Prevalence of OptiBreech collaborative care practice within the United Kingdom: a survey of National Health Service providers

OptiBreech collaborative care is a bundle of evidence-based care practices combined into a multi-disciplinary care pathway for women with a breech-presenting baby at the end of pregnancy. We are aware that some Trusts have implemented some elements of this care pathway, but we are not sure which elements are currently being used to guide practice, to what extent, and in what areas of the UK.

This project involves administering a survey of UK maternity units, which will help us to map this. The results will be used to inform recommendations around improvements in training to guide care in this area, and the expected costs of implementing OptiBreech collaborative care as the standard care pathway across the UK. The student will also contribute to an update of a systematic review of vaginal breech birth training evaluations.

We would like you to complete the attached survey. This should take approximately 10 minutes. If you do not know the answer to any of the questions, we ask that you consult your colleagues, so that the information provided about your service is accurate.

Closing date: 9 September 2024

For more information, please contact Dr Shawn Walker at [email protected] / [email protected] 

To explore the views and experiences of women who, despite expressing a preference for home or free-standing birth centres, faced a deviation from their desired choice.

The dual impact of staff shortages and the ongoing presence of Covid-19 had and continues to profoundly affect midwifery-led service provision in the UK. Nevertheless, these decisions, were not evidence-based, and there has been an increase in rate of interventions, which are associated with undesired consequences, and worsened experiences.

Overall, in the UK, maternity policy and clinical guidance state that women have the option to give birth either at home, in a midwife-led birth centre or in an obstetric-led unit. Nevertheless, closure of birth centres and restricting home births due to staff shortages or covid-19 meant many women could not fulfil their preferred birthplace in a community-based setting.

Further research should focus on the impact of this disruption on women’s and families’ experience of maternity care as these experiences had not been explored yet.

This study could bring data and evidence into policymaking and maternity services management and to consider the effects of depriving women of their choices and wishes and the long-term impact of this.

Closing date: 1 December 2025

For more information, please contact Irati Urbiola Íñiguez at [email protected]

This research impact project aims to assess alternative ways of sharing research findings, specifically through social media campaigns that direct users to a dedicated website detailing the results (see link below).

In 2020, an online UK national survey of midwives working in the NHS was conducted.  The survey sought to address a gap in the evidence, specifically how working practices, such as shift length, the ability to take rest breaks, finish shift on time or intershift recovery might influence midwives’ emotional wellbeing.  Over 2300 midwives from the four UK nations took part.  There were consistent associations between impeded recovery time from current working practices, including a lack of formal methods to monitor this, and poorer emotional wellbeing outcomes that potentially influence midwives’ ability to provide safe and effective care.  The findings highlight areas where job design and working practices may be improved, which may contribute to better understanding in staffing and retention strategies.

Whilst key research findings have been published in an open access international peer-reviewed midwifery journal (click here to access), the rise in social media platforms in recent years has introduced innovative methods of dissemination that can reach a wider audience and make the research more visible.  An infographic (below) will be used to engage social media audiences across a range of platforms.

Social media posts will direct users to an interactive website that has been created to share the survey’s findings, highlighting factors related to job design that may influence emotional wellbeing outcomes. Findings are also potentially relevant to other healthcare professionals. The website aims to present a plain English summary of the findings, with easy to navigate expandable links and pop-up boxes that provide more detailed information should users wish to explore further.  The website also includes interactive regional map of results and opportunity to provide feedback. Access website on this link

A duplicate copy of the website, with a unique URL has been created for midwifery leaders, specifically seeking feedback to understand whether they would consider modifying policies or aspects related to job design in light of the survey’s findings. This link will be shared by the Royal College of Midwives and circulated through their Director/Heads of Midwifery network, but midwifery leaders can request the unique link by emailing the researcher, Dr Jackie Dent via email [email protected]

This project is funded by the Economic and Social Research Council (ESRC), part of UK
Research and Innovation, through an award from the University of Hertfordshire’s ESRC Impact Acceleration Account. 2024.  UH Ethics protocol no. HSK/SF/UH/05619.
Project PI:  Dr Jackie Dent, Senior Midwifery Lecturer, University of Hertfordshire.

You can also find me on X @midwifejdent

This is a mixed method PhD study aiming to explore how NHS Trusts in the UK meet the needs of women and birthing people who make birth choices that fall outside of the guidelines and recommended care. The online survey aims to identify and understand current practice and clinical care pathways, challenges, and pave the way for innovative solutions regarding “Out of Guidance Birth Choices” across the country.

You need to be a consultant midwife /consultant midwife in a development role, senior midwife or a midwife assigned to complete the survey who is currently working in the maternity services of the NHS and you are invited to participate in this online survey. Therefore, if you are unable to provide this information, please pass this questionnaire to a more appropriate colleague. Taking part is completely voluntary and should take approximately 15-20 minutes to complete the survey. Rest assured; all responses will be treated with the utmost confidentiality. By contributing to this study, you will play a pivotal role in shaping the future of Out of Guidance birth choice services.

The survey will cover information about your maternity unit, including annual birth numbers, referrals to Out of Guidance birth clinics, Out of Guidance births, and related care policies, so you may want to look at this information before starting the survey.

Upon completing the survey, you will have an option to express your interest to participate in the second phase of the study. The second phase involves qualitative interviews to delve deeper into the standards, processes, and cultural contexts of supporting service users who make birth choices that fall outside the standard patterns of care provision. This phase aims to identify best practices and provide key recommendations for midwifery education and policy development.

If the QR code is not working, you can access the survey here
Should you have any queries or require further information, please do not hesitate to contact me at [email protected] 

Facebook: The MIROG Study – UK
Instagram: @midwiferyresearchoog

We are exploring the views and experiences of parents, midwives and doctors in connection with parents’ involvement in decisions about possible planned birth at 34⁺⁰-38⁺⁶ weeks of gestation.

Background

We know little about the input parents would like to have in decisions about the possible planned birth of their babies at late preterm or early term. We also know little about what kind of input midwives and doctors think parents should have. However, we do know that around half of women are dissatisfied with their involvement and that some of these go on to become dissatisfied with their maternity care overall. We also know that the views of midwives and doctors sometimes differ.

We are therefore interviewing those with recent experience of such discussions about their views and experiences and hope that this may help us identify ways that parents may best be supported during the decision-making process.

Who are the research team?

The Principal Investigator on this project, Dr Frances Mielewczyk, is a former paediatric and neonatal nurse now working as a researcher at the University of Leicester. Her work forms part of the Leicester City Football Club (LCFC) Research Programme, which is led by Professor Elaine Boyle, Consultant Neonatologist and LCFC Professor of Child Health, and funded by a generous donation from LCFC.

My name is Helen Parsons and I am a psychology PhD student at Birmingham City University. My topic is health behaviours, body image and mindfulness-based concepts in pregnancy. I want to find out about midwives’ experiences and perceptions of providing support and advice on healthy eating and lifestyle behaviours during pregnancy. I am also interested in their views on how healthy lifestyle services within maternity care could be improved. Given that Black and Asian women are more likely to have adverse birth outcomes compared to white women, I am especially interested to speak to midwives who provide antenatal care to pregnant women from ethnically-minoritised groups. For this study, I would like to talk to NHS midwives who work with women in the antenatal period of any band, in any setting. Third year midwifery students who are working alongside community midwives and who are close to completion of their studies may also be eligible to take part. It will be an opportunity for midwives to tell me about their experiences in this area of antenatal care and input into any recommendations or improvements they would like to see. Participation will involve completing a brief pre-interview questionnaire and taking part in a 30-minute online interview. My supervisors are Professor Helen Egan, Dr Kathrina Connabeer and Professor Michael Mantzios of Birmingham City University.

Background:

The proportion of births to women over 35 years of age has increased significantly in the last decade.  Care planning for older mothers was highlighted in the 2020 MMBRACE report as an area of concern with recommendations for improvements. However, the definition of advanced maternal age (AMA) varies in the literature. Women's care plans and care pathways are being defined based on these inconsistent parameters. As a method of validation and context for the PhD titled: Personalized care of women of advanced maternal age, it is important to understand how AMA is being defined in practice across the UK and what key documents are being used to guide clinical decision making and care planning.

The objective of the survey is to audit and map current practice across the UK. Identifying current definitions of advanced maternal age (AMA) and applicable clinical practice guidelines/protocols/care pathways used for this demographic of childbearing women. We aim to reach as many NHS Trusts and maternity units as possible to obtain broad information on different UK countries and regions.

We are seeking to answer the question: How is advanced maternal age being defined in practice across the UK today? 

Who is the researcher? 

Joanne Rack is a Clinical Doctorate student at the Centre for Midwifery and Women’s Health in the Faculty of Health and Social Sciences at Bournemouth University.  She is being supervised by Dr. Vanora Hundley, Dr. Edwin vanTelijligen and Dr. Ann Luce. A registered midwife with the Nursing and Midwifery Council (NMC) and with the College of Midwives of Ontario (CMO). She has an MSc. in Reproductive and Sexual Health Research from the London School of Hygiene and Tropical Medicine. As a maternal health researcher and practicing midwife, she sits on the provincial task force for the revision of current provincial clinical practice guidelines on post-partum haemorrhage for the Association of Ontario Midwives and is a research fellow and part time research assistant under Dr. Beth Murray Davis at The McMaster Midwifery Research Centre. 

We would be grateful if you would support this research.

Please click here to access the survey.

CALLING PARTICIPANTS for research study...

“A mixed method study exploring maternity services and support available within the United Kingdom NHS for women presenting in the antenatal period after previous experiences of self-defined traumatic birth.”

My name is Francesca Marino, a midwife and postgraduate student undertaking a Master (MRes) Degree in Health and Social Care Research from the University of Manchester. As part of my Masters Degree, I am undertaking a project looking at exploring maternity services and support provided to women or birthing people presenting in pregnancy with previous self-defined traumatic birth across Maternity Units in the UK.

The findings will provide valuable information on maternity services available, and the way they are provided and will inform future research, which may include reviewing or developing guidelines or developing standardised and evidence-based interventions with improved outcomes for women and families.

Participation will involve completing an online survey accessible via the link below. The survey is addressed to midwives who can provide information regarding NHS maternity antenatal services and support for women or birthing people with a history of previous traumatic birth. If you are unable to provide this information, please pass this e-mail on to a colleague to complete the survey. We would kindly ask you to ensure only one midwife representative of your maternity unit and Trust completes this survey to avoid obtaining more than one response from the same trust or maternity unit.

We aim to reach as many NHS Trusts and maternity units as possible to obtain broad information on different UK countries and regions.

Please note that the survey will ask for information on the maternity service including the number of births per year at your maternity unit, policy related to care, and pathways for previous experience of traumatic birth, so you may want to look at this information before starting the survey.

The survey will take approximately 15-20 minutes to complete depending on the time you need to gain the information stated above.

At the end of the survey, you will also be asked if you would like to participate in a follow-up interview to explore individual experiences and aspects related to caring for women with a previous traumatic birth, by those who provide the services.

We would be grateful if you could support this research.

Click here to access the survey.

Alternatively, you can scan the following QR code:

Please do not hesitate to contact me at [email protected] or my supervisors 

[email protected] or [email protected] if you have any further questions.

Melissa Loh is currently in post as an Oral Surgery Registrar working across the University Hospitals of Morecambe Bay NHS Foundation Trust. Allaan Heewa is in his second year as a Dental Core Trainee (DCT) in Paediatric Dentistry working in Barts Health NHS Trust. Both Melissa and Allaan are supervised directly by Mr. Rory Molloy, the Consultant Oral and Maxillofacial Surgeon (OMFS) working in the University Hospitals of Morecambe Bay NHS Foundation Trust with a keen interest in the diagnosis and management of tongue ties in paediatric patients.

This project, ‘Addressing Ankyloglossia’, reviews national data collection from Midwives to identify their incidence regarding their approach to tongue tie referral for release. In addition to analysing their experience with managing referrals into OMFS.

The project aims to review the current practice within OMFS departments across the nation. This includes frequency of tongue tie release, the indications for the treatment and review the overall consensus for active tongue tie release.

To help us develop the national questionnaire, the project aims to identify and understand whether OMFS departments have a dedicated clinic for assessment, and whether the patients are assessed by a qualified feeding specialist prior to referral; is there and age criteria and what is the current consensus in regards to follow up after the treatment.

Healthcare professions must consider a parents’ parent or guardian concerns and expectations during the consultation. By reviewing the current practice across the country, a consideration the development of national guidelines could be of unanimous benefit. This is often an emotive topic particularly when discussing the extent of the associated benefits of a tongue tie release; in particular, in relation to the breastfeeding relationship between mother and child.

The link to our online national survey aimed at healthcare professionals involved in tongue tie release identification and management. We would be grateful if you could spend a few minutes of your time completing this survey which will aid our data collection process. https://forms.gle/FgPXcfH7iP4gi7Uw6

For more information, please contact:

Melissa Loh (Oral Surgery Registrar): [email protected]

Are you a midwife?

Have you made an error in clinical practice?

Safety in maternity care is very important. I would like to invite you to take part in an anonymous PhD research study about midwives’ experiences of making errors in clinical practice entitled:

An exploratory study examining the concept of midwives as the second victim. What experience do midwives have as the second victim after making an error in clinical practice? IRAS number 312715.

I would like to find out about your experiences as a midwife if you have made an error in clinical practice with a view to establishing an evidence base for this and recommending a specific evidence-based support system for midwives.

All information collected during the research will be anonymous.

Completing the questionnaire and returning it indicates consent to the study. You can stop being part of the study at any time, without giving a reason, but we will keep information about you that we already have. 

As a thank you for your time in taking part, if you complete a separate link available at the end of the questionnaire, with your name and email address you will be entered into a draw to win a £25 Amazon Voucher. You will be notified by email if you have won.

Thank you for your help. Your views are so important to me, midwives’ voices need to be heard.

- Natasha Carr

Find the survey here.

Dr Christy Burden and Dr Anna Davies from the University of Bristol and Southmead Hospital (North Bristol NHS Trust), are undertaking a study investigating current and Covid pandemic-related changes in practice for identifying and managing overweight women and women with risk of gestational diabetes (GDM). This work is part of an international trial with colleagues in Australia, Ireland and Spain (Impact Diabetes: URL) in which they are trialing an App-based lifestyle intervention to prevent GDM and reduce maternal weight in pregnancy.

The aim of our survey is to map NHS practice and variations for managing overweight women and identifying and managing women with GDM. We would like staff who have a role in the care of women who are overweight and/or women with GDM to tell us about current practices in their maternity service. Please click on this Survey link, which takes around 10 minutes to complete.

Thank you for your support. Please email [email protected] for any information.

Rachel Rowe is an Associate Professor and Senior Health Services Researcher in the NPEU at the University of Oxford, and the Head of the UK Midwifery Study System (UKMidSS), which she set up in 2015, funded by an NIHR Post-doctoral Fellowship. Her research interests include intrapartum care, the organisation of maternity care and women’s experience of care, with a particular focus on midwifery-led settings. She is also a co-investigator for the NIHR Policy Research Unit in Maternal and Neonatal Health and Care.

The UK Midwifery Study System (UKMidSS) is national system for carrying out research in midwifery units.  The UKMidSS Diabetes Study aims to investigate how many women with diabetes (gestational or pre-existing) are admitted to midwifery units for labour care, what the characteristics and outcomes of these women (and their babies) are, and whether some women with diabetes might safely plan birth in a midwifery unit, particularly an alongside midwifery unit where there is ready access to neonatal care.

Ethical review has been obtained from NRES Committee South West – Frenchay

For more information or to discuss participation please visit our website or contact: [email protected]. 

Twitter: @NPEU_UKMidSS

This survey aims to assess current practice in UK maternity units for the detection of breech presentation at term. Some units are currently offering routine ultrasound scans to all women, or groups of women, to avoid undiagnosed breech presentation during labour. However, the rollout and use of such scanning in the UK is currently unknown. The aim of this survey is to understand how practice differs between NHS Trusts or Health Boards. This information will be helpful to assess the feasibility of implementing ultrasound screening as a tool to diagnose breech presentation at term. The aim is not to promote ultrasound screening at term, but to understand current practice across the UK.

The survey is being carried out by researchers at the University of Aberdeen and Cardiff University. We would be grateful if you could tell us about current practice at your maternity unit by clicking on the link to complete the survey.