NIHR | May 2018 | NIHR-funded research wins The BMJ’s ‘UK Research Paper of the Year’
An NIHR funded piece of research BUMPES has won the BMJ’s award for ‘UK Research Paper of the Year’. The research intended to explore the aimed to investigate the most ideal position a first-time mother with a low dose epidural should adopt to increase the chance of a birth without interventions such as forceps or a Caesarean. The randomized controlled trial trial found that a lying-down position in the second stage of labour in first-time mothers with an epidural achieved more spontaneous vaginal births than an upright position (source NIHR).
Full details about the project are available from the NIHR website Plain English Summary
The BUMPES study aimed to find out whether or not women having their first babies who have an epidural and give birth in an upright position (kneeling, sitting in a chair or upright in bed), rather than lying down (on their side), are more likely to have a vaginal birth and less likely to need forceps or ventouse.
Between October 2010 and January 2014, 3236 women took part in the study at 41 maternity units in England and Wales. Just over one-third (35.2%) of the women allocated to the ‘upright’ group had a spontaneous vaginal birth, compared with 41.1% in the ‘lying-down’ group. Outcomes for the health of the woman and baby (such as whether or not the baby needed special care or the woman had problems with incontinence) were no different between the two groups, either in the short term (just after the birth) or up to 1 year later.
The study offers clear evidence that women having their first baby and who have epidural pain relief in labour are more likely to have a straightforward vaginal birth if they adopt a lying-down position in the late stages of labour when their baby is ready to be born. There are no apparent disadvantages of lying down for either the woman or her baby in the short or long term.
Full reference: Bick D, Briley A, Brocklehurst P, Hardy P, Juszczak E, Lynch L, et al | A multicentre, randomised controlled trial of position during the late stages of labour in nulliparous women with an epidural: clinical effectiveness and an economic evaluation (BUMPES)|Health Technol Assess | 2017 | Vol. 21| (65)
NHS England|Fifteen steps for Maternity Quality from the perspective of people who use maternity services| May 2018
Fifteen steps for Maternity Quality from the perspective of people who use maternity service, is part of a suite of toolkits for The Fifteen Steps Challenge, which help to explore the experience of people who use maternity services and are a way of involving them in quality assurance processes.
This toolkit has been developed with Maternity Voice Partnerships (MVPs) in mind. MVPs are local teams of users/user reps, midwives, doctors and commissioners,
working together to review, co-design and co-produce local maternity services.
There are usually a number of MVPs per Local Maternity System (LMS). This toolkit is easy to use and aligns with NHS priorities for maternity care as outlined in the Better Births report published in 2016. This toolkit supports collaborative working between
all those involved in using, reviewing, designing and delivering maternity services, so that together improvements can be identified and implemented (Source: NHS England).
Maternity services survey 2017 | The Care Quality Commission
This survey looked at the experiences of women receiving maternity services. The results show that overall women are reporting a more positive experience of maternity care and treatment. The publication highlights improvements in areas such as choice of where to give birth, quality of information and access to help and support after giving birth, when compared to the results from previous years’ surveys.
Compared with the last survey in 2015 a greater proportion of women said that they:
were offered the choice of giving birth in a midwife-led unit or birth centre
saw the same midwife at every antenatal appointment
were ‘always’ treated with dignity and respect during labour and birth
were never left alone during the birth of their baby at a time when it worried them
could ‘always’ get help from a member of staff within a reasonable time while in hospital after the birth