Community maternity unit sets the standard

ISSN 0256-5004 (Print)

By Avril Nicoll

AIMS Journal 2003, Vol 15, No 4

Avril Nicoll discusses the Scottish Executive's controversial strategy to increase the number of community maternity units, which has received a boost with news of a remarkable turnaround at an existing unit

The midwife-led North Angus Community Maternity Unit in Montrose is celebrating the arrival of its 100th baby this year, a complete reversal of a downward trend experienced over many years. All local women receive their antenatal and postnatal care from the unit midwives, but a growing majority of women had been choosing a consultant unit for the birth of their baby. In 2002, only 47 women used Montrose.

Kirstin Hoggins, lay chair of the Angus Maternity Services Liaison Committee, comments, "When the unit was earmarked for closure during the Tayside Acute Services review, the Keep MUM (Maternity Unit in Montrose) campaign successfully argued that it should be reprieved, and that we should all work together to increase the number of births to 50 per cent of the local birthing population.

It is a credit to the commitment, skill and determination of the midwives that, although the total number of women in the area who are having children has stayed about the same, many more of them-in fact, 48 per cent so far this year-are now experiencing the quality of care available at Montrose."

Team leader and Supervisor of Midwives Bertha Leatherbarrow says, "For women who are at low risk of complications, research backs up our experience that there are many advantages to giving birth in a community maternity unit. Our midwives are taking every opportunity to let women and their families know about this, and the numbers speak for themselves." She adds, "The way our birthing room is set up, and our focus on encouraging women to follow their instincts during labour, positively encourages a straightforward, active birth to give mums and babies the best possible start together."

Community maternity units such as Montrose are suitable for women who are expected to have an uncomplicated birth. Research has shown that, for these women, planning to give birth in this type of facility reduces the likelihood that they will need medical interventions such as induction of labour, epidural anaesthesia, forceps and caesarean sections. In recent years, there has been increasing medicalisation of childbirth and centralisation in large consultant units, but community maternity units are part of the Scottish Executive's strategy[1] to reverse the trend and meet its commitment to local provision of services wherever possible.

Midwives and managers from other NHS boards have been visiting Montrose to find out the reasons for its success. Consultation is underway in Argyll and Clyde for a network of Community Maternity Units with one consultant unit, the preferred option of the NHS board.

Meanwhile, in NHS Tayside, which includes the Montrose unit and the South Angus Community Maternity Unit in Arbroath, Perth and Kinross public and midwives are considering whether to develop a midwife-led unit in Perth, or to put all local births to Dundee.

The North Angus Community Maternity Unit is 30 miles, or one hour, from the nearest consultant unit at Ninewells Hospital in Dundee. The team of 9.8 whole- time equivalent midwives are hospital- based, but are also responsible for community duties. They cover a rural area of approximately 317 square-miles with a population of nearly 26,000. This includes three main centres -Montrose, Brechin and Edzell-and they also see a number of women from the South Mearns area of Grampian.

The intrapartum transfer rate from Montrose (the percentage of women transferred to a consultant unit during labour because of complications) is under 11 per cent. The unit welcomes first-time mothers.

The North Angus Community Maternity Unit is currently situated in Montrose Royal Infirmary. A new purpose-built unit is planned for the end of 2004.

Births at the unit by year

Year 2003 2002 2001 2000 1999 1998 1997 1996 1991
Births 100+ 47 67 85 86 84 104 108 108

Note: Avril Nicoll is a user representative on the Angus Maternity Services Liaison Committee.

Reference

  1. Expert Group on Acute Maternity Services (EGAMS), 2002

Latest Content

Journal

« »

AIMS during the 1970s

AIMS Journal, 2020, Vol 32, No 3 By Shane Ridley AIMS Trustee I decided to read through the 1970s , starting with the Quarterly Newsletter for September 1970 which was ty…

Read more

AIMS during the 1960s

AIMS Journal, 2020, Vol 32, No 3 by Dorothy Brassington AIMS Trustee and Treasurer It has been fascinating to read the early newsletters and discover exactly what AIMS wa…

Read more

AIMS during the 1980s

AIMS Journal, 2020, Vol 32, No 3 by Verina Henchy AIMS Trustee I was delighted to hear that the theme for this Journal is to look back over a 60 year history of maternity…

Read more

Events

« »

AIMS 60th Anniversary Event - Confe…

POSTPONED FROM JUNE 2020 Making a difference past and future The purpose of the day is to celebrate what Birth Activists in general and AIMS in particular have achieved,…

Read more

ARM National Conference 2020: "How…

Chair: Professor Soo Downe, University of Central Lancashire Dr Gloria Esegbona, OBGYN and Winston Churchill Fellow 2015 Kings College Learning Institute Dr Gloria Esegbo…

Read more

NICE Annual Conference 2020

Registration for the NICE Annual Conference 2020 will open on 22 January 2020. For more details and to register your interest, please visit http://www.niceconference.org.…

Read more

Latest Campaigns

« »

AIMS Response to NICE consultation…

NICE is developing a quality standard relating to FASD (Fetal Alcohol Spectrum Disorder). AIMS welcomes the development of this quality standard as we agree that it is im…

Read more

AIMS submission to the Health and S…

AIMS' evidence to the Health and Social Care Select Committee - Safety of Maternitys Services in England In July 2020, the UK Parliament's Health and Social Care Select C…

Read more

AIMS comments on RCOG - Restoration…

A prioritisation framework for care in response to COVID-19 Version 2.1: Published Friday 26 June 2020 AIMS has welcomed the RCOG document Restoration and Recovery: prior…

Read more