Midwifery-Led Birth Reflections Service at The Rotunda Hospital
The Rotunda Hospital introduced a midwifery-led Birth Reflections service in February 2021 to empower women by providing debriefing and listening sessions post-birth. This innovative service aims to reduce emotional distress, enhance confidence for future pregnancies, and offer a unique opportunity for women to reflect on their birthing experience. Research supports the importance of debriefing, with positive outcomes demonstrated by the high number of women utilizing the service. Evaluation and ongoing data collection will ensure continuous improvement and success of this valuable initiative.
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Birth Reflections: The Rotunda Hospital Denise Kildea Birth Reflections Midwife birthreflections@rotunda.ie 087 3710313
Birth Reflections Background In February 2021, the Rotunda Hospital was delighted to announce the launch of a midwifery-led Birth Reflections service. This is a dedicated midwifery-led debriefing and listening service for women who have given birth in The Rotunda Hospital. The service grew from its inception, the first of its kind within the RCSI Hospitals Group, to support and empower women while they reflect on their pregnancy and birth experience. The timing during COVID-19 pandemic could not have been more suitable. This project also responds to 30% of women that replied to the first National Maternity Experience Survey (2020) in Ireland who said they were not given the opportunity postnatally to discuss their birthing experience. This service represents a unique opportunity to spread best practice through the power of listening throughout the RCSI group and national network of maternity hospitals and units. Aim The main focus of the service is to provide an opportunity for women or couples to discuss their experience and to express their feelings about the birth, in the hope of reducing the possibility of psychological or emotional distress, and thereby empowering women with more confidence going into future pregnancies. This service is a link between the Birth Trauma Clinic, Perinatal Mental Health and the Obstetric-led Complex Clinic. Change Initiative This midwifery-led service offers a one-off, one to one appointment to help support women to make peace with her birth or pregnancy experience based on empathy and compassion. It offers the woman the chance for a dedicated midwife to listen to any concerns a woman may have, to explore any issues and provide an opportunity to reflect on their birth experience. It encourages women to express how the experience has met their expectations . This service also includes coordination or referral to other disciplines if and as required and pathways are in in place to guide this process A birth reflection experience can help considerably to obtain a greater understanding of events surrounding the birth, why a possible intervention was necessary, and the possible implications for future births. Reviewing the birth notes can also help provide answers, fill in gaps, and give the hospital s account of the birth (Bailey, 2008).
Birth Reflections Research Research supports the need to debrief women and identifies the role of the midwife as ideal to support women and provide the gateway to access other services (Gamble & Creedy, 2009) It is important that this new service is deemed acceptable by the service users. Since the services implementation systems have been put in place to capture data. Collection of data has been on-going throughout year one and for 2022 the service shall continue to capture quantitative data to enhance appropriate service planning and delivery of the service. Key Outcomes The need for the service and the commitment to the service is evidenced by the 395 women who have availed of it since February 2021. The majority of referrals have been self-referrals from women through the dedicated email address and phone number indicating that women appreciate the opportunity to reflect on their experience. Moving Forward For year two, evaluation of the service is a priority to measure the innovation s achievements. Service user experience is paramount and as such a service user experience survey is scheduled to commence this month (March 2022). Women will be asked to complete an online survey following their Birth Reflections appointment asking for their comments on the service and for suggestions as to how the service may be improved. Through on-going data collection, it is hoped that the results will indicate that the implementation is a success and that the goals of the innovation are being achieved. Any discrepancies or issues that arise will be addressed swiftly and corrective action can be taken.
Birth Reflections Sustained Since its implementation in February 2021 the uptake in the service has been phenomenal. If women are afforded the opportunity to work through feelings associated with pregnancy and childbirth experiences this service can influence long term outcomes. Value to Patients and Staff The Rotunda promotes a culture of patient safety and quality of services in all areas. Feedback from Birth Reflections is used to facilitate positive changes in maternity care by identifying areas we can improve upon and by recognising what we are doing well which impacts positively on both patients and staff. It is hoped that the service has and will continue to empower and support more women throughout their pregnancy, birth and postnatal experience. This in turn aims to reduce the rates of dissatisfaction when their expectations have not been met, thus reducing the amount of complaints received by the hospital (Baxter et al., 2014) Spread Community links have also been strengthened. As the service has progressed the referral pathway has been opened up to GPs and Public Health Nurses who can refer women to the service if they believe it would be of benefit. Since the introduction of Hospital Groups in 2013 following the Higgins Report, the Rotunda is the lead maternity hospital for the RCSI Hospitals Group (The Rotunda Hospital, 2022). As such this model of care is transferrable to other maternity hospitals to empower and support more women and their partners and best practice is shared throughout the maternity network. It is important to acknowledge the impact that the COVID-19 pandemic has had on the hospital since its arrival in early 2020. Going forward it is hoped that Birth Reflections will move from a virtual platform to face to face within 2022, COVID-19 restrictions depending.
