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Comparison of instrumental vaginal births by assisted birth practitioner midwives and medical practitioners

02 October 2014
Volume 22 · Issue 10


The role of the assisted birth practitioner (ABP) midwife is extending the traditional scope of midwifery practice to include instrumental vaginal births.

A retrospective cohort study was carried out to examine the 6 months immediately after the introduction of ABP midwives into the middle-grade tier of a medical practitioner rota. Maternal and neonatal outcomes of births by ABP midwives were compared to those by medical practitioner. The results were analysed with a combination of independent (P<0.05), Mann-Whitney U and chi-square tests as appropriate. Qualitative data were also collected.

Of 57 instrumental vaginal births, 14 were performed by ABP midwives (25%) and 43 by medical practitioners (75%). Baseline demographic characteristics between the two groups were similar. There were no significant differences in maternal outcomes or in neonatal outcomes. Qualitative data were also very positive.

These results provide reassurance to both service users and providers. ABP midwives are able to offer a valuable and safe extended role through instrumental births.

Assisted birth practitioner (ABP) midwives are experienced midwives who have undertaken additional training through a recognised course such as the Assisted Birth Programme run by the University of Bradford, and in-house training. They have extended their scope of practice to include fetal blood sampling, instrumental vaginal birth, medical diagnostic assessments and advanced clinical decision making. This is seen as an important extension of women's care that allows valuable continuity, and can also be a rewarding career development for the individual midwife.

Changes in middle-grade medical practitioner training has created a service pressure at this level and the ABP midwife role offers a way of continuing safe service provision. Ongoing staffing pressure makes it likely that more midwives may pursue this training opportunity, and Health Boards and Trusts may seek to encourage this role extension. Service users and employees are likely to look for reassurance that such a service development is safe and effective. This article represents the interim findings of the first 6 months of a study of the first 12 months of such a service in Scotland.

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