Mercy Health is concerned about the distress so many women have experienced following last week’s media and social media commentary on the Mercy Family Birth Centre. To help ease some of the concern, we have put together a Q&A based on questions that have been raised. It is important that women are getting accurate information so they don’t have to go through any unnecessary anguish. Q&A What is the Family Birth Centre? The Family Birth Centre has been one of the birthing options for women with low risk pregnancies who wanted a low intervention birth experience in a homely environment. The Family Birth Centre has strict exclusion criteria, which means that many women wishing to be cared for in a low intervention model have been unable to access this model of care. For example, women over a certain age, women with some medical conditions or pregnancy complications and women seeking monitoring or some forms of pain relief have been excluded from the Centre. The public may not be aware of this or the fact that at least one in three women needs to be transferred away from the Family Birth Centre model either during pregnancy or labour. This has meant moving to a different physical space and care being transferred to an unfamiliar team of clinical staff. For women having their first baby, the transfer out rate increases to two in three women. We know from patient feedback that relocation, particularly during labour, can be distressing for some mothers. Are you closing the Centre? The Centre itself is not closing. We are changing the model of care that is offered in the Family Birth Centre to Maternity Group Practice so that more women can access and stay in a low intervention model. We also have a strong belief in continual improvement of the services we provide and use contemporary published research to inform our care models. The Maternity Group Practice will sit alongside our other care models, including Standard Care which is provided by obstetricians and midwives or Shared Care with a GP or Team Maternity Care. The Family Birth Centre model of care has been reviewed along with our other care models over the last two years and we are very excited about moving to this next phase of safe and accessible low intervention care. What is Maternity Group Practice? This model of care will allow a strong rapport to develop between a midwife and the woman and her family. It is where the same midwife will generally provide a woman with pregnancy care and be on call to attend the woman’s labour and birth. The same midwife will also provide follow up care to the mother and baby when they return home. Other clinical staff will form part of the broader team and will be on hand should their expertise be required at any time during pregnancy, labour, birth and in the postnatal period. The midwife with the primary caring responsibility will liaise with the other clinical staff to make sure that appropriate services are provided as needed. All staff working in or alongside Maternity Group Practice will understand and support the low intervention philosophy of the model. Maternity Group Practice is widely recognised as a patient centred care model and the published research shows lower intervention rates than standard care. We expect that Maternity Group Practice at Mercy Hospital for Women will also have low intervention rates. At the moment, a high number of women are transferred out of the Family Birth Centre and require increased care and monitoring due to unexpected complications. We also expect there to be high demand for this model of care as has been the experience of other hospitals that have already successfully implemented Maternity Group Practice. So, in short, we know that Maternity Group Practice is an excellent and proven low intervention model and an enhancement on the Family Birth Centre model. A good research paper on Maternity Group Practice is “Effects of continuity of care by a primary midwife (caseload midwifery) on caesarean section rates in women of low obstetric risk: the COSMOS randomised controlled trial.” ncbi.nlm.nih.gov/pubmed/22830446 What prompted you to make these changes? We have been conducting a review of our maternity services model over the past two years and, as a result, are looking to build on the traditional Family Birth Centre philosophy with modern evidence based improvements. We’re making changes so that more women can have a continuity of carer model of care to see them through their pregnancy without having to be transferred to another area of the hospital with a new care team. What is changing? • The same carer throughout: This new model of care will allow women to have the same carer instead of engaging with several midwives throughout a pregnancy, the same midwife will generally provide a mother with pregnancy care and be on call to attend their labour and birth. The same midwife will also provide follow up care to the mother and baby when they return home. This approach results in better birthing outcomes for women, particularly lower intervention rates than standard care for low risk women, and higher patient satisfaction. • Better access to medical care when required when the pregnancy and labour doesn’t proceed according to plan • Access for more women: Only around five per cent of births at our hospital in the last year have been within the Family Birth Centre. The new Maternity Group Practice will accept a broader range and number of women into this low intervention model. When will this happen? We do not yet have a date for implementation of this exciting new model of care. We will provide the new booking options once we have a commencement date. Do patients need to do anything? No, unless you have concerns that you wish to discuss. We will be in contact with patients when we are ready to start booking to the new model of care. We understand that the Family Birth Centre is valued by many people in the community and want to reassure you that our intention is to advance and expand low intervention options rather than limit or cease them, as has been inaccurately reported in some sections of the media. Note that Women’s Healthcare Australasia has commented on the inaccurate information that is being provided and is in strong support of Mercy Hospital for Women’s introduction of Midwifery Group Practice. women.wcha.asn.au/news/mercy-congratulated-mgp
Posted on: Mon, 01 Jul 2013 01:07:10 +0000
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