Donna Ockenden raises alarm over risk to mothers and babies of midwifery units too far from hospitals
Ms Ockenden led the investigation into the maternity errors linked to more than 200 baby deaths at the Shrewsbury and Telford Hospital Trust and is currently preparing a similar report into failings at the Nottingham Hospital Trust involving around 450 families.
She said that her investigations have revealed that freestanding midwifery units on sites some distance away from hospitals put mothers and babies at risk because of delays in transferring them to hospital when complications arose during labour and delivery.
Ms Ockenden said that she uncovered 'many' cases where expectant mothers were wrongly encouraged to give birth in freestanding units when clinical signs clearly indicated they needed consultant-led care.
The idea behind freestanding units typically housed on a separate site to a hospital is to generate a more comfortable and homely feel, but they lack access to obstetric, neonatal or anaesthetic care. NICE guidelines produced in 2014 said midwife-led care was safer than hospital care for women having 'straightforward, low risk, pregnancy'.
Ms Ockenden said she supports the idea of midwifery-led units alongside the labour ward so that women can chose to have their babies outside hospital, but that pregnant women should be given accurate information about the risks involved.
Part of this would be to find out from ambulance services how often they transfer women with complications during labour to hospital, giving an honest overview that a delay in transfer time can put mothers and babies in danger if one of them becomes critically unwell.
A study highlighted in the Ockenden Review compared the outcomes at midwifery-led centres with units with access to consultants. It found in 75 per cent of deaths, 'improvements in care were identified that might have made a difference to the outcome for the baby'.
As investigations into maternity failings continue, what repeatedly becomes clear is that women must first and foremost be listened to about their pregnancies and labour and that clear, honest discussions must take place about what is best for them – including information around vaginal delivery and caesarean sections.
The Royal College of Midwives (RCM) also issued advice last month that the language used by midwives and doctors to describe childbirth should be less judgemental and more personal.
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