Child and Maternal Health
Keeping Childbirth Natural and Dynamic
My dream job… Here I am a Consultant midwife at Dumfries and Galloway Royal Infirmary tasked with implementing Keeping Childbirth Natural and Dynamic (KCND). I needed birth to be natural and dynamic and with a caesarean section rate of 27% (ouch!!) I needed to reduce this. It soon became apparent this was not about me.
The whole team would have to engage with the issues, recognise the problem and believe they could make a difference. So after recognising we had a problem and that it was both desirable and achievable to do something about it, there followed much team working and a series of multi-disciplinary events to get to know each other and agree standards of behaviour within the unit.
The team had revisited why we do the jobs we do and acknowledged that there is always room for improvement. So effectively we brought back the joy and had a renewed respect and value for the roles and input of each and every team member. And we believed! Confidence levels were high that we could make a difference if we worked together. Then came the realisation it was not about us.
The final part of the jigsaw was to recognise what women and babies needed and expected from us. Women told us it was not about the type of birth per se and much more about the experience. “I just wanted the midwife to be nice to me”. The realisation it was about the experience and caring and compassion – if we could be truly person-centred all the other outcomes would follow on.
So where are we now – we recognise the value of working as a team with the woman as team leader. We have become a person-centred team who care about and show compassion towards each other and the women and babies that we care for. But what about the outcomes? Caesarean section rate 23.8%, spontaneous vaginal birth rate 66.9% and still looking to improve!
Contact: Karen King, Consultant Midwife, Dumfries and Galloway Royal Infirmary