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Centralisation in Kent

February 24, 2013

Two more free-standing midwife-led birth units close for deliveries

buckland hospital     dover family birthing centre    canterbury birthing unit

Canterbury Maternity Centre was created as a free-standing midwife-led unit (MLU) in 2004, when Kent & Canterbury Hospital’s consultant-led obstetric unit (CLU) closed and deliveries moved to William Harvey Hospital at Ashford. Dover Family Birthing Centre at Buckland Hospital was created when the Buckland Hospital CLU closed in the 1990s.

Both MLUs finally closed to births in 2012, allegedly on grounds of safety, because the birth rate was rising and putting pressure on midwives in the large consultant-led maternity hospitals, and because they had too few deliveries to justify the costs. The safety reason was unfortunate since it was only in 2011 that the Birthplace study (click here) showed that MLUs were safe.

The real reason is that such units are set up to fail. Planners find them expensive to run, and they are not popular with most women. After all if there was a real demand to deliver in a free-standing MLU, Dover would have been well placed to take women from France and Belgium where such units are undeveloped. But little or no such cross channel traffic occurred, and even the women of Dover preferred to go down the road to Ashford. It’s one thing to give birth in a co-located MLU, where if you need medical intervention you can just move down a corridor.  Quite another to do so in a unit where you need an ambulance ride to get an epidural.

Between 2006 and 2011 the birth numbers in Dover MLU fell from 398 to 158, and in Canterbury from 380 to 235.  Over the same period home births in the region fell from 291 to 247, and hospital births in Ashford rose from 3379 to 4142.

Those of us with long memories will remember the battles fought over the closure of the consultant unit in Canterbury in 2004.  Campaigners complained that local services were being downgraded, but health planners insisted they were improving services by developing the midwife-led unit.

Centralisation – the one thing you can reply on in the NHS.

Jim Thornton

Related stories here, and here.

with woman

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2 Comments leave one →
  1. May 3, 2013 3:35 pm

    Hi Jim,
    Interesting reflections on the popularity of free-standing midwifery-led units. I think local factors play the biggest role in their success or otherwise. My PhD work was at Lichfield which had a 20 year history of recurrent threat of closure, successfully defended in each occasion by an alliance of local women, midwives and some GP’s. Bournemouth is a long standing example (opened in the mid 1990’s) and averaging around 500 births/year still now. A positive relationship with the host obstetric unit (Poole in this case) is fundamental to success. Like wise the example I keep quoting Blackburn where there was sign up from local women, midwives and most obstetricians, particularly at leadership levels.

  2. May 3, 2013 9:47 pm

    Yes, Lichfield does seem to have hung on. Agree there is something in the local factors idea. Lichfield started as a GP unit and has been going for many years. Where people are used to a low risk unit without epidurals etc. they seem to be viable, but where the norm has been consultant units with all the trimmings, it’s often difficult to persuade large numbers to try the low intervention option.

    But I’ve just checked http://www.Birthchoiceuk.com. They say only 10 births per year at Lichfield! That can’t be right can it? If true, Lichfield will surely be for the chop soon.

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