Thursday, November 30, 2006

Future of Local Maternity Services

The Epsom and St Helier Trust has compared the two current sites and has come to the conclusion that if it moves services to St Helier it only loses 626 births (mainly to Kingston I suspect) out of the current combined total of 4,400 (2,600 St Helier, 1,800 Epsom) whilst if it moves services to Epsom it will lose 2,452 deliveries. The options it proposes are as follows:

Option 1 - Status Quo, but with development of early pregnancy assessment unit at Epsom

Option 2 - Maintain labour ward at Epsom without anaesthetic cover

Option 3 - Consolidate obstetric and neonatal services at St Helier with development of Midwifery Led Delivery Unit on both sites. Ultrasound scanning, antenatal and community midwifery services on both sites. Early Pregnancy Assessment Unit and Maternal Day Assessment Unit on both sites

Option 4 - As for option 3 but with elective caesarean sections also carried out at Epsom

Option 5 - Move all obstetric and neonatal in-patient services to St Helier. Ultrasound, antenatal, community midwifery, and Maternal Day Assessment Unit at Epsom

It is going to start consultation on Options 3 and 5, so Councillor Jayne McCoy had better start campaigning hard for 3 if she wants it. I suspect Option 5 will be adopted on cost grounds, unless there is a strong campaign. The problem for Jayne and the NCT is that people in Epsom may campaign for Option 1, so the Trust will divide and rule again and option 5 will be adopted.


Anonymous Jayne McCoy said...

I just want to clarify my position on this issue as you have slightly misrepresented my views (& those of the NCT) here. In an ideal world we would prefer to have the full range of options for maternity care available at both locations. Our campaign originally started to protest against the proposed centralisation of maternity services at one critical care hospital under the BHCH programme.

The NCT has been closely involved with maternity staff in developing the options for Epsom maternity services and we have to accept that in reality option 1 isn’t going to happen. There was a Safety & Sustainability Review that pointed out that the current situation at Epsom was ‘unsafe’. Obviously we cannot campaign for the continuation of a service that puts mothers and babies at risk. It is thanks in part to NCT involvement that proposals to retain any maternity services at Epsom are being put forward for consideration. What we have been trying to ‘sell’ is that a midwife-led unit is a viable option for low-risk women. If women are put off using a low-risk unit by the political scaremongering & general misinformation that the NCT is constantly battling, then a perceived lack of demand for the service will see it dismissed and Epsom will be left without any kind of maternity unit.

A midwife-led maternity unit will also give local women more choice than they have under the current system. Both Epsom & St Helier only have traditional, consultant-led maternity units at present. We were very pleased to discover that midwives at both Epsom & St Helier were as keen to deliver midwife-led care as the NCT, and it looks very much that whatever the decision for Epsom, St Helier will also be offering a midwife-led service in addition to its traditional labour ward.

I agree that the problem is that the public may well campaign for option 1 which will muddy the waters for us. There is a lot of general misunderstanding about the process of labour and birth due in no small part to its dramatisation in the media. If we believe what we are presented with in the soaps, once first contractions begin you have about half an hour to get to a hospital or you will be giving birth in the hospital car park, probably on Christmas Day! As a father yourself you will know that labour is a lot more drawn out & boring than this. The NCT is trying to emphasise the normality of birth and remove the idea that pregnancy is an illness that makes you a patient requiring automatic hospitalisation. Midwife-led units give women the opportunity to be empowered by their birth experience, rather than have control taken away from them by the medical professionals. I believe that if women can experience this kind of low-tech birth word will eventually get out & attitudes towards birth will change. However it is a big leap of faith for many women, and in the end it all boils down to the need to give women a choice.

10:46 am, December 01, 2006  
Blogger Charlie Mansell said...

Thank you for that comprehensive response. I fully accept the NCT want the maximum level of service as well as a wide choice for mothers.

Over the next few months most of the debate will be in Epsom. I hope the NCT are able to attend meetings over there to set out their views as part of the debate on the level of services.

5:59 pm, December 05, 2006  
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