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The changing face of town's midwives.

IF you thought services for mums-to-be and new mothers had moved out of Rugby with the closure of the maternity unit, think again.

And if your picture of a midwife is a battle axe with a black bag, barking instructions and patronising new mums, its time for a closer look.

For while news coming from St Cross Hospital has all too often been dismal in recent years, life at Owen Building - the hub of Rugby's maternity services - has never been healthier.

And the good news is that mums are in charge.

Rugby midwives are committed to giving pregnant women and new mums control, choice and continuity of care.

When it comes to actually giving birth, it isn't going to be at St Cross. Most mums who choose to have their babies in hospital will be taken to Walsgrave Hospital in Coventry for the delivery.

But their care right up to labour - and almost immediately after - takes place in Rugby and the midwives believe the standard is better than ever.

There are more midwives and more resources to meet the maternity needs of Rugby women than existed before the community midwife service was merged with Coventry's two years ago.

"We like to deliver as much of the service as possible in Rugby," said community midwifery manager Jackie Beasley.

And the midwives believe the fact that more mums in Rugby are choosing to give birth at home is a testament to the trust placed in them.

In 1998 Rugby's maternity unit at St Cross was closed and its work transferred to Coventry.

At that point the number of Rugby midwives was doubled to eight. In- patient services ended but all pre-natal and post-natal care remained in Rugby.

There are two specialist consultants based in Rugby where ante-natal and gynaecology clinics are held as before.

There is scanning equipment, baby heart monitoring equipment and all the necessary facilities to ensure that mother and baby receive total care.

There is also a breast feeding support group where mothers can talk about problems they are having with their babies and there is an ante- natal parent education group to help prepare mums and dads for the arrival of their baby.

Aqua natal classes are held at the Ken Marriott Leisure Centre.

On hand at the Owen Building are the Rugby Community Midwives to give advice, answer questions and respond to urgent calls.

There is a midwife available each morning and afternoon for mothers who want to drop in for advice. When the midwives are out, two receptionists help patients who call with problems and will immediately contact a midwife by mobile phone.

There is a midwife attached to each GP's surgery and she will see pregnant patients in her clinic at the surgery or at home.

From April 1999 to April this year about 1,000 Rugby babies were born. Of them, 75 to 80 were home births.

In the same twelve month period Coventry had about 4,500 deliveries. Only 29 were home deliveries.

"You might think the number of homebirths is high because Rugby women are not wanting to go to Coventry but it is difficult to say that is the reason they are opting for home births," said Bernadette Marshall, midwifery manager, women and children's services.

"Traditionally Warwickshire has always had a higher number of home births because of its rural areas.

"But also, having doubled the number of midwives, we are able to offer an improved service with resources that weren't available before."

Jackie said: "I wouldn't say we encourage hospital or home delivery. We look on it on an individual basis and give a woman all the information she needs to make her decision and try and support her in her choice of the best place for her to have her baby.

"Anyone who decides to have their baby at home tends to want a natural birth.

"We don't get many requests for birthing pools but people do aim to have as natural a birth as possible and we encourage them to do that, even if they decide to go into Walsgrave to have their baby."

Community midwives see their job as providing the right information and support without interfering. It is not only the ante-natal care they provide but also support after the birth.

They promote healthy living such as exercise and eating and the negative effects of smoking and drinking throughout pregnancy.

"But it is all done without preaching," Bernadette said.

After the birth, midwives are involved for a minimum of 10 days up to 28 days if needed and then hand care over to the health centre or GP.

"We get to know the mums quite well," said Jackie. "Continuity has really improved since we increased the number of midwives. Women do tend to see the same face throughout their pregnancy and post natally. We usually get to be quite good friends."

Bernadette added: "It is very important that the midwife and the mother get on together."

And when things do not go well, midwives will share the inevitable occasional sadnesses.

"This team does work well together and the midwives have to sit down and talk about the day's work and share the heartache and high points between themselves," said Bernadette.

The midwives are there for disadvantaged groups too such as lone young girls and pregnant women with drug and alcohol problems, to make sure there is no exclusion from maternity services.

"We're not here to judge but to help and support them as much as we can," said Bernadette

"We are still developing the Community Midwife Service here and still learning what Rugby wants. We can't get away from the fact that women can't have their babies here but we are doing everything in our power to improve our service.

"We are always looking for ways of doing things better."


In the year up until April as many as 8 per cent of all Rugby babies were born at home. In Coventry the figure is 0.6 per cent.

The Owen Building has housed obstetrics and gynaecological services since it opened.

There are eight full-time midwives covering the Rugby district. They include two rural midwives who live in the villages they cover.

Each doctor's surgery in Rugby has a midwife attached to it who runs clinics at the surgery and cares for every pregnant patient and new mum on the books.

Years ago mothers-to-be were given a long list of items for the baby they needed to have ready before they were admitted to maternity wards. That is no longer the case.

There are two specialist consultants at Rugby - Professor Steve Thornton and Tony Parsons, who was the original consultant for Rugby - who work at The Owen Building, supported by the midwives.

Some members of the team have been midwives in Rugby for more than 30 years.

There is an active focus group comprising the community midwives, the consultants, GPs, representatives of the National Childbirth Trust and Warwickshire Health Authority, as well as lay representatives. It looks at ways of improving the maternity services in Rugby and examines specific Rugby issues.
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Author:Court, Judith
Publication:Coventry Evening Telegraph (England)
Date:Aug 8, 2000
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