Working Together to facilitate Personalised Birth Choices as an MDT 

Barking, Havering and Redbridge Trust provides care for the residents of three diverse London boroughs; as well as providing healthcare services to people in south-west Essex. We operate from two main sites - King George Hospital in Goodmayes and Queen’s Hospital in Romford. We provide maternity care to around 7,250 women each year, making us one of the largest maternity services in the country.

As with many other services, we have seen an increase in requests for care outside of standard guidance, particularly from those who birthed during the covid pandemic. In early 2023, a new Obstetric Consultant joined the Trust, with an interest in provision of care to women and birthing people requesting care outside of standard guidance. The existing pathway was led by the Consultant Midwife for Midwifery-Led Care, with ad hoc input from Obstetricians. 

A new MDT antenatal clinic was established to see women and birthing people requesting care outside of standard national and local guidance, run jointly by the Consultant Obstetrician and Consultant Midwife. Appointments were arranged to be double the usual length and run predominantly in person, with remote video or telephone options available to those who requested them for reasons of convenience or hospital-based trauma. 

In the first 15 months of the service, 93 women and birthing people were cared for by the Birth Choices MDT. The most common reason for referral was seeking a VBAC in a low risk setting (MLU or at home). Other common reasons for falling outside of current guidance were raised BMI, maternal age, declining IOL, previous PPH, large/multiple fibroids, diabetes and other maternal medical conditions.

Future work includes further publicising the service, and wider work around informed consent and personalised care across the department.