Statement: Response to the Interim Ockenden Report
(released 18th December 2020)
Download the PDF version of the statement by clicking on the following link: Position Statement: Response to the Interim Ockenden Report
In response to the Interim Ockenden Report describing findings and recommendations from the independent review of maternity services at Shrewsbury and Telford Hospital NHS Trust (SaTH), Midwifery Unit Network (MUNet) wish to extend our heartfelt sympathies and support for the women and families affected by the shocking tragedies and enduring trauma suffered by all involved. It is through their courage, voices and tenacity that we must learn, improve and fight for systemic change within the NHS maternity services.
The Ockenden Report is a complex review covering every facet of the maternity system and highlights appalling examples where safety, dignity and autonomy in childbirth were disregarded. Person-centred care and listening to women and families are core principles of well-functioning midwifery units. The report highlights how Midwifery Units must be well integrated within maternity services and that multi-disciplinary team working is of crucial importance. Cross-boundary collaboration is also central to safe, personalised care, so that communities on the geographical periphery of one system can use services in another maternity system when required, as recommended in Better Births.
The Midwifery Unit Network (*) welcomes recommendations within the SaTH review that encourage an urgent proactive move to bring about positive improvements to the structure of maternity organisations and create a genuine multi-professional maternity working culture.
The Midwifery Unit Standards published by the network and endorsed by NICE provide a framework based on a systematic evidence review and expert Delphi survey that services can use to guide and support service quality and improvement. However, the Midwifery Unit Standards have only been implemented to a variable degree across NHS Trusts, and midwifery unit staff are not as well supported or resourced as needed. The Midwifery Unit Network provides training and support for staff in midwifery units to achieve (and maintain) those standards and we believe that the Ockenden Report can stimulate a constructive effort to identify areas for further improvement.
We support evidence-based maternity care, and highlight clear evidence that, for low-risk women, Midwifery Units are associated with: Improved maternal outcomes & experiences, maternal satisfaction and are cost-effective, with similar outcomes for babies compared to obstetric unit care.
MUNet can contribute to positive improvements in maternity care in the following ways:
• At the heart of our work is an ethos of person-centred, rights-respecting, safe and appropriate midwifery care. We believe that working in partnership and continuously listening to women and families creates positive birth experiences. Kindness, respect and responsiveness must be core to delivering maternity care.
• Our philosophy and mission are grounded in the robust evidence and science surrounding the benefits of Midwifery Units and the bio-psycho-social model of care (including Continuity of Carer) for women with healthy pregnancies (Rocca-Ihenacho et al., 2018; Sandall et al., 2016).
• We encourage continuous risk assessment throughout maternity care, utilising the NICE (CG62 and CG190) guidelines. We proactively promote birth workers to engage in honest and open discussions with women and their families about the evidence surrounding place of birth, supportive referral pathways, autonomous decision-making and the benefits and iatrogenic effects of interventions in birth.
• The functions of the Midwifery Unit Network (training and education, networking and influencing, consultancy and ‘Midwifery Unit Standards’) endeavour to support services in achieving best practice in a positive way, through multi-professional collaborations, ring-fenced funding, strong leadership and clear communication and pathways of care.
• We educate and work within our area of expertise, with great respect for all other professionals within the maternity service; for the highest levels of safe care to be upheld strong, caring and kind midwifery services must be part of collaborative maternity teams.
The Midwifery Unit Network firmly believes that, following this report, supportive and supported midwifery services and Midwifery Units are an integral part of the positive and systemic solution urgently needed within the NHS maternity services as identified and promoted by Better Births in the Cumberledge Review (2016).
1) For further information on this statement, contact Dr Lucia Rocca-Ihenacho on Lucia@munetwork.org +44 (0) 7989230313
2) For further information on the Midwifery Unit Network visit www.midwiferyunitnetwork.org
* The Midwifery Unit Network is a not-for-profit social enterprise with a vision for women and families to have positive
childbirth experiences that enhance their physical and psychological wellbeing and give their babies an optimal start in life.
Registered Number: 11830326. Registered Office TN6 2QX