CHHS17/264

Canberra Hospital and Health ServicesClinical Guideline Role of the Support Person in Labour and BirthContents

Contents....................................................................................................................................1

Guideline Statement.................................................................................................................2

Scope........................................................................................................................................ 2

Section 1 – Process................................................................................................................... 2

Implementation........................................................................................................................ 3

Related Policies, Procedures, Guidelines and Legislation.........................................................3

References................................................................................................................................ 4

Definition of Terms...................................................................................................................4

Search Terms............................................................................................................................ 5

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CHHS17/264

Guideline Statement

BackgroundWomen can have the support person/s of their choice during labour and birth. This could include paid support people such as a private midwife, doula or complementary therapist. Evidence suggests that continuity of support in labour can improve birth outcomes and women’s satisfaction. Support people will be welcomed into the Birthing environment.

Key ObjectivesTo provide a guide for working with a woman’s chosen support people for labour and birth including employed/engaged support persons.

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Scope

This document applies to: Medical Officers Midwives and Nurses who are working within their scope of practice (Refer to Scope of

Practice for Nurses and Midwives Policy) Medical students, Student Midwives and Nurses under direct supervision.

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Section 1 – Process

The scope of this document does not include Eligible/Endorsed privately practicing midwives with visiting rights to the Centenary Hospital for Women & Children (CHWC)

Informed consent can only be provided by the childbearing woman The presence of support people will be important to the woman’s emotional safety Midwives and medical staff may request privately employed/engaged support person/s

to leave the Birthing Room if they are acting in a manner that is contrary to the woman’s wishes

ACT Health staff are responsible for the provision of the clinical care that the woman receives, the privately practising midwife retains the role of support person

If the midwife is concerned that the support persons are providing care outside of their scope, this should be escalated to the team leader

An off-duty ACT Health employed midwife acting in the role of support person may not provide clinical care

A doula whether they are employed or engaged with or without fee, is considered a support person

A complementary therapist employed by the woman may attend during labour as a support person. Any planned complementary therapy needs to be discussed with the allocated midwife

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On admission to Birthing services the admitting midwife will determine and discuss the role of any accompanying support people

The midwife will document the presence of the privately practising midwife, doula or other support person, recording the names of support persons during labour and the witnesses at the birth

Children may be present if the woman wishes, provided there is a responsible adult specifically available to provide support and supervision for young children

In consultation with the woman, midwives and medical staff may request support person/s to leave if their presence is no longer appropriate or is inhibiting the provision of clinical care

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Implementation

Education will be provided to medical and midwifery staff on this clinical guideline and its relevance to practice. The Clinical Procedure will accessible online via the Policy Register.

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Related Policies, Procedures, Guidelines and Legislation

Policies Health Directorate Nursing and Midwifery Continuing Competence Policy Consent and Treatment Labour Care 1st, 2nd and 3rd Stage Endorsed Privately Practicing Midwives

Procedures CHHS Healthcare Associated Infections Clinical Procedure CHHS Patient Identification and Procedure Matching Policy

Legislation Health Records (Privacy and Access) Act 1997 Human Rights Act 2004 Work Health and Safety Act 2011

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References

1. Hodnett ED, Gates S, Hofmeyr GJ and Sakala C (2007) Continuous support for women during childbirth. Cochrane database of systematic reviews 2007, Issue 3 Art no :CD003766 DOI 10.1002/14561858.CD003766.pub2

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2. Hoga LAK, Gouveia LMR, Manganiello A, Higashi AB, Roth F. (2015) The experience and role of the companion during normal labour and childbirth: systematic review of qualitative evidence. Johanna Briggs Institute

3. National Institute of Clinical Excellence (NICE) (2007) Intrapartum Care: care of healthy women and their babies. London: National Institute for Health and Care excellence

4. Romano A and Lothian JA (2008) Promoting, Protecting and Supporting (2008) Promoting, Protecting and Supporting Normal Birth: a look at the evidence. JOGNN, 37, 94-105;

5. Royal College of Midwives (RCM)(2012) Evidenced based guidelines for midwifery led care in labour. The Royal College of Midwives 2012 access June 23 2013 http://www.rcm.org.uk/college/policy-practice/evidence-based-guidelines/

6. Simon, RM.; Johnson, K M.; Liddell, J (2016). Amount, Source, and Quality of Support as Predictors of Women's Birth Evaluations. Birth: Issues in Perinatal Care (BIRTH), Sep2016; 43(3): 226-232. (7p)

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Definition of Terms

Doula: a birth support person employed by the woman to offer support during her labour and birth. Doulas are not qualified health professionals. There is no prescribed education or training required to be a doula.

Endorsed Privately Practising midwives: are registered midwives with endorsement to prescribe schedule 2, 3, 4 and 8 medicines and to provide associated services required for midwifery practice in accordance with relevant and territory legislation. Endorsed Privately Practising midwives are credentialed by CHHS to provide private midwifery care at the CHWC. The Endorsed Privately Practising midwives must also have a current collaborative arrangement between her/himself and a named specified medical practitioner and/or the CHWC Obstetric Service. The Endorsed Privately Practising midwives must also hold a current “Access Agreement for the Provision of Private Midwifery services with ACT Health”.

Private practicing midwife: a midwife not associated with CHWC employed by the woman to provided midwifery services.

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Search Terms

Support person, Doula, Privately practicing midwife

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Disclaimer: This document has been developed by Health Directorate, Canberra Hospital and Health Services specifically for its own use. Use of this document and any reliance on the information contained therein by any third party is at his or her own risk and Health Directorate assumes no responsibility whatsoever.

(to be completed by the HCID Policy Team)Date Amended Section Amended Approved ByEg: 17 August 2014 Section 1 ED/CHHSPC Chair

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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register