Albany should remain a model for maternity care

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An independent midwifery service specialising in home births that had its contract with the NHS terminated over safety concerns should remain a model for maternity care, according to the country’s most senior midwife.

Professor Cathy Warwick, general secretary of the Royal College of Midwives, described the loss of the Albany practice, a leading group based in South London, as a “great disappointment”. She said she was concerned it was being used to “colour the debate” on giving birth at home.

... In her first interview since King’s College Hospital ended the Albany contract last year, Professor Warwick told The Times that the situation should have been avoided as it was widely acknowledged that the home birth service brought “a huge number of positives”.

Professor Warwick’s comments come after fierce criticism of the decision to axe the Albany by mothers, health professionals and politicians. She said that a confidential report into the practice, commissioned by King’s, had highlighted legitimate issues of governance, but it had neither recommended closure nor supported conclusions being drawn about the safety of giving birth away from hospital.

Professor Warwick, the former director of midwifery and women’s services at King’s, was responsible for drawing up the first contract with the Albany service in 1997. The group was widely celebrated as a pioneering means of providing expectant mothers with more birthing choices and a greater continuity of care during and after pregnancy ...

... King’s remained one of the best providers of maternity care in hospital and community settings ... “I think there is still a core of people who do fundamentally feel that babies are better born in hospital,” ...

... The CMACE review was commissioned after King’s identified 11 cases ... brain damage ... in two and a half years.

The report ... concluded that “risk factors for a poor outcome in pregnancy were being overlooked by Albany midwives”, and that home births were sometimes being encouraged when not medically appropriate. It does not recommend the termination of the service, and also criticises the negative attitudes of some hospital staff “to the whole concept of birth taking place outside a hospital’s perimeters, and towards midwives who promote home birth”.

Dozens of mothers and other campaigners have protested over the termination of the contract ...

Professor Warwick said ... she felt the service had fallen victim to wrangling by both sides which had prevented a satisfactory resolution. She said: “The inference is being made that [this midwifery model] is on the more extreme end of safety. You cannot say this model is more or less safe in terms of morbidity and mortality,” she said. “The issue that is most pertinent is we want to give women choice.”

King’s, which has one of the best records of home birth in the country, said it remains committed to midwifery-led care for women.

Melissa Maimann, Essential Birth Consulting 0400 418 448