Highland Midwife - I wonder if there are more birth issues as a result?

[Slartybartfast]

Saw this programme last night. the mother had to go 4 hours by road to get to hospital after being transferred from the midwife led birthing unit.
i guess plenty of rural areas, ie, cornwall, have this issue.
i wonder if there are more birthing issues?

otoh it is not just birthing issues affected by these great distances in hospitals
where i live people complain that there is an hour between the midwife led unit and the hospital. Should they thank their lucky stars?

however i doubt the results are released to general public

I used to work in a fairly rural area with a midwifery unit an hour away from the consultant led unit. Plenty of women their homes are over an hour from the obstetric unit. I’ve certainly known babies die due to the transfer time/distance.

4 hours seems insane. In the back of an ambulance you’re so limited to what you can do. Can’t even monitor the Fetal heart and to be honest there’s no point because you can’t do much even if there’s an issue. But the thought of the woman in labour for 4 hours without checking the fetal heart is scary!

I would assume in such areas they have a much lower threshold for transfer. Both prior to labour starting and in labour. And for something serious maybe a helicopter?

The weather wouldnt allow a helicopter on this occasion.

I think you are probably right, the threshold for transfer is lower.
the fetal heart can be monitored though

Where I am as a midwife you legally have to be strapped in a seat the other side of the ambulance from the woman so I can't reach her. Paramedics won't drive the ambulance with you loose in the back. Maybe in the highlands they turn a blind eye?

But I was always taught it's pointless. If you have a bradycardia you can't do a section or a forceps. Ambulance is already on blues and twos so it's not going to go any faster.

just be there for the mother's piece of mind i guess?

Peace

Certainly in areas with a two hour transfer time the incidence of birth complications and babies own en route isn’t an outlier. The information is maintained and whilst not put in the local press is available in a few ways - FOI requests (although that costs the trust and deflects funding to bureaucracy. You can also look at the board minutes as it’s usually recorded as part of the assurance framework dashboard for women and children. The third way is to look at the latest inspection report as the figures will be in there somewhere.
Careful assessment of suitability, lower threshold and early transfer are all important.

My mum had my sister at home for this reason. She talks a lot about the birth plan discussions. Apparently there was an ambulance on standby if she needed it

Won't help the mother's peace of mind if you cant find it or it's really low.

no, the midwife accompanying the mother in the ambulance, do they? would be there for the mother?

I spose each area has to do the best with the facilities they have.

That transfer time is terrifying, I had a 24 weeker in a hospital with no intensive care neonatal unit (should of been moved, by baby number four, I can tell the difference between pissing myself and my waters breaking ) and his death was in part due to that.

I'm hoping with a transfer time like that the hospital staff would be a lot more cautious?

My local hospital lost its obstetric unit, and now only has a midwife unit. If there is unexpected major haemorrhage or severe fetal distress, the labouring mother has to wait for an emergency ambulance to arrive and transfer her 25 miles down a road that has twice been blocked by snow in previous winters, to reach the only remaining obstetric unit in 2000 square miles of Scotland.
We have already lost one baby- a late diagnosed breech presentation which delivered in a lay-by.
Mothers who choose home delivery obviously accept the risks that they or their baby may die, but if they’re in a midwife unit in a hospital, they might not realise that the risk is still there, and that transfer to a properly equipped and staffed unit may be lengthy and difficult. Or in the winter, sometimes impossible.

I honk it fine acknowledging high risk deliveries need access to full obstetric units but overall maternal and baby outcomes are significantly better in middies led units.

Oh that's interesting cherry

If it’s an emergency and the usual medical helicopter can’t fly, they’ll get a military helicopter (Seaking) to Glasgow or Edinburgh.

Did anyone else see the program?

I live in the highlands. And had to travel 4 hours to have my babies even though it was pretty smooth sailing. They was just worried if anything did go wrong they wouldn't be able to do anything. I dread to think people who are in labour when the roads are closed coz of the snow gates....there a petition somewhere online