Birthplace follow-on analysis to enhance policy and service delivery decision-making for planned place of birth
Jennifer Hollowell (NPEU (Former member))
Peter Brocklehurst (NPEU), Marian Knight (NPEU), Louise Linsell (NPEU), Maggie Redshaw (NPEU (Former member)), Rachel Rowe (NPEU)
Labour and delivery, Organisation and delivery of maternity and neonatal care
National Institute for Health Research
The aim of this follow-on project is to support the development and delivery of safe, equitable and effective maternity services by strengthening the evidence-base relating to planned place of birth. The project will:
Describe and explore the impact of service configuration, unit characteristics and other aspects of the organisation and delivery of services on birth outcomes, with a particular focus on maternal outcomes which impact on future pregnancies, such as caesarean section or complicated vaginal delivery
Further describe intrapartum transfers (e.g. transfer rates, duration of transfer) and explore the possible impact on transfers of factors relating to the organisation and delivery of services, for example staffing, time of day, distance from the nearest obstetric unit.
Explore the clinical characteristics, management and outcomes of 'higher' risk women who opt for a non-OU birth.
Key findings to date
Duration and urgency of transfer in births planned at home and in freestanding midwifery units
Intrapartum transfers from home or freestanding midwifery unit (FMU) commonly take up to 60 minutes from decision to transfer to first assessment in an OU, even for transfers for potentially urgent reasons.
Most transfers are not urgent and emergencies and adverse outcomes are uncommon
Urgent transfer is more likely for nulliparous women