Midwives from NGH who reduce caesarean births up for award

Midwifes Paula Briody and Anne Richley
Midwifes Paula Briody and Anne Richley
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Midwives from Northampton General Hospital have been shortlisted for the ‘Excellence in Maternity Care’ award.

Paula Briody, Sian Davidson and Anne Richley planned and implemented a Birth After Caesarean (BAC) clinic to help reduce the number of women wanting to have a caesarean section, which are potentially risky.

They are now jointly nominated for the Royal College of Midwives’ (RCM) award, the ceremony for which will be held in London tomorrow.

Anne, who is now the midwifery sister leading the new clinic, said: “There are lots of reasons why women elect, or are advised, to have a caesarean section in order to deliver their baby safely. However in the majority of cases this does not mean that they will automatically need a section with their next pregnancy.

“We now run a regular clinic and workshops, and work in partnership with medical staff to help ensure that women and their partners have consistent evidence-based information to make their birth choices.

Out of the women who choose to have a vaginal birth after caesarean over 80 per cent will be successful, which is higher than the national average.

“Women in the BAC clinic expressed a desire to hold and cuddle their baby against their skin straight after a caesarean birth.

“We are delighted to say that we now encourage the women to have skin-to-skin cuddles with their baby in theatre with their baby placed inside their gown.”

All women who have had a previous caesarean section are referred to the BAC clinic at 16 weeks and then 36 weeks of pregnancy. A specialist midwife reviews with them their records and discusses the advantages and disadvantages of each type of birth.

With no other additional risk factors, they then see an obstetrician at 32-34 weeks.

At 36 weeks all women return to the BAC clinic and an individualised birth plan is developed.

Special workshops have also been developed for women, which include a visit to the birthing pool room which they are encouraged to use for birth.

The midwives in the BAC clinic also worked closely with the infant feeding coordinator and the diabetic team to put in place a plan where diabetic women collect colostrum from 36 weeks.

One early success was a lady with diabetes whose first baby had gone to the neonatal unit for two weeks after the birth for the stabilising of blood sugars.

This time with her plan in place, her baby stayed with her and left hospital within 48 hours of her birth.

This woman was keen to share her success and has become the contact for other women who wish to have a similar plan put in place.

Midwifery matron Paula Briody said: “Overall, your risk of complications is lower if you are able to have a vaginal birth than if you have a caesarean section.

“In general, your recovery time will be quicker, you will have a shorter stay in hospital and often, a more successful start to breastfeeding.

“You will also be able to resume normal activities at home sooner, such as driving and caring for your other children.”

Commenting on the shortlisting, Cathy Warwick, chief executive of the RCM, said: “This year we have had a record number of entries for our awards and the standard has been phenomenally high, so I applaud Paula and her team on reaching this stage, and

wish them luck at the awards ceremony.

“It is vital that midwives and maternity services keep thinking about the services they offer mothers, babies and families and continue to push boundaries and innovate, as this team has done, so that they can give the most up to date care.”