1. LSA Midwifery Conference ‘Lessons Learnt’ Freebirth - the Challenges for Supervisors of Midwives Wed 29 th January 2014 Martina Doolan CMTL and SOM Bid McKeown Lead MW Community & Public Health and SOM

2. What is a Freebirth? “Free or unassisted birth…means a woman giving birth without medical or professional help” NMC 9/13

3. What are the Challenges for the SOM? Knowledge base? Experience? Best Practice Guidelines? Safety – Protection of the Public? Meeting Service User Expectations

4. Is it Legal? “Free birthing is legal as long as the birth is not attended or the responsibility for care is not assumed or undertaken by an unqualified individual” NMC 9/13

5. Scenario

6. So what advice could a SOM give??!  Inform manager  Seek Advice/Support  Literature search  Build a Trusting Relationship  Patient Choice

7. Informed ‘Consent’ Home Visit Open discussion with client by CMTL and Named CMW Information Options discussion including tailored home birth but………..

8. Outcome: Disengagement Thanks but No Thanks

9. What now? Management Plan On call rota Local Maternity Unit aware Other Maternity Unit informed NIAS advised - Alert Flag raised if emergency call received

10. Management Plan cont. Supporting Staff CMW Team meeting with CMTL & Consultant MW / PDev Midwife Skills Drills Emergency kit for midwives ‘just in case’

11. Open Door Approach Letter to mother All services still available ‘unqualified individual’ Emergency Advice  999 initially  contact CDS for further advice Request – inform us P/N Birth documentation

12. Lessons Learnt So far…. Freebirth is legal (although ?not yet tested through court process) Very unusual in Northern Ireland Open Door Approach Communication & Documentation Networking for advice and support

13. Not Alone…….. CMW CMTL Lead MW GP HV P Dev MW Cons MW HOM AD CD NI SOMs LSAMO UK LSAMO Network

14. Ah but……………. What about Safeguarding?

15. Thank-You Martina Doolan CMTL and SOM email: martina.doolan@northerntrust.hscni.net Bid McKeown Lead MW Community & Public Health and SOM email: brigid.mckeown@northerntrust.hscni.net