About the project
Overview
Women in England have different choices for where to have their baby:
- in traditional labour wards in a maternity hospital
- in midwifery units (MUs)
- at home
MUs are run by midwives and are suitable for women having a straight-forward pregnancy and expecting an uncomplicated birth. There are two types of MUs:
- alongside midwifery units (AMUs) attached to a maternity hospital
- freestanding midwifery units (FMUs) geographically separate from a maternity hospital
Aim
The Midwifery Unit Project will explore why usage varies so much and why many maternity services have never developed MUs.
Methodology
Stage one
A survey mapping exercise of all English local maternity services, specifically examining the availability and usage of midwifery units as well as investigating why some services have opened and then closed midwifery units over the past 10 years. This stage repeats the Birthplace Mapping exercise undertaken in 2010.
Stage two
6 in-depth case studies of:
- two areas in England where 20% or more of women are having their babies in MUs
- two areas in England where 10% or fewer of women in England give birth in MUs
- two areas where there are no MUs
Comparative case studies are a good way of exploring large, complex organisations like maternity services and they will enable us to understand the differences between services that have led to the variations in MU provision.
We will run focus groups within each site with women who have given birth within the previous 12 months, as well as with community and hospital midwives. We are also doing interviews with NHS managers, other maternity care professionals and commissioners.
Stage three
A Stakeholder Workshop where the findings of stages one and two will be shared and service guidance developed for commissioners and providers.
Potential Impact
We estimate that by increasing provision so that 20% of all women give birth in MUs, the caesarean section rate for these women would reduce and the normal birth rate increase, resulting in fewer babies needing neonatal care. Care would also be cheaper and mothers’ satisfaction with childbirth would improve.
The research has the potential to significantly improve the experience of maternity care for thousands of women and make considerable cost savings (3% of maternity care budget) for the NHS.