Safeguarding Normal Birth

Released on 28/09/2010

Safeguarding Normal Birth,

In order to help maternity healthcare professionals improve outcomes for parents, NCT, the UK’s largest parenting charity, has published a report drawing together evidence that highlights how giving birth without major medical procedures can be used as a measure of good midwifery care. 
The report, entitled ‘Normal birth as a measure of the quality of care’, by Miranda Dodwell and Mary Newburn, gives practical actions to guide the planning of service developments which increase opportunities for normal birth – whether at home, in a birth centre or in a hospital setting – without compromising safety or women’s experiences.
These include:    
Providing continuity of midwife-led care.     
Offering birth at home or in a birth centre.        
Providing birth preparation classes.       
Ensuring one-to-one midwifery care for women in labour.       
Encouraging mobility and upright positions during labour.       
Offering access to immersion in water during labour for pain relief. 
NCT’s report sets out the case for using normal birth rates as a measure of quality and draws on a range of research literature, evidence-based NCT publications and women’s stories. Recent statistics for normal birth show that rates have fallen over the last two decades - figures for 2006 show that in England around 47% of women having their baby in hospital had a normal birth compared to 60% in 1990, and in 2008 in Scotland this figure was less than 41%. 
The report also looks at different components of care which have been shown to increase normal birth rates and summarises key points of evidence on how these contribute to high quality midwifery care. It suggests ways in which these aspects of care can be measured in local services and used to drive improvements in the quality of care that women and their families receive. 
Mary Newburn, NCT’s Head of Research and Information and co-author of the report, says: “The concern over increased medical interventions during birth has led to a renewed focus on how it is possible to promote normality in labour and birth. This means finding out what is acceptable to women and midwives, what is actively welcomed by them and what makes a real difference. This report brings together evidence on practices that increase the quality of care for women and their families.” 
Included in the report are women’s own stories, showing the importance of birth in their lives – both the positive nature of normal birth and the potential negative effect that interventions can have when they diminish a woman’s sense of autonomy and control during labour.  
One mother says: “The fact that I was surrounded by people who cared about me and that inside of my head a voice was singing ‘I did it!’, made the first moments of being that child’s mother confident ones.” 
Another is quoted saying: “Being allowed to trust my instincts about where I wanted to be and when I wanted to push was important… I had a midwife with me throughout labour. I needed the comfort and support of a caring and qualified female presence.” 
NCT’s report is in line with policy from the new coalition Government. The recent Department of Health White Paper Equity and Excellence: Liberating the NHS (July 2010) stated: “The primary purpose of the NHS is to improve the outcomes of healthcare for all: to deliver care that is safer, more effective and that provides a better experience for patients. Building on Lord Darzi’s work, the Government will now establish improvement in quality and healthcare outcomes as the primary purpose of all NHS-funded care.” 
NCT’s report was used to inform the recent Midwifery 2020 programme report, a UK-wide vision for the future of midwifery which aims to improve the experience of women during their maternity care and outcomes for mothers, babies and families.  

Over the last 50 years, NCT has been working to improve parents’ experiences. With 105,000 members and over 10,000 volunteers, NCT supports up to a million parents each year through its information and supporter services. The charity also campaigns to improve services and facilities to help build skilled and confident parents for the future.

You can view the full report, ‘Normal birth as a measure of the quality of care’

here.