MINUTES OF NORMAL BIRTH FOCUS GROUP – 1ST FEBRUARY 2010

HELD AT SHERWOOD HEALTH CENTRE, NOTTINGHAM

In attendance;
Jackie Gandy Jennifer Ross
Kathryn McNamara Gemma Herbert
Lisa Common Dena Smiles
Nikki Kacerovski Dennis Walsh
Jenny Arnold Heather Finch
Kimberly Stafford Andrea Lee
Beth Beckett Claire Gribbin
Angie Springhall

Apologies;
Nicole McKay Jane Hutchby
Paula Burbridge Karen Jackson
Helen Wightman

The group was welcomed and reminded of the purpose of a focus group.
Ground rules were repeated and all present introduced themselves.

The Terms of Reference were reviewed and agreed by the group.

Members highlighted the importance of not replicating other ongoing
work e.g. clinical pathways work. Members felt it was good to have this
opportunity to voice their views as they may not necessarily otherwise
get the opportunity to do so.

Members were asked to look at ideas generated at the 1st Normal Birth
Focus Group and decide which aspect the group would address first. It
was decided to look at ideas around the education of staff in order to
increase their confidence in skills for normal birth.

A long discussion took place with regards to specific ideas for staff
education. The following ideas were generated;

Preceptorship
• New starter preceptorship could contain a section with a normality
focus, not just focusing on midwifery led care but also skills to
normalise in consultant led care.
 • 6-month competency list to include skills such as waterbirth,
physiological 3rd stage and caring for women in alternative
positions.
• Possible rotations between community and hospital to develop skills
The group decided to ask the clinical educators to attend next group to
further discuss some of these ideas.

Study Days for Midwives

• General consensus that it would be of benefit for midwives to have
mandatory study days on skills for normal birth in order to
increase their confidence in this area of practice.
• Further discussion generated the idea that it would be good for
medical staff, possibly including anaesthetists to join in these
study days
A group representative will speak to senior management with regards
to the feasibility of such study days. If can be actioned focus group
to advise on content for these days.

Multi-disciplinary Working
• Ideas generated by the group to commence case reviews with a
normality focus to include multi-disciplinary team (similar to the
way the weekly LSCS meetings run at each hospital).
• Suggested to create a target for numbers of normal births to
help focus the multi-disciplinary team to promote normality.
Group representatives to make a plan to commence normality
focused case reviews and investigate possibility of creating normal
birth targets.

Further discussions also took place surrounding how important it

was to have good leadership on labour ward to promote normality.
Labour ward co-ordinators are seen as key to support midwives and
enhance their confidence in promoting normality. The hope was
that with the new Band 7s coming into post there would be an
opportunity for Band 7s to look after more normal labourers as
they are often co-ordinating and don’t get much opportunity to do
this.

Waterbirth was discussed at length. There was a general feeling

that lots of midwives are not confident in waterbirth but this was
partly thought to be because we are unable to offer waterbirths to
very many women due to there only being one pool on each site.
The group felt it would be good to have a pool on the consultant
side of labour suite at QMC and more pools at CHN. It was
thought this would need to coincide with more training, possibly on
the previously discussed normal birth study day. A group
representative will investigate portable birthing pools and their
feasibility to be used on labour suite.

It was acknowledged that some community midwives don’t get the

opportunity to attend/offer intrapartum care including waterbirth.
Ideas were generated about community midwives and hospital
midwives doing seconded swaps for a certain period of time. This
was felt would promote community hospital workings and increase
confidence/experience but was acknowledged to be very difficult
to achieve due to employment by separate trusts.

The name of the focus group was reviewed and all agreed to keep
the name as Normal Birth Focus Group, as it was acknowledged
that the group would not be focusing only on normal births, but
rather the need to introduce normality principles into every birth
whatever the circumstance/risk.

Dates of next meetings;

Monday 29th March 2010 (12.30-2pm)
Monday 7th June 2010 (12.30-2pm)
Monday 9th August 2010 (1pm-2.30pm)
Monday 4th October 2010 (12.30-2pm)
Monday 6th December 2010 (12.30-2pm)