Researcher: Daisy Wiggins
Having just Qualified as a Midwife I was honoured to be given this amazing opportunity to commence my postgraduate degree researching a topic that is integral to midwifery – informed choice and giving women the right to actively participate in the decision-making process regarding their care.
Choice of birth place has been a topic of promotion by the Government, the National Health Service (NHS) and the National Institute for Clinical Excellence (NICE) for more than two decades. The concept of choice and continuity has been a target of more than a dozen projects, white papers and government reports all highlighting the importance of women having all the options to exercise choice and control of their care when accessing maternity services. These choices included home, stand-alone midwifery-led birth centres, birth centres attached to the obstetric unit and in the obstetric unit itself.
The proposed research is assessing the effectiveness of a web based intermediary (App) created by Portsmouth Hospital Trust giving relevant information to women about choice of birthplace and the different options available. The app draws upon statistics from a national prospective cohort study on maternal and perinatal outcomes by planned place of birth published in 2011, which gives clear information about neonatal and maternal mortality and morbidity associated with place of birth.
The research will involve evaluating the effectiveness and acceptability of the web based intermediary in assisting with, and as an information providing tool to, aid women’s decision making process. With the possibility of conducting a randomised control trial (RCT) comparing two groups of pregnant women, one utilising the app alongside a midwife, compared to a control group that have not had access to the app during standard care.
Intended outcomes of this research are to:
- Assess the acceptability and effectiveness of the app from both midwives and women’s perspectives.
- Looking directly at the decision made at 36 weeks on planned place of birth in both groups.
- Assess whether it directly impacted the decision making process of women by comparing decisions made by the group using the app and the control group of comparable women.
- Secondary outcomes are assessing the intervention rates, caesarean section rates, epidurals and instrumental deliveries and birth place statistics during the research period to see if the app has an effect on increasing out of hospital births, in turn lowering interventions.
Portsmouth Hospitals Trust Project write-up by The Health Foundation:
My Birthplace webpage – Portsmouth Hospital Trust: