AIMS IrelandMidwife-led Care
MLU Eligibility Criteria for Ireland
1 Exclusion criteria for midwifery-led unit delivery
Exclusion Criteria
Maternal
· Booking visit after 24 weeks
· ≥40years of age and ≤16 years age at delivery
· Grand multiparity (>5)
· BMI <18 or ≥30
· Medical History
o respiratory, renal, infective, immune, neurological, cardiovascular, gastrointestinal, haematological, endocrine, mental health, musculoskeletal.
· Social
o Current history of drug misuse
o Smoking ≥15 cigarettes per day
· Latex allergy
· Previous obstetric history
o History of preterm birth at < 34 completed weeks gestation, Recurrent miscarriage, Moderate to severe pre-eclampsia (see detailed guidelines), Intra Uterine Growth Restriction (see detailed guidelines), Caesarean section, previous unexplained stillbirth, eclampsia, uterine rupture, placental abruption, PUPP, Obstetric cholestasis, 3rd or 4th degree tear, definitive PPH , manual removal of placenta, shoulder dystocia, neonatal death, infant with hypoxic ischaemic encephalopathy, midtrimester miscarriage
· Previous gynaecological history
o Uterine surgery, Myomectomy, Hysterotomy, Cone biopsy (unless subsequent term vaginal delivery), Lletz procedure, Hydatidiform mole, Cervical cerclage, Infertility (see detailed guidelines), Uterine anomaly
Galway Public Lecture on Midwife-Led Care, Sept 27th
“Making Birth Choices a Reality: Toward Midwife-Led Care in Ireland”
Date: Monday, 27 September 2010 at 7 pm
Location: School of Nursing & Midwifery, Áras Moyola, NUI Galway
This event looked at Midwife-Led Care: the research behind it, its value for women and midwives, success stories from the UK and Ireland and the challenge of making this fundamental birth choice available to women throughout Ireland.
Guest speakers included:
Beverley Lawrence Beech, Hon Chair, AIMS UK
Sally Millar, Self-Employed Community Midwife and Lecturer, TCD, “Woman and Midwife” Read Sally’s presentation here:
Declan Devane, School of Nursing & Midwifery, NUIG, “Midwife-Led Care: Evidence for Change. Read Declan’s presentation here:
RCM Review of Midwife-Led Models of Care – Nov 2010
The Royal College of Midwives (UK) has launched the findings of a new review of the effectiveness of midwife-led models of care.
Conclusions of “Socioeconomic Value of the Midwife: A systematic review, meta-analysis, meta-synthesis and economic analysis of midwife-led models of care” include:
1. The majority of women will benefit from midwife-led models of care, including models that have and do not have an antenatal component, without any adverse consequences for them or their infants. The clear benefit and absence of evidence of harm maintains that midwife-led models of care should become the dominant model of care for childbearing women.
2. The findings suggest that current trends in centralisation of birthing facilities could be detrimental to the experience and outcomes of care unless birth centres or their characteristics are introduced alongside this centralised provision.
3. Midwife-led services for eligible maternities may offer a cost-effective alternative to the prevailing maternity care model, but this is based on limited evidence. The midwife-led model of care, including models that have and do not have an antenatal component, merits further attention from policy makers.
Note: Home birth was not included in this review (need for comprehensive review specifically for home birth), but it does include various other models of midwife-led care.
Devane D, Brennan M, Begley C, Clarke M, Walsh D, Sandall J, Ryan P, Revill P, Normand C. (2010) A systematic review, meta-analysis, meta-synthesis and economic analysis of midwife-led models of care. Royal College of Midwives: London.
Published by the Royal College of Midwives Trust, November 2010 © RCM Trust