Local guidelines for admission to UK midwifery units compared with national guidance: a national survey using the UK Midwifery Study System (UKMidSS)
<p><strong>Objectives:</strong> To describe the extent to which local guidelines for admission to UK midwifery units align with national guidance; to describe variation in individual admission criteria; and to describe the extent to which alongside midwifery units (AMUs) are the de...
| Päätekijät: | , , |
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| Aineistotyyppi: | Journal article |
| Kieli: | English |
| Julkaistu: |
Public Library of Science
2020
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| _version_ | 1826281016763875328 |
|---|---|
| author | Glenister, C Burns, E Rowe, R |
| author_facet | Glenister, C Burns, E Rowe, R |
| author_sort | Glenister, C |
| collection | OXFORD |
| description | <p><strong>Objectives:</strong> To describe the extent to which local guidelines for admission to UK midwifery units align with national guidance; to describe variation in individual admission criteria; and to describe the extent to which alongside midwifery units (AMUs) are the default option for eligible women.</p>
<p><strong>Design:</strong> National cross-sectional survey.</p>
<p><strong>Setting:</strong> All 122 UK maternity services with midwifery units, between October 2018 and February 2019.</p>
<p><strong>Outcome measures:</strong> Alignment of local admission guidelines with national guidance (NICE CG190); frequency and nature of variation in individual admission criteria; percentage of services with AMU as default birth setting for eligible women.</p>
<p><strong>Results:</strong> Admission guidelines were received from 87 maternity services (71%), representing 153 units, and we analysed 85 individual guideline documents. Overall, 92% of local admission guidelines varied from national guidance; 76% contained both some admission criteria that were ‘more inclusive’ and some that were ‘more restrictive’ than national guidance. The most common ‘more inclusive’ admission criteria, occurring in 40-80% of guidelines, were: explicit admission of women with parity ≥4; aged 35-40yrs; with a BMI 30-35kg/m2; selective admission of women with a BMI 35-40kg/m2; Group B Streptococcus carriers; and those undergoing induction of labour. The most common ‘more restrictive’ admission criteria, occurring in around 30% of guidelines, excluded women who: declined blood products; had experienced female genital cutting; were aged <16yrs; or had not attended for regular antenatal care. Over half of 3
services (59%) reported the AMU as the default option for healthy women with straightforward pregnancies.</p>
<p><strong>Conclusions:</strong> The variation in local midwifery unit admission criteria found in this study represents a potentially confusing and inequitable basis for women making choices about planned place of birth. A review of national guidance may be indicated and where a lack of relevant evidence underlies variation in admission criteria, further research by planned place of birth is required.</p> |
| first_indexed | 2024-03-07T00:22:27Z |
| format | Journal article |
| id | oxford-uuid:7d0776ee-34c5-4d87-a906-4af9e07b2b3f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:22:27Z |
| publishDate | 2020 |
| publisher | Public Library of Science |
| record_format | dspace |
| spelling | oxford-uuid:7d0776ee-34c5-4d87-a906-4af9e07b2b3f2022-03-26T21:00:42ZLocal guidelines for admission to UK midwifery units compared with national guidance: a national survey using the UK Midwifery Study System (UKMidSS)Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7d0776ee-34c5-4d87-a906-4af9e07b2b3fEnglishSymplectic ElementsPublic Library of Science2020Glenister, CBurns, ERowe, R<p><strong>Objectives:</strong> To describe the extent to which local guidelines for admission to UK midwifery units align with national guidance; to describe variation in individual admission criteria; and to describe the extent to which alongside midwifery units (AMUs) are the default option for eligible women.</p> <p><strong>Design:</strong> National cross-sectional survey.</p> <p><strong>Setting:</strong> All 122 UK maternity services with midwifery units, between October 2018 and February 2019.</p> <p><strong>Outcome measures:</strong> Alignment of local admission guidelines with national guidance (NICE CG190); frequency and nature of variation in individual admission criteria; percentage of services with AMU as default birth setting for eligible women.</p> <p><strong>Results:</strong> Admission guidelines were received from 87 maternity services (71%), representing 153 units, and we analysed 85 individual guideline documents. Overall, 92% of local admission guidelines varied from national guidance; 76% contained both some admission criteria that were ‘more inclusive’ and some that were ‘more restrictive’ than national guidance. The most common ‘more inclusive’ admission criteria, occurring in 40-80% of guidelines, were: explicit admission of women with parity ≥4; aged 35-40yrs; with a BMI 30-35kg/m2; selective admission of women with a BMI 35-40kg/m2; Group B Streptococcus carriers; and those undergoing induction of labour. The most common ‘more restrictive’ admission criteria, occurring in around 30% of guidelines, excluded women who: declined blood products; had experienced female genital cutting; were aged <16yrs; or had not attended for regular antenatal care. Over half of 3 services (59%) reported the AMU as the default option for healthy women with straightforward pregnancies.</p> <p><strong>Conclusions:</strong> The variation in local midwifery unit admission criteria found in this study represents a potentially confusing and inequitable basis for women making choices about planned place of birth. A review of national guidance may be indicated and where a lack of relevant evidence underlies variation in admission criteria, further research by planned place of birth is required.</p> |
| spellingShingle | Glenister, C Burns, E Rowe, R Local guidelines for admission to UK midwifery units compared with national guidance: a national survey using the UK Midwifery Study System (UKMidSS) |
| title | Local guidelines for admission to UK midwifery units compared with national guidance: a national survey using the UK Midwifery Study System (UKMidSS) |
| title_full | Local guidelines for admission to UK midwifery units compared with national guidance: a national survey using the UK Midwifery Study System (UKMidSS) |
| title_fullStr | Local guidelines for admission to UK midwifery units compared with national guidance: a national survey using the UK Midwifery Study System (UKMidSS) |
| title_full_unstemmed | Local guidelines for admission to UK midwifery units compared with national guidance: a national survey using the UK Midwifery Study System (UKMidSS) |
| title_short | Local guidelines for admission to UK midwifery units compared with national guidance: a national survey using the UK Midwifery Study System (UKMidSS) |
| title_sort | local guidelines for admission to uk midwifery units compared with national guidance a national survey using the uk midwifery study system ukmidss |
| work_keys_str_mv | AT glenisterc localguidelinesforadmissiontoukmidwiferyunitscomparedwithnationalguidanceanationalsurveyusingtheukmidwiferystudysystemukmidss AT burnse localguidelinesforadmissiontoukmidwiferyunitscomparedwithnationalguidanceanationalsurveyusingtheukmidwiferystudysystemukmidss AT rower localguidelinesforadmissiontoukmidwiferyunitscomparedwithnationalguidanceanationalsurveyusingtheukmidwiferystudysystemukmidss |