Maternity & Newborn Safety Investigations: Birthing outside of guidance (January 2025)

Summary

To help women / birthing people have a safe and healthy birth there are national and local healthcare guidelines. However, from time to time, people may choose to give birth outside of these guidelines. Based on findings from MNSI investigations, this paper explores how healthcare professionals can support people who choose to give birth outside of guidance and what we can learn.  

Content

What can maternity providers do?

Maternity providers can discuss and explore with their teams what support is available when someone decides to give birth outside of guidance. These ‘safety prompts’ will help facilitate those conversations.

Safety prompts

1. Do you have a guideline or process to support staff and mothers / birthing people when care choices are outside of national or local guidance?
2. Is there any training available for staff in how to navigate conversations in order to facilitate supported decision making?
3. Can women / birthing people benefit from birth choice clinics that are multi professional and use supported decision-making principles?
4. When a woman / birthing person requests a birth plan that deviates from national or local guidance, is this agreed in advance of birth? Do discussions include contingencies so there are clear parameters for acceptable care pathways when the situation changes, or an emergency occurs?
5. Are there resources (leaflets/videos/infographics) available that include up to date information, that are easily accessible and clear, to assist mothers / birthing people in supported decision-making when seeking care outside of national or local guidance?
6. Have you considered exploring with families their reasons for choosing to birth outside of guidance to enable learning?