Salford’s ‘new from old’ service

AIMS Journal, 2012, Vol 24 No 4

Alison Richardson introduces Saint Mary’s Birth Centre

Salford in the North West of England has a long history of providing a midwife-led service for women. The maternity unit was opened in 1966 and incorporated a 4-bed ‘GP unit’. This unit was staffed by community midwives who provided care in labour for low-risk, healthy, multiparous women, who were then discharged home after six hours. There were approximately 250 births per year in this co-located unit.

Over the next four decades the service changed in many ways: General Practitioners became less involved in the care of labouring women, its name was changed to the Birth Centre, women having their first baby were ‘allowed’ to birth here too and the number of births increased to 665 by 2010.

Sadly, Salford’s in-patient maternity services ended in November 2011 as part of the Greater Manchester ‘Making it Better’ reconfiguration programme. However, it had been agreed to set up a new stand-alone birth centre on the Salford Royal site, to be managed by the Central Manchester Foundation Trust (CMFT).

The Salford midwives were used to working autonomously in the co-located birth centre and many chose to continue working in the new stand-alone unit. We were further encouraged by the Birthplace study¹ which found that free-standing birth centres were safer for babies and safer for women than hospital births, with fewer interventions and therefore less morbidity.

Following the closure of Salford’s maternity unit, there were two weeks of refurbishment which included the fitting of a new birth pool. The six rooms, three of which are en-suite, were given a more calm, relaxed, homely ambience, with each one named after a plant with calming, soothing properties rather than a number. The colour of the plant is incorporated into the colour scheme of the room with co-ordinating birth ball, recliner, mats and bean bag. All rooms have tea and coffee making facilities and women are encouraged to eat and drink throughout labour. All equipment is kept in a cupboard so it is not on display to the women, which makes the room more like a bedroom than a hospital room. Women are free to choose their room and are encouraged to make it ‘theirs’ for the duration of their stay. They may have who they want to accompany them in labour, one person may stay overnight with them if they wish and there are no restrictions on visiting. Women may go home as soon as possible after giving birth, or remain overnight if they prefer. 100% of women who have birthed here would recommend it, and described the room and facilities as homely, excellent, relaxing and clean. Fast, painful, fantastic, relaxed and calm were words used to explain their experience of birth.

The Saint Mary’s Birth Centre in Salford opened on 5 December 2011 and with over 100 wonderful births so far, we are ‘on target’ for the anticipated 200 births per year. The centre is staffed 24 hours a day by core and community staff who are committed to providing a safe, relaxed, calm environment with a homely atmosphere within which they are able to give excellent, evidence based one-to-one care. This is possible as there is at least one midwife and one support worker on each shift, with another midwife called when a birth is imminent. 98% of women describe the staff as friendly, approachable, reassuring, helpful, professional and calming. The midwives have the experience and confidence to support women in their choices and most have attended Neonatal Life Support and Examination of the Newborn courses. Staff encourage women to use water, remain mobile and adopt whatever position is comfortable for labour and birth. Analgesia is given if women ask for it, although our statistics show that using water and remaining mobile reduce the need for drugs. 75% of women choose to use water in labour, with 52% having pool births. Midwives working in our birth centre feel it enables them to empower women and helps them to feel empowered themselves.

Progress of the new birth centre is closely monitored by Central Manchester Foundation Trust, supervisors of midwives, the North West Network, the ‘Making it Better’ team, the Salford Maternity Services Liaison Committee, midwives and, of course, the women who use our service. The birth centre was initially commissioned for two years, but it is hoped that its success will allow it to continue providing an excellent alternative choice to birthing at home, or in hospital, for women.

1. National Perinatal Epidemiology Unit (NPEU) (2011) Birthplace in England Study. Available at www.npeu.ox.ac.uk/birthplace