23 / 01 / 2009
For those midwives who wished to promote normality within their units, the launch of the initiative would thereby reduce the caesarean section rate.
NHS West Midlands
Shropshire has a long standing history of promoting and facilitating normal childbirth. This is reflected in the consistently low caesarean section rate (12%). In addition, it has been awarded CNST Level 3 and has succeeded in gaining three 'All parliamentary awards' for the highest number of normal deliveries, increasing home birth and raising the profile of normal child birth. The Shrewsbury and Telford Maternity Services regularly receive enquires as to how this is achieved. In order to answer this, we decided to invite other midwives to our trusts to share and learn from the Shropshire experience. Firstly a study day was launched with the aim to heighten awareness about 'Promoting and facilitating normal childbirth'. The day was positively evaluated and set the scene for the launch of a new innovative Staffordshire University/RCN accredited midwifery module which focuses on normal child birth.
From March to May 2008
- To provide the opportunity for experienced midwives from other trusts in the West Midlands to gain an understanding on how to promote normal child birth within their trusts. This was achieved by offering an accredited level 3 theoretical module underpinned by work-based learning experience at Shropshire five midwife-led units. The purpose was to increase midwives' awareness and understanding of how to promote normal child birth within their trusts.
The Shrewsbury and Telford Trust and Staffordshire University launched a new innovative Module 'Promoting and Facilitating Normal Child birth' for experienced midwives working in the West Midlands who wished to promote normality within their units, thereby reducing the caesarean section rate. It consisted of three theoretical days and also 10 days clinical experience placement days at Shropshire's 5 MLU. This geographical provision of care is unique to Shropshire. The clinical placements were designed to be flexible to suit individual needs. Each person was allocated a midwife mentor during the allocation. The course required: a portfolio of evidence, a 3,000 word critical analysis and a 500 word action plan, all of which were assessed at level 3 (15 credits). The purpose of these clinical days was to give midwives from other trusts the opportunity to gain experience in midwife-led care, normal birth, water births and home births using the low risk care pathway.
The West Midlands Workforce Development agreed to fully sponsor the cost of the module (£750) as a pilot.
It is in the process of being formally evaluated. A pre-audit was undertaken to bench mark current knowledge and experience, clinical placement was evaluated positively and this will be followed by a post audit six months later to ascertain if the course had an impact on midwifery practice. This will be collated in a report to the West Midlands Workforce Development.
The results and next steps
The cohort consisted of nine Midwives but one had to intermit at the beginning of the course. All of the midwives completed the clinical placement and seven successfully passed the theoretical assessment.
It was a requirement that their action plans were formally presented, so they each could appreciate the personal learning value and the implications to their organisation.
The evaluations of the clinical practice and pre-audit were shared with the Shropshire midwives and the West Midlands Workforce Development.
Initial findings were presented at the West Midlands Local Supervising Authority study day.
Accredited work-based learning can be challenging at first as it is a new concept to most of us, but it provides the opportunity to reward core clinical skills/knowledge and this has to be the way forward.
Angela Hughes, Clinical Practice Project Midwife at firstname.lastname@example.org