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NCT Better Birth
Environment CampaignLisa Cunningham
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About the NCT
Huge network of branches covering 100%of UK
Supports parents of babies and toddlers,before and after birth
Maintains a community network of supportgroups, events and resources for newparents
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The NCT package
Local knowledge - parents views andexperiences
Policy awareness national policy in all four countries of the UK
Woman-centred and parent focused perspective User advocacy empowerment of all parents,
access and involvement Evidence-informed knowledge of relevant
research evidence (NICE guidelines etc.)
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NCT services
Antenatal courses in range of formats to meetdifferent needs subsidised places available Breastfeeding counselling and support via local
networks
Postnatal courses and informal groups NCT helplines
Enquiries Line - 0300 33 00 770
Pregnancy & Birth Line - 0300 330 0772Breastfeeding Line - 0300 330 0771
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The NCT Birth PolicyNCT wants all women tobe able to give birth withconfidence and dignityand every opportunity to
have a straightforwardvaginal birthDownload Birth Policy athttp://www.nct.org.uk/about-us/what-we-do/policy/pregnancyandbirth
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What is the NCT position based on?
National Services Framework for Children, Young People and Maternity Services (2004)
Maternity Matters (2007) - Choice, access and
continuity of care in a safe service - nationalchoice guarantee, to be implemented by theend of 2009. Choices include type of antenatal care, place of birth and place of postnatal care
The experience and needs of our members
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Changes in caesarean and normal delivery ratesin England
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What women told us they wanted
9 out of 10women feel thatthe physicalenvironmentcan affect howeasy or difficult
it is to give birth.
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Hodnett ED, Gates S, Hofmeyr GJ, Sakala C.Continuous support for women during childbirth.The Cochrane Library, Issue 3. Oxford: UpdateSoftware, 2003. page 2 of 15 (electronic version)
During labour women may be uniquelyvulnerable to environmental influences; modernobstetric care frequently subjects women to
institutional routines, high rates of intervention,unfamiliar personnel, lack of privacy, and other conditions that may be experienced as harsh.These conditions may have an adverse effect
on the progress of labour and on thedevelopment of feelings of competence andconfidence.
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NCT Better Birth Environmentcampaign (BBE)
An Audit Toolkit
was sent to everyhead of midwifery
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Model -Birth Centres
One-to-one midwifery care Familiar midwives, clear philosophy of
care Access local community service Individualised care choice
Normal birth, breastfeeding support
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Birth centres good practice during labour and birth
Compared with hospital, women more likely to: Feel able to walk around, Have a private toilet and access to a birth pool,
Have a homely looking room with a comfortablechair for companion,
Have control over the temperature, lighting andwho enters the room,
Be able to move furniture to suit their needsSource: NCT Better Birth Environment Survey 2003
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Birth centres- good practice after birth
Women using a birth centre more likely to: stay in the same room after the birth, have companions staying with them, and have a good meal after birth
Source: West Hertfordshire Survey 2006
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Birth Centres - Evidence
NICE Intrapartum Care Guideline(September 2007) reported:
Reduced: use of pharmacological painrelief
Increased: intact perineum,spontaneous vaginal birth, satisfaction
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NCT Evidence-based briefingMaternity care in free standing birth centres part 1Denis Walsh, Senior Lecturer in Midwifery, University of Central Lancashire
Evidence suggests that birth centres are very positiveenvironments for normal birth, in terms of clinicaloutcomes and the satisfaction of women.
Qualitative studies show that the ethos and behaviour of staff and parents in small midwife-led birth centresare very different from those in many hospitalmaternity hospitals.
Birth centres may bring a number of organisationaland environmental benefits that are more difficult toachieve in larger units.
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Model home births
Midwives based in the community, ideallycaring a small personal caseload of women
Benefits to women care in their ownhome, close to their family, midwife aguest rather than authority figure
High rates of normal birth low need for pain relief or medical interventions
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Model home birthsRequirements for success Committed midwifery leadership at all
levels
Understanding of the clinical evidence andbenefits for women Support and development for midwives
with limited experience of home birth Midwives based in the community,
working as autonomous practitioners
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Model hospitals
Perth Royal Infirmary, Scotland
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Summary
Government policy supports choice of placeof birth and parents being fully involved inplanning local services
Evidence shows the environment in birthcentres and at home is valued by parents andsupportive of straightforward labour
In contrast, conditions in some hospitals canupset the progress of labour and moreinterventions are usual
Development of birth centresand access to home birth is a priority
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Further information
www.nct.org.uk
http://www.nct.org.uk/http://www.nct.org.uk/