Within our last Quality Account I made the following challenge:
“That real choice is given to women, that they are informed of all the options available to them and that choices made are based on an individual’s decision to suit their personal needs. After all in this modern society we expect the right to choose in every other aspect of our lives, it’s time to extend this to pregnancy and birth. The NHS should and must respect this principle.
“ One to One Midwives are providing real choice for women today. This Quality Account explores and demonstrates how choice does and can work if women are given the right to self determination and offered a real choice that ensures that they are able to work in partnership with their midwives – the outcomes demonstrated in this Quality Account are evidence of this.
It is our experience that women will choose a provider that meets her choices for her pregnancy and birth, women will choose care that supports their beliefs and values, women will choose to birth in an environment that ensures them a positive birth memory but more importantly women will make choices to ensure that they and their baby remain healthy and safe.
Choice is a driving principle throughout the NHS but it remains a major concern that patients across the NHS are being denied this right but it is even more so within maternity services – in 2014 pregnant women remain excluded from the NHS Constitution and choice is still not a legal right for women. The lack of choice is a theme that runs throughout maternity services; choice of provider; choice of antenatal care, choice of postnatal care; choice of how you want care provided and even choice of place of birth. In reality for the vast majority of pregnant women within the UK, true choice is still out of reach.
Commissioners need to continue to develop ways in which they can support women in making the right choices for their pregnancy, their baby and their families. Until Commissioners are able to achieve this women will have to be content with the limited model of care that the local provider is willing to provide. This is often in a busy community or hospital clinic with very few home visits being offered. Women do not have a choice of place of birth – midwifery led units are under increasing pressure from poor staffing levels. Staffing levels also impact on home birth services (a choice that is often only available to women who are defined as low risk by the provider), which are often the first to be withdrawn when staffing levels are at risk
One to One Midwives are now the largest caseloading midwifery service in the UK and are one of the leading providers in this model of care internationally. We employ 45 midwives and to date we have cared for nearly 4000 women. Our outcomes demonstrate that caseloading midwifery can work to scale and can achieve excellent outcomes for a large number of women – if we extrapolate these outcomes for the 700,000 births that take place a year in the UK, then maternity services and women’s’ lives would be transformed.
Commissioners, regulators, professional bodies and providers of midwifery services across the UK need to address the practical, ethical and moral dilemma of how to provide midwifery services that offer women a real choice. One to One Midwives continue to demonstrate at a local, national and international level that delivering a model of care, which has the women at its centre, is not just cost effective, but is safe and sustainable.
I hope this document inspires and encourages you to further support the choices agenda for women, so that the current and future generations of women including our daughters and granddaughters can benefit from and experience the very best of midwifery care.
One to One Midwives philosophy of care continues to be centred on:
“Your pregnancy, your midwife, your choice”.