Measurement: Interventions in Normal Labour and Birth

The Royal College of Midwives have worked in collaboration with the University of Central Lancashire (UCLAN) to pilot a survey tool and report (UCLAN/RCM, 2016)that is available for 7 trusts in England.

The simple two page survey tool can be completed prospectively or retrospectively and is comprised of a simple, two page instrument with tick box style binary questions (mainly yes/no) and a text box to record any associated details (where necessary).

The tool starts with questions on how the birth was recorded (normal, natural or spontaneous) and then lists a number of potential complications including prematurity, breech, multiple pregnancy and delivery by caesarean section, ventouse or forceps.

The measurements then include parity (primiparous or multiparous) and risk status (high or low) at labour onset as well as a set of items included in the Trent survey and added following the pilot including:

  • Induction (before labour started)
  • Augmentation of labour
  • Artificial rupture of membranes
  • Epidural anaesthesia
  • Episiotomy
  • CTG (> 1 hour continuous)
  • Use of a catheter
  • Fetal blood sampling
  • Antibiotics during labour
  • A blank box to add any other local intervention or procedure

Simple descriptive statistics were then used to understand the trends and also the recording errors taking place. This report can be used to understand how an audit or survey tool can be used at local and commissioning/planning level.

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