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Local guidelines for admission to UK midwifery units compared with national guidance: A national survey using the UK Midwifery Study System (UKMidSS)
- Source :
- PLoS ONE, PLoS ONE, Vol 15, Iss 10, p e0239311 (2020)
- Publication Year :
- 2020
- Publisher :
- Public Library of Science, 2020.
-
Abstract
- Objectives: 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. Design: National cross-sectional survey. Setting: All 122 UK maternity services with midwifery units, between October 2018 and February 2019. Outcome measures: 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. Results: 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 Conclusions: 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.
- Subjects :
- Epidemiology
Physiology
Maternal Health
Nice
Surveys
Midwives
Body Mass Index
0302 clinical medicine
Pregnancy
Surveys and Questionnaires
Medicine and Health Sciences
Medicine
030212 general & internal medicine
Medical Personnel
computer.programming_language
030219 obstetrics & reproductive medicine
Multidisciplinary
Obstetrics
Outcome measures
Obstetrics and Gynecology
Anemia
Prenatal Care
Hematology
Place of birth
Body Fluids
Hospitalization
Professions
Parity
Blood
Research Design
Female
Anatomy
Research Article
Female circumcision
Adult
medicine.medical_specialty
Science
Guidelines as Topic
Research and Analysis Methods
Midwifery
Birthing Centers
Streptococcus agalactiae
03 medical and health sciences
Antenatal Care
Streptococcal Infections
Humans
Survey Research
business.industry
Biology and Life Sciences
Guideline
medicine.disease
United Kingdom
Cross-Sectional Studies
Medical Risk Factors
People and Places
Birth
Women's Health
Population Groupings
Default - option
business
computer
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 15
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....66010d3fa19e7217eafb9c515434cca7