What Should Community Midwives' Carry?
A project to standardise what equipment is carried to homebirths in the UK and how it is carried.
As part of our work to ensure the best outcome possible from pregnancy and birth, Baby Lifeline provides specialist maternity CPD training, which is developed and delivered by frontline professionals, for frontline professionals. This training is delivered by Baby Lifeline Training, a not-for-profit, social enterprise. Childbirth Emergencies in the Community is one such training programme.
Childbirth Emergencies in the Community
Childbirth Emergencies in the Community is a highly evaluated, one-day course focusing on the practicalities of managing emergency situations which may arise during planned or unplanned out-of-hospital births. This course is delivered in a multi-professional, and multi-organisational environment, facilitating shared learning and standardisation of practice. It is available to all professionals who care for women giving birth outside of hospital, including community midwives and paramedics.
Of all our courses, this one in particular saw a massive increase in demand when appropriate funding was made available – demand for the course increased by 1504% following a one-off government investment in ongoing training for maternity healthcare professionals: the £8.1million Maternity Safety Training Fund. This significant increase in demand for our course starkly demonstrates the need for investment in this area of practice.
“Firstly, our sphere and way of working just being acknowledged. Even though we are community based our training is always hospital orientated and can feel like we are outsiders…the training was completely relevant to my daily work. I feel more empowered to react to situations where things deviate from the norm or are truly an emergency… Because we were practising skills as though we were in someone’s house, not a hospital ward with all the immediate backup.”
Community Midwife – 15/4/2018
From Cornwall to Carlisle (via Jersey)
Since this funding was made available, in April 2017, Baby Lifeline has provided 49 of these courses, training 1000+ midwives in locations across England and the Channel Islands; we plan to go even further in 2019.
No matter the location, frontline community midwives told us the same thing on almost every course. Nationally, there is no standardisation in what equipment is carried to community births.
Baby Lifeline’s faculty of frontline midwives, paramedics and obstetricians came to realise that there was an urgent need to standardise equipment carried by midwives to births in the community, as well as clear processes to keep equipment and supplies fully stocked and up to date.
Evidence from the Frontline: Stakeholder Survey and Social Media Campaign
Baby Lifeline decided to find out more and conducted a stakeholder survey of frontline community midwives to investigate the scope of the issue. 115 responses were gathered in total from August 2018 to February 2019 (not all complete responses). These responses came from midwives who had attended our training, and midwives responding to the survey link online – this was advertised by Baby Lifeline and the RCM.
We also ran a social media campaign to encourage midwives to join the conversation and show us the bags they currently carry nationally called, #HowDoYouCarryYours?
Key Findings from the Survey:
35% of midwives responding had sourced and purchased the bag/container they used to carry equipment to homebirths themselves using personal funds.
30% of midwives felt that the bag/container they used was not safe for use.
When respondents were asked if their bag/container adequately met their needs 40% answered no.
27% did not feel that they currently carried everything that they might need to facilitate a homebirth in the community (including dealing with an emergency).
“Standardisation would be great, with shared practice we can achieve better results”
“Unfortunately, we have had to source our own bags…this has the potential to be unsafe in an emergency. Previous trusts I have worked for provided the bag and it was packed exactly the same way for all community midwives which meant that in an emergency we knew where everything was.”
Comments from Community Midwives
Baby Lifeline’s Response
In response to this issue, Baby Lifeline assembled an expert working group, including frontline midwives, paramedics and obstetricians, to develop a standardised equipment bag, as well as investigate processes to ensure that all equipment and supplies are always kept up to date.
The expert working group developed a rucksack style bag with adjustable straps and optional wheels. The bag has been designed with Human Factors principles in mind; it is compartmentalised, and colour coded to make it easier to identify equipment quickly. The bag includes everything from scissors to cut the cord, to a hat and towels to dry and warm the new born baby, as well as equipment for emergencies that, although rare, can occur.
‘Baby Lifeline believes that every woman who gives birth in the community, no matter where in the country she is, should have access to the same essential equipment through her midwife. Equally, every midwife should have access to the equipment needed to deliver safe and effective care. This is what we are working to achieve through this project.’
Judy Ledger, Baby Lifeline Founder and Chief Executive
The Trial & Launch
Starting in April 2019, 69 of these bags will be trialled by frontline community midwives in nine UK trusts and also in Jersey.
To mark the official launch of the project, Baby Lifeline are hosting a special event in London on the 1st March attended by British TV stars Linda Bassett and Leonie Elliott (Call the Midwife). The event will be hosted by Baby Lifeline’s Ambassador and Ormer Mayfair’s celebrity chef, Shaun Rankin, who will prepare lunch for the stars and the six midwives leading the trial.
If you are a community midwife and want to find out more about the project, please email firstname.lastname@example.org
The project is funded by Fawsley Birth Centre, a charity which promoted high standards of education in all matters affecting the ante natal, peri natal and post natal care of mothers and babies. When the Trustees decided to close the Fawsley Birth Centre, they wanted to choose a suitable project to invest their retained funds in. After a long search they donated the funds to Baby Lifeline for the community midwives’ bags.