Download PPI-Call-Midwifery-unit-projectJuly15

Opportunity to be involved in our research
Factors influencing the utilisation of free-standing and alongside
midwifery units in England: A Mixed Methods Research Study
Research Lead: Denis Walsh
Summary
Women in England have three choices for where to have their baby: in
traditional labour wards in a maternity hospital, in midwifery units (MUs) or at
home. MUs are run by midwives and are suitable for women having a normal
pregnancy and expecting a normal birth. There are two types of MUs: alongside
midwifery units (AMUs) attached to a maternity hospital and freestanding
midwifery units (FMUs) geographically separate from a maternity hospital. Only
11% of women in England have their baby in a MU. This is despite very good
evidence that having a baby in a MU results in better outcomes than having a
baby on a traditional labour ward and is cheaper.
Not all maternity services have MUs and of those that do, some are not being
fully utilised. We want to explore why usage varies so much and why many
maternity services have never developed MUs. We will address this by examining
two areas of England where 20% or more of women are having their babies in
MUs, two areas where 10% or less of women give birth in MUs, two areas where
there are no MUs and other maternity services that have opened a MU and then
closed it. We estimate that by increasing provision so that 20% of all women
give birth in MUs, the caesarean section rate for these women would reduce and
the normal birth rate increase. Care would also be cheaper and mothers’
satisfaction with childbirth would improve.
Comparative case studies are a good way of exploring large, complex
organisations like maternity services and they will enable us to understand the
differences between services that have led to the variations in MU provision. We
will choose 6 areas to study in depth. In each place we will gather information
from women who have used maternity services, midwives, and NHS managers
and commissioners using interviews and focus groups, and will analyse the
policies of each organisation. We will also look at how the local press and
television have covered maternity provision issues. We will compare the results
of the individual case studies with each other and explore how what we learn can
be transferred to other NHS hospitals and services. These methods will help us
identify why some services are successful in opening and promoting MUs and
others are not.
We will develop guidance for local maternity services to help increase the
provision and uptake of MUs.
What are the benefits of the research?
This research is important because the NHS is seeking to improve health
outcomes and the quality of care without compromising safety within finite
resources.
The most comprehensive study of low risk pregnant women ever undertaken in
England (Birthplace study) showed that birthing in a MU reduced labour and
birth interventions significantly. Operative births and labour interventions put
the mother at greater risk both physically and psychologically. The reduction in
all of these labour interventions and operative birth outcomes should be
achieved if low risk women birth in MUs. Critically, outcomes for babies when
women birth in MUs is no different to OUs. Having a baby in a MU is cheaper and
savings to the NHS maternity budget could be around £85 million. MUs also
improve continuity of care, one-to-one care in labour (Walsh & Devane, 2012)
and increase women’s sense of control and their satisfaction with care (Hodnett
et al, 2013).
Current stage
The project has been funded by the National Institute for Health Research and
will start in October.
Opportunities for involvement
You are invited to join sub-committee of Nottingham Maternity Research
Network to support the project. You would ideally support the project over the
full 26 months (but we understand that your circumstances may change and
some people will not be able to support the whole project).
You will help design posters, information sheets, and interview schedules as well
as reviewing the interpretation of findings, proposed interventions and service
guidance.
There is an opportunity for one or two members of the sub-committee to help to
facilitate focus groups. This will involve travelling to research sites. These have
not yet been identified but could be anywhere in England.
See below for expenses.
Time commitment
The project starts in October 2015 and lasts 26 months. The sub-committee will
meet 6 times over the lifetime of the project, at the University of Nottingham.
You may receive ad-hoc requests for feedback on specific aspects of the project
in between meetings, usually by email or phone.
One or two people will have the opportunity to facilitate focus groups. This will
require a greater time commitment for training, travel to the research sites, and
the focus groups themselves.
Skills or experience needed
You should have experience of using maternity services. No research experience
is needed. Ability to use a computer, particularly to access email, would be
welcome.
What support is available?
Helen Spiby will liaise between the sub-committee and the other project groups
and will be available to answer questions and provide support. You will find it
helpful to also be involved in the main group - Nottingham Maternity Research
Network – as this provided peer support and training opportunities.
Are DBS or occupational health checks required?
You do not need any checks to become a member of the sub-committee. If you
become involved in data collection (e.g. facilitating focus groups) you will need a
Disclosure and Barring Service (DBS) check and occupational health checks in
order to get a “research passport”. The University will help you with these
checks and meet any costs.
Payment and expenses
Members of the sub-committee are asked to volunteer their time but we will
reimburse travel and any additional childcare costs incurred.
Further information
For an informal chat about this opportunity please contact:
Denis Walsh – E: [email protected] T: 0115 8230987
Or
Helen Spiby – E: [email protected] T: 0115 8230820