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Midwife-supported homebirths will not be re-introduced

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Friday 04 March 2022

The Committee for Health & Social Care has explained that it is not possible for midwife-supported homebirths to be re-introduced following their suspension last year due to COVID-19.

Ensuring appropriate support is in place for homebirths relies on a demanding on-call commitment from community midwives on top of their contracted hours. To facilitate a single birth at home, two of the five community midwives are required to be on-call for 24 hours a day, for up to five weeks at a time. This is very difficult for a small team to accommodate and can impact the core priority of supporting deliveries on Loveridge Ward, which is where the vast majority of expectant parents decide to give birth.

The Committee recognises that some women may wish to give birth at home, and it would like to be in a position to provide a homebirth service locally, however the Committee is duty-bound to ensure the core services on Loveridge Ward are maintained at all times. The Committee must carefully balance the desire of women to choose their preferred place of birth against the rights of all women to receive a safe level of maternity care. There have been approximately 15 planned homebirths in the last five years.

Using national guidelines, the following dedicated midwifery resource is required to meet the safety and care requirements for women and babies admitted to Loveridge Ward:

Clinical shift

Midwifery establishment

Loveridge Ward - day shift

1 Clinical Lead Midwife (Band 7)

4 Midwives (Band 6)

Loveridge Ward - night shift

1 Clinical Lead Midwife (Band 7)

3 Midwives (Band 6)

1 Midwife on-call (Band 6)

 

Midwives working on Loveridge Ward cannot travel to attend a homebirth without reducing the available capacity on the ward, which is why a demanding on-call rota was needed for midwives to be available for homebirths.

Deputy Tina Bury, Vice-President of the Committee for Health & Social Care, said:

'Decisions involving health and care are often difficult and this is a clear example. Everyone involved in the delivery of maternity services, from staff to the Committee, would like to be in a position where we could re-introduce midwife-supported homebirths. But we are responsible for ensuring that the Maternity Service is adequately staffed so that it can provide safe, high-quality, care to all women throughout their pregnancy, labour and the postnatal period. The midwifery team is small and it was simply not sustainable or safe in the long-term to provide the kind of on-call cover needed to support homebirths. We have to focus our limited resources where they are of greatest benefit to the significant majority of women who choose to give birth on Loveridge Ward. Nevertheless, we are very sorry for the impact this will have on expectant parents who had their hearts set on giving birth at home.'

Annabel Nicholas, Associate Director, Midwifery and Paediatrics, said:

'While we wish we were still able to offer this service, as the Maternity Team is passionate about being able to offer choice in birthing environments, expectant parents should be reassured that midwifery-led care is available on Loveridge Ward and that every effort will be made to meet their wishes in the hospital environment. We have tried really hard in recent years to improve the delivery suite area on Loveridge Ward so that it feels more homely, for example delivery rooms have been refurbished and birthing pools are available. We continue to work hard to develop and improve services that are personal and based on the needs and wishes of women and their families in the Bailiwick.'

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