign
  3. Why not Homebirth? A Maternity Strategy for Northern Ireland (DHSSPS 2012) NHSCT Strategy for Maternity Services 2009-2014 “To provide for all, equality of a service we expect for our families and ourselves”
  4. NHSCT homebirths since 2009Less than 1% of births
  5. Challenges facing Team leaders in NHSCT Workforce Policy and Guidance Resources
  6. Workforce Providing an “on-call” service while maintaining normal community services On-call provided by community staff Training, maintaining skills and regular updating Work/life balance Working time directives Maintaining Staff morale Change in GP contract
  7. NHSCT Policy and Guidance Homebirth guidance (currently in draft form) Water for labour and Birth NHSCT /11/378 Care of Women in Labour NHSCT/13/667
  8. Resources Budgets not set up to include the additional costs for homebirth On call costs and call out costs Increase in the “on -call period” payments 2011 Equipment costs including provision of equipment, drugs, medical gases and their transportation and the necessary equipment servicing payments Aging equipment
  9. Challenges faced as a Team Leader This means that the home birth service is provided as a reactive service and not a proactive service.
  10. How we have met the challengesWorkforce Revision of on call rotas Yearly update in maternity unit Yearly attendance at PROMPT training with specific Community scenarios Targeted skills and drills for challenging cases Regular team meeting and debrief following homebirth Each midwife contacts their respective SoM for advice and support while on call for Homebirth Working together with hospital staff to accommodate Examination of the Newborn
  11. Meeting the challenges Policies and Guidelines Home birth guidelines (updating 2013) Water for labour and birth NHSCT 11/378 Care of Women in Labour NHSCT/13/667 Robust Risk assessment tool Home visit to clients sitting outside of guidance “wearing 2 hats” (SoM and Team leader) Management plans for those who sit outside guidelines who continue to wish to homebirth On-call rota to all SoMs and maternity units
  12. Meeting the challengesResources Homebirth Drug Boxes Business case for the updating of essential homebirth equipment e.g. Entonox heads etc. Business plan to provide a dedicated medical gas supply available at all times for homebirth only Revision of on call rotas to reduce the payment of oncall periods Accessing services of Consultant Midwife to provide Skills and Drills Maintaining good working relationships with the hospital staff and SoMs
  13. Homebirth Drug Boxes
  14. Homebirth drug boxes
  15. Case Scenarios
  16. The way forward? A dedicated homebirth team Offer a safe alternative to hospital birth fully resourced and funded Example of Northampton model Increase our current homebirth rate Truly providing choice Fully Integrated with “Acute services”
  17. THANK YOU! ANY QUESTIONS???
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