In line with the National Maternity Strategy (2016) The National Maternity Hospital provides three separate maternity care pathways; Supported Care, Assisted Care and Specialised Care. Women are offered choice regarding their preferred pathway of care, in line with safety, their clinical needs and best practice. Insofar as possible, all care pathways support the normalisation of pregnancy and birth. Whatever pathway the woman is on she will have continuity of care, one to one care in labour and her care will be shared with her GP.
Most women experience a normal-risk pregnancy and birth. Medium-risk mothers/babies require higher level of oversight, while high-risk mothers/babies require a more intensive level of care, either throughout or at particular stages of care. To determine the most appropriate care pathway for each individual woman, an initial assessment of clinical risk or need will be carried out and this will be repeated at each visit. This process of continuous risk assessment will ensure that if the needs of the mother and/or baby change at any stage during the pregnancy, our services will be responsive to ensure that the increased need is quickly identified and that the mother is placed on the correct pathway.
Below is a description of the care pathways in The National Maternity Hospital.
Supported Care Pathway
The Supported Care Pathway is intended for mothers and babies who are considered to be at normal-risk, with midwives leading and delivering care within a multidisciplinary framework. Antenatal care on The Supported Care Pathway is provided in midwife led clinics in the hospital or in the community. The woman can exercise a choice about the birth setting, which may be in the hospital, or at home, depending on catchment area and eligibility. A woman may need to transfer, either temporarily or permanently, to another model of care because of an emerging risk. She may also choose to transfer to another care pathway for example if she chooses to be under the care of an obstetrician. For hospital births, postnatal care will start in the hospital and generally move to the community following Early Transfer Home which is dependent on catchment area and suitability.
Assisted Care Pathway
The Assisted Care Pathway is intended for mothers and babies who are considered to be at medium-risk, and for women at normal risk who choose to be under the care of a consultant. Care will be led by a named consultant, and care will be delivered by obstetricians and midwives as part of a multidisciplinary team. Care will be provided across the hospital and the community, and births will take place in the hospital. Postnatal care will start in the hospital and move to the community on discharge. Access to Early Transfer Home Service may be an option dependent on catchment area and suitability.
Specialised Care Pathway
The Specialised Care Pathway is intended for mothers and babies who are considered to be at high-risk and will be led by a named consultant. Care will be delivered by obstetricians and midwives as part of a multidisciplinary team. Care will, in the main, be provided in the hospital in our specialist clinics. Births will take place in the hospital. An individualized, multidisciplinary, multi-specialty approach to care and care planning (for both the hospital and the woman) will be used. Postnatal care will start in the hospital and move to the community on discharge.