Midwife-Led Care
Women and birthing people who are categorised as low-risk and meet our eligibility criteria are able to choose midwife-led care. Our dedicated team of experienced midwives will look after you and are on call 24 hours a day, 7 days a week for advice or concerns throughout your pregnancy, delivery and postnatal period. If you initially meet our low-risk criteria but things change, you can either be transferred to consultant-led care or to NHS care as required and according to your preference.
Midwife-led care is most suitable for those who are expecting a birth which is uncomplicated. We advise patients to check the following criteria or speak to our midwives prior to booking.
Inclusion Criteria
- Women who are motivated to labour naturally (may have epidural)
- Singleton pregnancy with cephalic presentation
- BMI up to 35 at booking
- Maternal age up to 40 at time of delivery
- Normal antenatal period
- Normal ultrasound scans
- Medically fit
- Women with known GBS (Group B Strep Infection) and an otherwise normal course of events are eligible
- Normally situated placenta
Exclusion Criteria
- Multiparity equal to or more than 5
- Previous postpartum haemorrhage (PPH) of greater than 500ml
- Aged 40 or over at time of delivery
- Multiple pregnancy
- Previous caesarean section or uterine surgery
- Polyhydramnios or oligohydramnios
- Abnormally located placenta
- Previous retained placenta
- Previous shoulder dystocia
- Female genital mutilation (FGM)
- Abnormal blood tests (identified from booking)
- Growth up to 10th centile on ultrasound scan (USS) or suspected growth restriction
- Haemoglobin levels: Hb up to 9g/dL
- Platelet count of up to 100 x 10*9/L
- Women who have had a previous postpartum haemorrhage (PPH) of more than 500ml due to uterine atony or over 750ml if from a perineal tear
- Disease that affects childbearing e.g. diabetes mellitus, epilepsy, clotting disorders, cardiac disease, uncontrolled asthma
- Recurrent antepartum haemorrhages (APH) in pregnancy greater than a ‘show’
- High blood pressure
- Refusal of blood transfusion
- No scans during pregnancy
- Fibroids – must have a recent ultrasound scan to assess size/position of fibroids
- Current primary herpes outbreak
- Previous 3rd/4th degree tear
Obstetric Consultant Review
- Low lying placenta in early pregnancy- may move as pregnancy progresses
- Hypo/hyperthyroidism
- Mental health history if significant
- Heart murmur
- Cervical surgery- LLETZ (large loop excision of the transformation zone) will need cervical measurements during pregnancy
- Previous herpes outbreak (will need medication late pregnancy)
- Previous retained placenta
- Previous shoulder dystocia
- Female genital mutilation (FGM)
- Abnormal blood tests (identified from booking)
- Growth up to 10th centile on ultrasound scan (USS) or suspected growth restriction
- Haemoglobin levels: Hb up to 9g/dL
- Platelet count of up to 100 x 10*9/L
- Women who have had a previous postpartum haemorrhage (PPH) of more than 500ml due to uterine atony or over 750ml if from a perineal tear
- Disease that affects childbearing e.g. diabetes mellitus, epilepsy, clotting disorders, cardiac disease, uncontrolled asthma
- Recurrent antepartum haemorrhages (APH) in pregnancy greater than a ‘show’
- High blood pressure
- Refusal of blood transfusion
- No scans during pregnancy
- Fibroids – must have a recent ultrasound scan to assess size/position of fibroids
- Current primary herpes outbreak
- Previous 3rd/4th degree tear
- Women with known GBS (Group B Strep Infection) and an otherwise normal course of events are eligible
- Normally situated placenta