The Way Forward – Voicing the Vision Facilitated by Professor Paul Lewis

o 1. Confident, well trained and supported midwives on a one to one basis, who want to be there. o 2. Birth choice information that needs to take the form of informal, easily accessed, including social drop-in available to all involved. o 3. Support women to make decisions on place of birth as late as possible, by home visits (in labour) positive language and well equipped midwives. What information and support do women need to have the confidence to give birth at home? Group A – Gill Thorn

Can midwives trust their instincts and skills when there is no ‘emergency button’? Group B – Heather Bower o 1. INSTINCT: women need confidence to act instinctively – how do we achieve this? o 2. SKILLS: “less is more” – do mothers and midwives need to understand that “doing nothing” is a skill? o 3. SAFETY: do we need continuity of care and mutual trust between mother and midwife to negotiate safety?

Are current medical guidelines on who is suitable for a home birth appropriate? Group C - Caroline Miller o 1. No – Too generalised o 2. Individual care plan/Research based - respecting women’s choice o 3. Continuity of carer

How does HB fit into the lives of community midwives with other commitments? Group D – Mavis Kirkham o 1. Effective deployment of resources for non-midwifery work. o 2. Effective networking, negotiation and communication and awareness of our role modelling here. o 3.Fostering a nurturing environment for all - Looking after Each other - A Labour of love reciprocated

Normal births in hospital and normal birth at home – are they one and the same? Group E – Ethel Burns o 1. Environment – Physical Care giver o 2. Shift in beliefs – Accepting the reality of risk and taking responsibility Mother and staff o 3. Promoting ripple effect – Midwife/medical student placements Challenging practices

How do we encourage home birth as the norm? Group F – Beverley Beech o 1. Set targets for Home birth - Commissioners o 2. Training – Students, midwives, doctors to complete 5 homebirths o 3. Parents – Tell Everyone HB support Groups

How can we all work together to support home birth? Group G – Gillian Fletcher o 1. Midwives as first contact for women, although we need midwives to promote choice o 2. Antenatal education to embrace choice – i.e. having someone from Homebirth support group o 3. Using MSLC as a vehicle for working together to promote change within your locality.

Are birth centres a distraction for women who are unsure about home birth? Group H – Sue Learner o 1. No because - They give more women the opportunity for midwife-led labour and birth. Less births in obstetric unit. o 2. Midwives can gain/regain traditional skills o 3. Empower women to have confidence in their ability to labour and give birth.

Who supports midwives to provide a safe and sustainable home birth services? Group I – Carole Garrick o 1. Supervision of Midwives o 2. Strong political groups such as IMA, NCT, AIMS, MSLC’s and other user groups, etc o 3.Peer Groups

Pain, mess and safety – how can we address prejudice against home birth? Group K – Sarah Barton o 1. Education/Media/ Parent-craft o 2. Leaflets, Info, Statistics aimed for DADS o 3. Integration of Midwives

Any Questions or Comments