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Volume 447: debated on Tuesday 13 June 2006

To ask the Secretary of State for Health (1) what recent studies she has carried out into independent midwife-led birth units, with particular reference to care for mothers with learning disabilities; (75991)

(2) what research she has evaluated on the effects of a normal birth with minimal interventions on the incidence of post-natal depression; and what recent assessment she has made of the comparative rates of normal births in different settings;

(3) what opportunities there are to increase choice in maternity provision, with particular reference to midwife-led units in acute hospital settings;

(4) what recent studies she has carried out into the impact on (a) ante-natal and (b) post natal care of closing independent midwife units;

(5) what support the National Service Framework offers midwife-led maternity units;

(6) what research the Department (a) is undertaking and (b) has commissioned into (i) the effects of maternity provision being placed in the community and (ii) the merits of midwife-led units outside district general hospitals.

The Department has not carried out studies that cover birth settings or their effectiveness on specific client groups or the impact of their closure on antenatal and postnatal care. However, in a survey of patients conducted on behalf of the Department1, asking for a preference as to where the next delivery would take place, 36.9 per cent. wanted to give birth outside a hospital setting (home—13.1 per cent., midwife unit—20.4 per cent., general practitioner unit—3.4 per cent.).

Through the service delivery and organisation research and development programme, the Department has commissioned a three-year study, ‘An Evaluation of Maternity Units in England’, about the effectiveness, acceptability and efficiency of maternity units. We expect to be able to make an announcement about the award of the contract shortly.

The maternity standard of the national service framework for children, young people and maternity services is quite clear that maternity services should be designed, reviewed and improved through a programme of consultation with users and that the full range of choices of types of birth, antenatal and postnatal care, and birth environment should be offered. It also advocates that local options for midwife-led care will include midwife-led units in the community. Ultimately, it is for local health communities to decide on the best pattern of service provision, taking into account the needs of local people, evidence of effectiveness and available resources.

We have made commitments in the 2005 manifesto and in the White Paper ‘Our Health, Our Care, Our Say’ which was published in January 2006, to offer all women a choice over where and how they have their baby, including in hospital, a midwifery-led unit and at home—this will be in place by 2009.

1 Different models of maternity care: an evaluation of the roles of primary health care workers, Hewison J, Renfrew MJ, Gregson B, Young, G, Braunholtz D, Dowswell T, Hirst J, Ross-McGill H, 2003.

To ask the Secretary of State for Health (1) pursuant to the answer of 18 May 2006 to the hon. Member for Rossendale and Darwen (Janet Anderson), Official Report, column 1173W, on midwives, if she will publish the results of the assessment on its completion; (74749)

(2) what estimate she has made of the minimum number of midwives needed in England to enable all women a choice as to where and how to have their baby, broken down by (a) strategic health authority and (b) primary care trust; and if she will make a statement.

A maternity services outline delivery plan is being developed, which will set out a single vision for choice in maternity services, identify risks and management strategies and also set out the strategy for delivery including performance management arrangements, governance structures nationally, stakeholder engagement and the communication plan to support delivery. This is due to be published in autumn 2006.

Local national health service organisations are responsible for developing maternity services in response to the needs of their local population, and for ensuring that they have sufficient staff, with the right skills, to offer appropriate choices.