Free Standing Childbirth Units
June 2006
The Australian College of Midwives supports free standing childbirth
units.
A free standing childbirth unit is a facility that offers care to
women with an uncomplicated pregnancy and where midwives take primary
professional responsibility for care. During labour and birth, medical services
should they be needed, including obstetric, neonatal and anaesthetic care are
available, from a separate site. Access to these may involve transfer by car or
ambulance.
Evidence suggests benefits are associated with this model of
care for women with an uncomplicated pregnancy and labour, including decreased
rates of medical intervention and higher rates of spontaneous vaginal birth,
breastfeeding, and increased maternal satisfaction.
Guidelines:
•
Women and their families should be informed antenatally of the maternity
services that are available and the limitations/implications of these
•
Formally networked systems must be in place to ensure the safe and timely
transfer of women and/or their babies who require medical or other specialist
care.
• Where possible, provision should be made for women transferring
from freestanding units to continue to receive midwifery care from their known
midwife.
• The basis of midwifery practice should be underpinned by the
ANMC midwifery competency guidelines, the ACM National Midwifery Guidelines for
Consultation and Referral and by participation in the ACM Midwifery Practice
Review Program.
• Robust systems are in place to collect and analyse data
on clinical processes and birth outcomes, and to monitor women’s experiences and
satisfaction. Regular multidisciplinary meetings are held to audit and review
referral patterns and outcomes in order to evaluate and improve the
service.
References
Gottvall K, Grunewald C, Waldenstrom U.(2004)
Safety of birth centre care: perinatal mortality over a 10-year period. BJOG Jan
2004,111:71-78.
Hodnett ED, Downe S, Edwards N, Walsh D. Home-like versus
conventional institutional settings for birth. The Cochrane Database of
Systematic Reviews 2005, Issue 1
Rooks JP Weatherby EK Stapleton s Rosen D
& Rosenfield (1996) Outcomes of care in birth centres. The National Birth
Centre Study. J Health Care Finance 1996 Fall; 23(1): 23-47.
Royal College of
Midwives (2004) Position Statement No.7 Birth Centres.
Tracy SK, Hartz D
(2006) The Quality Review of Ryde Midwifery Group Practice September 2004 to
October 2005. Final Report Northern Sydney & Centra Coast Health.
Walsh
D, Downe S (2004) Outcomes of Free-standing, Midwife-Led Birth Centres: a
Structured Review. Birth Sept 2004
(31)3.