Born before arrival: Supervision in action

Abstract

Clinical incident reporting at Birmingham Women's Foundation NHS Trust alerted supervisors of midwives (SOMs) to an increase in the numbers of reported babies born before arrival (BBA) of a midwife. A subsequent clinical audit surrounding BBA was undertaken that highlighted the importance of midwifery care and expertise in ensuring timely and optimal care for women and babies. Documentation about the sequence of events around the time of birth for women who had experienced a BBA was also considered to be in need of improvement. This article describes the background to the audit, methodology, and the main findings. It also provides evidence of SOMs maintaining the profile of supervision ( Nursing and Midwifery Council (NMC) 2009 ; NMC, 2012a ) The audit has been instrumental in enabling service improvement. The timeliness of the audit has since resulted in funding being secured locally for midwives to attend all imminent births and BBAs as part of the new dedicated homebirth service. The aim is that locally, women who give birth at home unexpectedly will receive a skilled midwifery assessment at home. A clinical decision will be made regarding an ongoing plan of care, whether that is to either remain at home or to be transferred to hospital. The new service aims to provide prompt midwifery care at the point of need at home. For many, it is envisaged that this development will avoid disruption for the woman and her family as well as unnecessary hospital admission.