Roisin Lennon RAMP Midwifery Care SUH RAMP SUH Responding to the Challenges of Change Maternity Services Sligo University Hospital 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH “The greatest privilege of a human life is to become a midwife to the awakening of the Soul in another person.” Plato 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH Highly skilled and recognised expert who provides a complete episode of care for healthy pregnant women and their new-born babies 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH Policy Change UK 1940s birth shifted from home to hospital 1940-1960 2/3rd births in hospital 1970 <5% home birth >1970 ↑ technology >Intervention no ↓ problems 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH 1990s on Research/Evidence Based Practice Woman’s Choice National Maternity Strategy 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH Changing Practice Normalise birth Reduce Unnecessary Intervention Continuity of care Partnership woman, family and midwife Informed decision making One to one Midwifery Care Educate woman and family 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH Irish Midwives 4000 Practising Midwives 10 RAMP 64000 births/year 19 maternity units 2 Midwife Led Units 3 DOMINO/Home birth 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH Births SUH 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Service Needs Analysis 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

“Every women needs a midwife and some need a doctor too.” Sandall 2011 “Every women needs a midwife and some need a doctor too.” 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH Vision for AMP Midwifery model of care for supported care Normalising pregnancy and birth assisted care-e.g. raised BMI/VBAC, stable medical conditions 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH Change 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH Criteria Supported Care Assisted/Advanced Practice Care Stakeholder agreement 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH RAMP Pathway 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

RAMP SUH Ongoing recruitment at each ANC Option 1: Midwife couch at consultant clinic SUH (supported and assisted care) Option 2: Midwife antenatal clinic Mon pm (supported care) Option 3: Outreach antenatal clinic Tues pm (supported and assisted care) 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH SUH ANC Care 2017 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH RAMP Care 2017 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH Caseload 2017 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH Caseload 2017 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH Support Services 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH RAMP Birth 2017 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH Comparing SUH 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH EM CS RAMP 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH To be done Midwife discharge Midwife suturing Community service Extend clinics Midwife Care Birthing Room Early transfer home 2nd RAMP 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Thanks for Listening Any Questions? 28/12/2018 Roisin Lennon RAMP Midwifery Care SUH

Roisin Lennon RAMP Midwifery Care SUH Sheila Stubbs “The midwife considers the miracle of childbirth as normal, and leaves it alone unless there's trouble. The obstetrician normally sees childbirth as trouble; if he leaves it alone, it's a miracle.”  28/12/2018 Roisin Lennon RAMP Midwifery Care SUH