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A report on a quality improvement initiative to increase midwives' confidence in attending home birth

02 April 2020
Volume 28 · Issue 4


Since the dissolvement of the ‘supervisor of midwives’ role, NHS England has introduced a new midwifery role: the professional midwifery advocate (PMA) via the advocating for education and quality improvement (A-EQUIP) model. The author undertook the long course PMA study, which is a six-month module. A requirement of the module was to implement a quality improvement project within the student PMA NHS Trust. As part of a wider project under the ‘Better Births Maternity Transformation Programme’ (2016) to increase the home birth rate for the trust, the author chose to implement a quality improvement project to improve the (shared) home birth equipment available to community midwives, aiming to increase midwives’ confidence in attending home birth. Through the use of quality improvement tools and utilising a compassionate leadership model, the project aim was met: 75% of midwives reported they felt increased confidence in attending home birth with the new equipment offering.

Aquality improvement project was initiated with the aim of increasing home birth within a London NHS trust. In 2016, the ‘Better Births’ report (NHS, 2016) was published. As an early adopter for the ‘Better Births Maternity Transformation Programme’ (NHS, 2019), the unit had targets to increase it's continuity of carer and to support more out-of-hospital births. Meeting both targets aims to:

As part of the project, the following were undertaken:

The overall (author's emphasis) aim of the project is to increase the home birth rate for the trust by 100%. The home birth rate for the trust at the start of the project sat at just under 1% (47 home births per annum) and the overall impact of this is still to be determined as it requires a full 12-month audit of the figures. This report considers the implementation of a new home birth kit for the community midwives.

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