Purpose of the study

How can NICE intrapartum guidelines recommendations on place of birth for woman with uncomplicated pregnancies be implemented in practice?

Strong evidence suggests that, when focusing on a population of healthy women with uncomplicated pregnancies midwifery units are safer than obstetric units, as they are associated with lower rates of interventions and maternal morbidity and similar rates of adverse outcomes for newborn babies. Midwifery units have also been shown to be cost-effective.

The NICE intrapartum guidelines (2014) as well as the NICE Quality Standards (2015) recommended offering healthy women with uncomplicated pregnancies choice between four places of birth: Freestanding Midwifery Unit (FMU), Alongside Midwifery Unit (AMU), home and the Obstetric Unit (OU).

The aim of this study is to develop and evaluate a theoretically informed knowledge implementation pathway that service providers and commissioners can use as a guide to implement evidence on birthplace into NHS services which require complex organisational and professional practice change.

A Participatory Action Research (PAR) approach is used and the Promoting Action on Research Implementation in Health Services (PARIHS) framework has been adapted to guide implementation design and evaluation. Data collection includes qualitative and quantitative methods (analysis of routinely collected data, user surveys, local audits, focus groups, field notes and in-depth interviews).