Task shifting: Maternity Support Workers as the second health worker at a home birth in the UK: a qualitative study

on 28 October 2019

Taylor B, Henshall C, Goodwin L et al (2018). Task shifting: Midwifery Support Workers as the second health worker at a home birth in the UK: a qualitative study. Midwifery 62 (July 2018): 109-15.

Traditionally two midwives attend home births in the UK. This paper explores the implementation of a new home birth care model where births to low-risk women are attended by one midwife and one Midwifery Support Worker (MSW).

The study setting was a dedicated home birth service provided by a large UK urban hospital. Seventy-three individuals participated in the study over a three year period, including: 13 home birth midwives, seven MSWs, seven commissioners, nine managers, 23 community midwives and 14 hospital midwives.

The midwife-MSW model for home births was reported to have been implemented successfully in practice, with MSWs working well, and emergencies well-managed. There were challenges in implementation, including: defining the role of MSWs; content and timing of training; providing MSWs with pre-deployment exposure to home birth; sustainability (recruiting and retaining MSWs, and a continuing need to provide two midwife cover for high-risk births). The Service had responded to challenges and modified the approach to recruitment, training and deployment.

The study concluded that the midwife-MSW model for home birth shows potential for task shifting to release midwife capacity and provide reliable home birth care to low risk women. [Author abstract, edited]

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