What this means for you

Patient stories

The following patient stories are typical of the experiences of women who use our services now and what would be different under our proposal. These stories are told by local midwives, drawing on their wealth of experience and evidence and reflecting the rich community mix across our Local Maternity System. The profiles of Alison, Priya, Sarah, Yasmin and Lucy are typical of those women whose care will be transformed.
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Patient Story: Alison

Alison is a first-time mum, she is low risk and would like a midwife-led birth but she is worried about the risk of requiring transfer in labour so is reluctant to book for a Freestanding Midwifery Unit birth.

Now:
Alison's current choices are:
  • Home birth
  • Freestanding Midwifery Unit birth
  • Obstetric Unit birth
Under our proposals:
Alison's choices will be:
  • Home birth
  • Freestanding Midwifery Unit birth
  • Obstetric Unit birth
  • Alongside Midwifery Unit birth




Patient Story: Priya

Priya is expecting her first baby, she has a known infection requiring administration of intravenous antibiotics in labour, she is advised to have her baby in an Obstetric Unit.


Now:
Priya's current choices are:
  • Obstetric Unit birth
Under our proposals:
Priya's choices will be:
  • Obstetric Unit birth
  • Alongside Midwifery Unit birth




Patient Story: Sarah

Sarah is pregnant with her second child. Her first was born in the Obstetric Unit; however, this time around she is keen for a midwifery-led birth environment. Her first baby was reluctant to feed and she required readmission as she had lost quite a bit of weight.


Now:
Sarah's current choices are:
  • Home birth
  • Freestanding Midwifery Unit birth
  • Obstetric Unit birth
Under our proposals:
Sarah's choices will be:
  • Home birth
  • Freestanding Midwifery Unit birth
  • Obstetric Unit birth
  • Alongside Midwifery Unit Birth




Patient Story: Yasmin

Yasmin is pregnant with her third child, she would like to give birth in a midwifery-led environment however, the only choices available to her in her area are an Obstetric Unit or a home birth.


Now:
Yasmin's current choices are:
  • Home birth
  • Obstetric Unit birth
Under our proposals:
Yasmin's choices will be:
  • Home birth
  • Obstetric Unit birth
  • Alongside Midwifery Unit birth




Patient Story: Lucy

Lucy is expecting her third child, her first was born in an Obstetric Unit because she was very overdue and her second was at the Freestanding Midwifery Unit but she nearly didn't get there in time.


Now:
Lucy's current choices are:
  • Home birth
  • Freestanding Midwifery Unit birth
  • Obstetric Unit birth
Under our proposals:
Lucy's choices will be:
  • Home birth
  • Freestanding Midwifery Unit birth
  • Obstetric Unit birth
  • Alongside Midwifery Unit birth






What does it mean for staff?

Staff have been closely involved in the development of this proposal, they are on the frontline and can see the challenges, and the ways we need to change. Our staff want to be providing the best possible care for women, babies and families now and in the future.

  • Staff in our busy Obstetric Units, where 85% of all births currently take place, will be more able to focus on women who have a clinical need to be in an Obstetric Unit, as low risk women will have the choice of an alongside unit at the RUH and Salisbury hospitals, in addition to the Alongside Midwifery Unit already available at Great Western Hospital.
  • Staff in our freestanding units who may feel frustrated at being moved around at short notice, or disheartened at looking after empty beds and buildings rather than women and babies will be able to focus on supporting births in two units.

We'll still need the same number of staff, but our proposal will mean some staff need to work in different ways or different locations, or develop new skills. We know we have great staff delivering great services and we will continue to involve our staff in planning for the future.

"We know we can make changes that will bring our services more in line with national best practice, give even better quality of care, choice and experience for women and their families, and provide a great place for our clinical teams to work both now and in the future."

 

How have we arrived at our proposal for change?

It's been a long process, involving many people and over eighteen months to get to this point. We've listened to over 2000 women, families, staff and people with an interest in these services and they've told us what works well, what doesn't and what they want from their future maternity services.

Some key themes have emerged, people have told us they wanted:

To be offered choices from the beginning of their pregnancy

"Personal, informed choice is the key. Mothers should be given good information on which to base decisions. They should then feel adequately informed to make the decision as to whether to give birth locally without obstetric consultants or emergency care on hand, or to travel further to a consultant led unit." — Service user

"When first contact is made we explain choices including home births so women come to first appointment informed." — Member of staff

Women value the Freestanding Midwifery Units

"Women who attend them feel normal and they are supported and trusted that the belief is they can give birth normally." — Service user

Having your own space and not having to worry about transferring during labour

"If you were to wish for an epidural or if significant difficulties arise during labour arranging a transfer and moving locations during labour would be really hard to cope with." — Service user

Promote home birth and consider providing a dedicated home birth service

"Encouragement of home birth more openly (they were supportive but it isn't exactly advertised as an option!)" — Service User

More time with midwife and continuity of care is important, particularly antenatal and post-natal care

"Ideally I'd like to see women have the same midwife or small group of midwives that would see her through antenatal care, birth and post-natal care." — Service user

Improve breastfeeding support

"Provide more information and more help with breastfeeding in initial days." — Service user

We used this feedback, along with all the other feedback we ask for, collect and receive on a regular basis and worked with a wide range of people to develop a list of options for how we could provide our services in the future.

You can read about this process in more detail and see how we arrived at our proposal for change in our consultation document and our pre-consultation business case.

We developed our vision and our proposal for change by working and talking closely with our clinical teams, local health professionals and, importantly, women and families and those with an interest in maternity services.