References
Train together to work together: Reviewing feedback of community-based skills drills training for midwives and paramedics
Abstract
Homebirth is recommended in the UK for women considered low-risk, but homebirth rates remain low. With the aim of enabling women to safely achieve the birth they want, and enabling midwives to support them in this, a community-based skills drills training session was organised by midwives at Hinchingbrooke Health Care NHS Trust, and attended by midwives, student midwives, maternity care assistants and paramedics. A questionnaire was given to participants to evaluate the training. A 100% response rate was achieved (n = 36). Results show a positive response from all parties in relation to the setting, which was deemed a more realistic environment for this workforce than that offered by hospital-based training. More funding and research to support this type of training may aid in raising homebirth rates, as well as developing midwives' and paramedics' confidence in dealing with emergencies in such settings.
Skills drills are the accepted format by which health professionals, including midwives, learn and maintain the skills to manage a range of obstetric emergencies (Rogers, 2007). It has been suggested that skills drills training should be inter-professional (Rogers, 2007), and perhaps this ought to be extended outside of the labour ward multidisciplinary setting. This was a point highlighted in the recent National Maternity Review (2016: 10), which stated that ‘those who work together should train together’. Research exploring the benefits of collaborative training would, therefore, be useful. However, such research must be conducted sensitively, assuring practitioners that the information they disclose will be kept confidential, to ensure true representation of opinions and enable further evaluation to provide the most appropriate training initiatives.
The Birthplace Study reviewed more than 64 000 births in the UK, concluding that for multiparous women, there were no significant differences in adverse perinatal outcomes between planned homebirths or midwifery units and planned births in obstetric units (Birthplace in England Collaborative Group, 2011) In fact, these women would have significantly reduced odds of an intrapartum caesarean section, instrumental birth or episiotomy. There is an acknowledged significant increased risk of adverse perinatal outcomes (intrapartum stillbirth, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, and specified birth-related injuries including brachial plexus injury) for babies of nulliparous mothers in the case of planned homebirth. However, as noted by obstetrician professor, Jim Thornton (2015):
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