Friends of Belmont Birthing

Belmont is Designed for Safety

In 2015 Australia was rated one of the top ten countries in the world for maternal and child health.[i] The USA, in comparison, was ranked 33rd. [ii] We have one of the safest maternity systems in the world.

The maternity service at Belmont was developed using expert obstetric, neonatology and midwifery input and the highest quality research evidence available. It has been designed to provide a safe, integrated service to enhance your chance of normal birth in a calm and intimate environment while providing a ready response to access obstetric care and tertiary services if needed.

newborn apgar check

Safety in Numbers – evaluations of Free Standing Midwifery Units.

Belmont birth centre is one of two Free Standing Midwifery Units (FMU) in NSW. FMU are more common elsewhere. For example, in 2017 there were 96 FMU in the UK[i] and 54 in New Zealand[ii].

Peer reviewed research has evaluated FMU in NSW, UK, New Zealand and Denmark

Results from the Australian study

Australian research compared the results of births for matched groups of low-risk women. One group birthed at the two FMU in NSW (Belmont and Ryde). The other group birthed at the nearby tertiary-level maternity units (Royal North Shore and John Hunter Hospital). The significant findings for the FMU are described below.[i]

Mothers birthing at the FMU were:

  • significantly more likely to have a spontaneous vaginal birth
  • twice as likely to go into labour naturally
  • more likely to have blood loss less than 500 ml after the baby was born even though more women chose to wait for spontaneous delivery of the placenta without drugs (known as physiological third stage).

Babies were:

  • Significantly less likely to be admitted to Special Care Nursery or Neonatal Intensive Care
  • Significantly more likely to require NO resuscitation at birth
  • Significantly fewer babies were less than 37 weeks gestation
  • Significantly more babies were greater than 42 weeks gestation, were breastfed at birth and exclusively breastfed on hospital discharge

Because of small numbers, the research was not powerful enough to detect any differences in infrequent events such as perinatal mortality. No stillbirths during labour or birth occurred in either the FMU or the obstetric units during the study.

 

Results from the UK study

Research that evaluated outcomes of different places of birth in the UK included a greater number of women and FMUs.[i] The results showed that:

  • Mothers were significantly more likely to have normal births (no induction of labour, no epidural, spinal or general analgesia, no forceps, ventouse, caesarean or episiotomy) in FMUs compared to obstetric units and midwifery units ‘alongside’ or in the obstetric units.

There were no differences for babies in perinatal mortality, and, injuries and mortalities related to labour and birth between obstetric, alongside midwifery units or free-standing midwifery units.

Results from New Zealand and Denmark

Evaluations of free-standing midwifery units in New Zealand[i] and Denmark[ii] showed similar results of increased rates of safe, normal births with good outcomes for babies. But don’t just take our word for it. Richard Porter, Consultant Obstetrician, was Director of Maternity Services of Royal United Hospital NHS Trust. The trust had one of the highest number of FMU’s in the UK. Listen to him talk about the best professionals to care for low risk pregnant women here (3 mins):

 

 

[i] NMPA (2017). Introduction to the National Maternal and Perinatal Audit [PowerPoint slides]. Retrieved 6/5/18 from www.maternityaudit.org.uk/FilesUploaded/NMPA%20slides%209Nov2017.pptx

[ii] Grigg CP, Tracy SK, Tracy M, et al Evaluating Maternity Units: a prospective cohort study of freestanding midwife-led primary maternity units in New Zealand—clinical outcomes BMJ Open 2017;7: e016288. doi: 10.1136/bmjopen-2017-016288

[i] Birthplace in England Collaborative, G. (2012). Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: The Birthplace in England national prospective cohort study. BMJ: British Medical Journal, (7840), 17.

[i] Monk A, Tracy M, Foureur M, et al Evaluating Midwifery Units (EMU): a prospective cohort study of freestanding midwifery units in New South Wales, Australia BMJ Open 2014;4:e006252. doi: 10.1136/bmjopen-2014-006252

[i] Save the Children. State of the World’s Mothers 2015. Retrieved 5/5/18 from https://www.savethechildren.org.au/__data/assets/pdf_file/0010/92584/SOWM-2015-INT-Asia-full-report-low-res.pdf

[ii] ibid

[i] Grigg et al 2017 op. cit. p.1.

[ii] Christensen, L.C. & Overgaard, C. Are freestanding units a safe alternative to obstetric units for low-risk, primiparous childbirth? An analysis of effect differences by parity in a matched cohort study. BMC Pregnancy and Childbirth (2017) 17:14 DOI 10.1186/s12884-016-1208-1.