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New European Midwifery Unit Network launched at City

City-led European group of the Midwifery Unit Network aims offer women a choice about where they give birth

by George Wigmore (Senior Communications Officer)

The first meeting of a new EU initiative promoting the benefits of giving birth in midwifery-led units was held today at City University London.

The City-led European group of the Midwifery Unit Network (E-MUNet) aims to consolidate all the learning and knowledge within midwifery units so that it can be shared and accessed by commissioners and midwifery managers quickly and easily across Europe.

This initiative builds on the development of the UK Midwifery Unit Network, backed by the Royal College of Midwives, which was formally launched at the evening event opened by Baroness Julia Cumberlege, who chaired the national Maternity Review.

Recent studies have shown that midwifery-led units provide a better option for healthy women without any pregnancy complications, as the outcomes are similar to consultant-led obstetric units in hospitals while also resulting in fewer interventions and lower morbidity for mothers. This evidence is now reflected in the NICE national guidelines for care at birth.

Yet despite the strong evidence for midwifery-led care and midwifery units, most EU countries still offer the 4.7 million European women giving birth each year a very limited choice regarding place of birth. In many EU countries obstetric units in hospitals are in fact the only available birth setting. As a result, the Midwifery Unit Network is supporting the development of midwifery-led units – also known as birth centres - across the UK and also in mainland Europe.

To launch the European network, midwives and academics from City, Barts Health NHS Trust, and the University of Central Lancashire, hosted a European meeting for maternity stakeholders from Italy, Spain, Portugal, Greece and the Czech Republic. Participants also shared ideas and expertise about how to set up midwifery units in their own countries and how to evaluate their effects.

As part of research into midwifery-led units at City, Professor McCourt was an investigator in the Birthplace Programme – which looked at evidence on safety and quality of care in different settings for women with healthy pregnancies according to where they planned their care at the start of labour. This evidence contributed to the 2014 updated NICE guidelines on intrapartum care, which recommended that women should be offered choices around where they give birth. A subsequent study led by Professor McCourt looked at the organisational and management challenges for developing, managing and sustaining care in midwifery units.

At the EU level, a project led by Professor Downe (University of Central Lancashire) called ‘Childbirth Cultures, Concerns, and Consequences: Creating a dynamic EU framework for optimal maternity care’ is also laying some foundations for the improvement of outcomes and experiences for women having straightforward pregnancies.

Speaking about the launch, Lucia Rocca-Ihenacho, Midwifery Lecturer and NIHR Research Fellow at City and MUNet Co-founder, said:

“Building on previous work at City and other institutions, such as the Birthplace in England study, we hope to not only offer women a choice about where they give birth, but also improve maternal and child health in the EU through the creation of a community which can develop and support the implementation of Midwifery-units in the EU.  MUNet will build bridges between researchers, service users and providers, organisational managers and commissioners, engaging all those who are charged with implementing or improving the performance of a Midwifery Unit.”

Felipe Castro Cardona, MUNet co-founder and Consultant Midwife, said:

“We are at a turning point in the history of childbirth in England. While the majority of healthy pregnant women still birth in consultant-led obstetric units; the Birthplace study, NICE intrapartum guidelines and the National Maternity Review pave the way for more births at Home and in Midwifery Units. Midwifery Units are safe and cost-effective. The maternity team operates within a social model of care, which puts women at the centre and empowers women and midwives alike. Our vision at MUNet is for midwifery units to be the mainstream option for women with uncomplicated pregnancies. It is an absolute privilege to play a part in this journey.”

Sheena Byrom OBE, MUNet co-founder and Consultant Midwife, said :

“We need everyone to know about their local midwifery unit, what it offers and how to book their care there. Midwifery units are still a too well kept secret. We also want to assist maternity services who are looking to develop MLUs by providing resources on our website, and connecting them which established successful midwifery units.”

Mary Newburn, MUNet co-founder, said:

“Limited numbers of midwifery units, means women are being denied choice. They should have the opportunity to plan for the kind of birth care they want, but it also means that healthy women without any pregnancy complications are experiencing more major interventions during labour and birth that could be avoided if more were referred to a midwifery unit.”

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City, University of London is an independent member institution of the University of London. Established by Royal Charter in 1836, the University of London consists of 18 independent member institutions with outstanding global reputations and several prestigious central academic bodies and activities.