2020 January – June

It’s been a whirlwind of a year so far, with Covid restrictions and the temporary suspension of the team having a impact on this half years statistics.

83 clients were cared for within our caseload during this period. This includes those clients who were impacted by the temporary suspension of the team due to covid.

Out of these 83 clients, 89% of their babies were breastfeeding or receiving breastmilk at discharge to the health visitors.

52 of these clients changed their planned place of birth prior to the start of active labour – 25 of these were due to the covid suspension. Of these 25 Mums, 14 were still cared for by the team at The Royal Surrey. Additionally we have seen a change from a midwifery led caseload to a mixed caseload with a higher number of clients (24%) joining the caseload having consultant input in their pregnancies.

31 clients from the total caseload were still intending to birth their babies at home at the start of active labour. Of these mothers, 100% had vaginal births, and 84% were cared for by a midwife they knew.

Of these 31 mothers who started labour at home:

5 required transfer in labour, 3 required postnatal transfer (Transfer rate of 26%).

76% had physiological third stages with optimal cord clamping

58% of the births that occurred at home, happened in the pool. A further 10% of clients who laboured at home used the pool for pain relief.

If you would like to learn more about the team and birthing your baby at home, and you live within the team’s catchment https://surreyhillshomebirth.org/about/

Contact us for a one to one chat: rsch.homebirth.referrals@nhs.net

BRAIN: Continuity

Surrey Hills homebirth team provide a continuity model of care to families planning to birth their babies at home.

Our clients are allocated a named midwife who provides the majority of their antenatal care. Towards the end of pregnancy clients are provided with the opportunity to meet the other members of the team, increasing the likelihood that they will know one or both midwives who attend their labour at home.

The team also continues to provide care in the postnatal period until they handover of care to your Health Visiting teams and GP.

In 2019, 82% of our clients knew the midwife who cared for them in labour.

A Cochrane review of 15 trials, involving 17,674 women, compared women who received continuity of midwifery care with shared or medically led care.

The results found continuity of midwifery care was associated with significant benefits for mothers and babies, and had no identified adverse effects. Findings demonstrated Women who received continuity of midwifery care were…

19% less likely to lose their baby before 24 weeks

16% less likely to have a late pregnancy loss (after 24 weeks)

24% less likely to experience a preterm birth (birth prior to 37 weeks)

15% less likely to have regional analgesia (Epidural)

7 x More likely to know their midwife in labour

16% less likely to have an episiotomy

If you would like to learn more about birthing your baby at home contact us at rsch.homebirth.referrals@nhs.net

BRAIN: The Benefits of Homebirth

Research over the last two decades has found that planned home birth is at least as safe as hospital for healthy women with uncomplicated pregnancies, it is also associated with good outcomes for birthing parent and babies

Clients choosing home birth are half as likely to have a caesarean section, half as likely to have an assisted delivery and have a lower risk of haemorrhage and infection, perception of pain is reduced, and babies born at home are less likely to need resuscitation

Overall studies have shown that clients who give birth at home feel more in control of their labour and feel it was a positive, empowering experience. They enter parenthood with increased self esteem and have an overwhelming preference for planning home birth again for future pregnancies.

In their recent systematic review, Reitsma et al (2020), explored the outcomes of 500,000 planned homebirths. They Concluded that “Among low-risk women, those intending to birth at home experienced fewer birth interventions and untoward maternal outcomes.”

Further findings from the Lancet (2020) study demonstrated that people with uncomplicated pregnancies planning ​homebirths, when compared with those with similar health backgrounds intending to give birth in hospital were…

40% less likely to have a caesarean birth

50% less likely to have an instrumental birth

70% less likely to have an epidural

55% less likely to have an episiotomy

40% less likely to have a 3rd or 4th degree tear

60% less likely to have their labour augmented (sped up) using an oxytocin drip

The Surrey Hill’s team stats also reflect these findings and in 2019 98% of their clients had vaginal births.

The main hormones that facilitate labour, Oxytocin (the love hormone) and Endorphins (your natural morphine), are produced when you are relaxed, safe and comfortable so the best place to birth is where you feel safe, supported and empowered.

If you are having midwifery led care (low risk), you are an ideal person to consider a homebirth. If you have additional considerations recommending obstetric input in your pregnancy and would like to
explore the option of homebirth, please contact the team for an individualised discussion.

To discuss your birth place options further, including the Benefits, Risks and Alternatives of Homebirth contact the team at Rsch.homebirth.referrals@nhs.net

For more information on BRAIN see this post from Royal Surrey Maternity https://www.facebook.com/royalsurreymaternity/photos/a.856651127799946/1883734445091604/?type=3

#FridayFeedback

alt text: white speech bubble graphic sitting on a black background. The speak bubble contains a quote from the post’s main text

“Just a little note to say thank you for all of your support in bringing our little girl in to the world.

Lucy made me so excited about birth and gave [redacted] the confidence to support me and be apart of the birth.

Caroline’s advice on baby care will also stick in my head- Pringle fingers and poo pockets. She also gave me the confidence to have a positive hospital birth once we knew that was the route we were taking.

Kirsty and Becca have been great now our little one is here and helped us adjust to parent life.

Thank you so much for everything,

Lots of love,

[redacted]”

Myth-Busting: Am I a Homebirth sort of person?

Homebirth Myth-Busting

Question: Am I a Homebirth Sort of person?

Answer: Maybe

There is no set “homebirth sort of person”,
homebirth can suit people with a variety of backgrounds, beliefs and experiences. Home birth allows many women to remain in their own familiar and comfortable environment.

The main hormones that facilitate labour, Oxytocin (the love hormone) and Endorphins (your natural morphine), are produced when you are relaxed, safe and comfortable. The best place to birth is where you feel safe, supported and empowered.

In their recent systematic review,
Reitsma et al (2020), explored the outcomes of 500,000 planned homebirths. They Concluded that “Among low-risk women, those intending to birth at home experienced fewer birth interventions and untoward maternal outcomes.”

If you are having midwifery led care (low risk), you are an ideal person to consider a homebirth.

If you have additional considerations recommending obstetric input in your pregnancy and would like to explore the option of homebirth, please contact the team for an individualised discussion.​

For more information about birthing at home contact the team for a chat at rsch.homebirth.referrals@nhs.net

Read this birth story of a previous client who didn’t think that she was a homebirth sort of person before she met the team https://surreyhillshomebirth.org/2016/09/20/home-birth-sort-of-person/

Homebirth #continuity #Choice

Introducing…Becca

alt text: head shot of team member Becca wearing a light blue scrub top. Over payed with text box that reads “hello my name is Becca Surrey Hills Team”

Hello my name is Becca and I have joined the Surrey Hills Homebirth Team in June 2020.

I am so excited to join this team of dedicated midwives. I know that continuity of care  and caseloading are the safest and most gratifying experiences I can give to the family’s I care for.

I grew up in a very busy household (7 brothers and 1 sister!!). Having planned to give birth at home with her fourth baby, my mum has always talked about having a friendly familiar face throughout all of her later pregnancies and how this improved her relationship and trust in her self and her midwife who she still remembers fondly all these years later.

I started my training in 2014 in Worcester and since qualifying I have worked in Somerset and in Essex. I am now looking forward to coming home to the beautiful Surrey hills with my husband.

I am looking forward to individualising my care for you to create your perfect pregnancy, blissful birthing environment and fabulous first days at home with your newborn.

If you would like to learn more about the team and birthing your baby in your own home contact us at rsch.homebirth.referrals@nhs.netto arrange a chat.

#HelloMyNameIs #MeetTheTeam #SurreyHillsTeam #SurreyHillsHomebirthTeam #Homebirth #Continuity #Caseloading #Choice #Supportyou

Myth-busting: There’s no pain relief at home

alt text: infographic with the words Homebirth myth-busting in an orange banner. Below in a speech bubble originating from a graphic of a house, on the right of the image, the words “There’s no pain relief at home”. On the opposite side of the image a speech bubble from a graphic of a woman reads “No, find out more below”

Myth: There’s no pain relief available at homebirths

Truth: There’s a variety of pain relief options available for use at home, both natural and pharmacological.

These options are discussed in more detail during your initial chat with the team and during the homebirth advisory appointment.

Many Mums choose to use TENS in during their latent phase or early labour, which they purchase or hire themselves.

Lots of our clients also choose to hire birth pools which can be very effective in supporting labour. In 2019, 133 Mums used pools in their labours. Baths and even showers can also be ways of utilising water in labour.

As a Team, we carry Entonox or “Gas and Air”, which is available for women to use in labour. Many women find this very effective as a next step from using TENS or water.

We can also arrange a prescription of Meptid for women who would like this option. Like Pethidine, Meptid is an Opioid injection but is less strong. It can be very effective in the first stage of labour, particularly during a long latent phase where it can aid rest.

Myth-busting: Is Homebirth just for people who have birthed before?

alt text: infographic with the words Homebirth myth-busting in an orange banner. Below in a speech bubble originating from a graphic of a house, on the right of the image, the words “ Homebirth is only for 2nd time mums”. On the opposite side of the image a speech bubble from a graphic of a woman reads “No, find out more below”

Homebirth Myth-busting

Question: is homebirth just for people who’ve had a baby before?

Answer:
No. Homebirth can be a suitable option
for any pregnant people having midwifery led care* and has lots of advantages (see https://www.facebook.com/855315194600206/posts/1982972391834475/?d=n for some advantages)

In 2019 32% of our clients were people planning their first birth.

*If you have a more complex situation requiring consultant led or shared care but would still like to explore your birth place options, including birth at home, get in touch with the team. We can arrange a 1-2-1 chat with an experienced midwife and if the situation warrants it a discussion with the named Obstetric Consultant for homebirth

Myth-busting- Is Homebirth Messy?

alt text: infographic with the words Homebirth myth-busting in an orange banner. Below in a speech bubble originating from a graphic of a house, on the right of the image, the words “Is homebirth messy?”. On the opposite side of the image a speech bubble from a graphic of a woman reads “No, find out more below”

Question:
Is Homebirth messy?

Answer:
No

We make sure the families under our care feel prepared for their labour and birth. At 36 weeks we will arrange a Homebirth Advisory appointment with you, where we discuss in detail your plans and preferences, and the equipment you might like to use ( read more about equipment and supplies here)

We recommend the use of waterproof coverings such as decorating sheets or shower curtains to protect soft furnishings. Absorbent pads are also advised. Cover with towels or blankets to make this lovely and cosy.

Many of our clients will choose to use a pool for their labour. Use of the pool’s disposable liner and submergible pump makes tidying up very simple.

If you would prefer not to keep your placenta, the homebirth team can take it away and arrange its disposal.

If you have any other questions about home birth or would like further information contact the Surrey Hills Team at rsch.homebirth.referrals@nhs.net

MythBusting #BirthPlaceChoice #Homebirth