Another guest post:
What if… A woman is told “there are no midwives available for homebirth”…
Quick answer: If couples decline hospital transfer and insist on remaining at home there’s a good chance that the hospital trust will be able to organise attendance by other midwives.
Longer answer: The government report ‘Maternity Matters’ (2007) guaranteed that every woman in England would have the choice of giving birth at hospital, at a birth centre or at home. This promise is far from being met as maternity services remain overstretched.
The Nursing and Midwifery Council say “Should a conflict arise between service provision and a woman’s choice for place of birth, a midwife has a duty of care to attend her… Withdrawal of a home birth service is no less significant to women than withdrawal of services for a hospital birth” (NMC 2010).
A health authority is legally obliged to provide emergency care, although it cannot be forced by law to provide a homebirth service. However, if women decline hospital transfer and insist on staying at home in labour then the trust do their utmost to provide a midwife.
If a woman’s local team is already busy or unavailable, midwives can be called in from other local areas. If other community teams are busy or unavailable the on-call supervisor of midwives will be asked to attend. As a last resort paramedics can be called to attend.
Birth partners should advocate for the woman clearly, calmly and assertively on the telephone. Calmly repeating phrases such as “No, she does not wish to transfer to hospital, we’re having a homebirth. Please arrange for a midwife to attend. There’s no way she’s getting out of the pool” sends out the message loud and clear.
Some women voice concerns that insisting on midwives coming out might mean that they get grumpy care providers… I have to say, when I’ve supported local couples in these circumstances as a doula, the midwives who arrive have always been professional and happy to be there.
Obviously, women should only stay at home if they still feel comfortable doing so.
If a woman is involuntarily pushing (especially near the beginning of each contraction) and a midwife might not arrive in time, birth partners are advised to call 999 just as a precaution and prepare for an unassisted birth… And keep calm!
Cornwall homebirth provision…
Maternity service commissioners here in Cornwall have requested that any incidents of threatened or denied homebirth provision should be reported to them.
Kernow Clinical Commissioning Group can be contacted directly, or you can pass your comments to the Maternity Services Liaison Committe via myself (Alice Kirby) of the chair Mandy Wells (07833 054664).
Many thanks to Alice Kirby of Hypnobirthing with Alice Kirby here in Cornwall for letting me post this very useful info. This is often a concern for pregnant mothers and it’s good to know where we stand.