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Positive Birth Conference 2016: Informed Choice

Day featured excellent contributions from professionals and service users around positive birth


The Centre for Maternal and Child Health Research held a conference towards the end of July which aimed to share ideas, experiences and energy around positive birth.

Featuring a number of high profile speakers and guests from the area, the day shared some of the latest research from the discipline as well as service users’ experiences in order to explore the concepts of positive birth and informed choice. The event was organised by Judith Flood, a midwifery lecturer in the School of Health Sciences at City.

Positive birth has been described in terms of empowerment, joy and redemption. Recent research has also suggested that midwifery-led care, in a freestanding birth unit, is an optimal environment for women to achieve a positive birth.

Touching on these aspects, Dr Mandie Scamell, a medical anthropologist and midwife at City University London who specialises in risk and the maternity services in the UK, spoke about the ethics of choice when it comes to where women give birth.

Discussing her research in the area, Dr Scamell spoke about a recent paper which looked at the issue of midwives actively pursuing ‘risking out’, which is the practice of denying some women who are at high risk access to the birthing environment where women-centred care, rather than medical intervention, can be prioritised.

Following on from this Dr Scamell also spoke about whether it is ethical for midwives to deny high-risk women access to birth centres which are traditionally for low risk pregnancies. Following this she suggested using a bioethical approach to take apart some of the assumptions – such as risk – and how it determines where women give birth.

“Positive birth can impact on not just the mother and the infant, but it can go much further as it can impact on society too,” said Dr Scamell.

Suzanne Lee, a midwifery lecturer at City, then spoke about her PhD research which is in the area of risk perception in high risk pregnancy. Suzanne’s study looked at 26 women with obstetric and medical pregnancy complications; half were planning to give birth in hospital while the other half were planning homebirths.

Taking a psychological approach to risk, Suzanne analysed how the women reacted to risks and looked at the psychological processes, finding that how the women perceived risk affected decisions made about pregnancy and labour, as well as their attributes towards medical advice.

In particular, women planning home births define risk and safety differently to those planning hospital births, as those planning to give birth at home judge themselves to have a lower risk while those who decided to give birth in hospital were more varied in this assessment of their own risk. However, it was found that both groups prioritise their baby’s wellbeing. The choice of place of birth is also related to risk perception and philosophy of childbirth. Therefore there are implications for professionals working with pregnant women.

Sheena Byrom OBE, a freelance midwifery consultant, then talked about the Midwifery Unit network (MUNet), which is a new EU initiative promoting the benefits of giving birth in midwifery-led units. The network, which includes academics from City University London, aims to build a community of people across Europe with an interest in supporting and promoting midwifery-led units, with the hope that they will become more mainstream and available for everyone.

Finishing up the talks, Lucia Rocca-Ihenacho, a midwifery lecturer at City, spoke about her research which has looked into whether mindfulness is a key feature of freestanding midwifery unit care. The work was carried out at the Berkantine birth centre in Tower Hamlets, which has a very diverse and multi-ethnic population. Lucia took an ethnographic approach suggested that mindfulness is useful to improving inner knowledge, and that it could help midwives pick up signs and knowledge in pregnant women which could improve safety.

The day concluded with panel discussion about whether maternity services enable informed choice. The debate included Cathy Warwick CBE, from the Royal College of Midwives; Sheena Byrom; and Milli Hill, a writer and founder of the Positive Birth Movement.

Having given ten minute presentations on the topic, the panel then answer questions from the audience, with the discussion highlighting that the system doesn’t always offer choice to pregnant women, and that often midwives feel their hands are tied when it comes to trying to offer such choice.

Speaking about the day, Judith Sunderland, Lead Midwife for Education and Programme Director for the Undergraduate Midwifery Programmes at City University London, said:

“The day was a great success, and featured an excellent contributions from professionals and service users. Importantly, women’s voice came through loud and clear, and showed clear partnership between professionals and pregnant women. As a result, the future is clearly bright for positive birth and also when it comes to more informed choice for women.”

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