Wednesday, 3 December 2014

Nice NICE Guidance and sucking eggs

I haven't updated this blog for a little while but it seems fitting to break the fast with the wonderful news today that NICE guidance has finally been updated to reflect the evidence surrounding birthing at home, one to one midwifery care, delayed cord clamping and minimising separation of mother and baby.

You can view the updated guidance here:

http://www.nice.org.uk/guidance/CG190

While I am over the moon at the update I can't help the feeling that this is a little like teaching Grandma to suck eggs and actually most of this is good old fashioned excellent midwifery philosophy already but it would seem churlish to point this out at length.

What is key however is that while much of it is midwifery wisdom - what midwife will argue that one to one care and keeping mother and baby together needs new research and evidence to inform our practice with this - it is not yet in the public forum. Women have been scared out of having their babies at home and this latest guidance lays it out on a plate.

"If you are having your second or subsequent baby, and you are 'low risk', that is to say that you and your unborn child are healthy and you have had normal previous births, then giving birth at home is a safe option for you" (NICE CG190. My paraphrase)

It is interesting to note that the Guidance also points out that practitioners should not disclose personal judgements or views (1.1.9) about the woman's choice of birth place. I'm saddened that it needs to be laid out so explicitly. Presumably the 'haters are going to hate' (I'm talking about you 'Dr' Amy Tuteur) but it is exciting to have the updated evidence to hand, to be able to signpost women to the information they need to make an informed choice and this is at the heart of midwifery.

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