SEEK: Salford Environment for Expertise and Knowledge

Report for External Body
January 2010

Association for Improvements in the Maternity Services (AIMS) critique of 'The London Project: A confidential enquiry into a series of term babies born in an unexpectedly poor condition' by the Centre for Maternal and Child Enquiries (The Report)

Davies, S E & Pilley-Edwards, N 2010, 'Association for Improvements in the Maternity Services (AIMS) critique of 'The London Project: A confidential enquiry into a series of term babies born in an unexpectedly poor condition' by the Centre for Maternal and Child Enquiries (The Report) ', for: Association for Improvements in Maternity Services, AIMS, LONDON, UK.

Abstract

The AIMS critique of the CMACE Report includes the following concerns

:

„h

 

why the report was requested by King’s College Hospital the selection of cases that were sent to be reviewed

„h

the methods used to review them

„h

the validity of the conclusions that were drawn

The AIMS critique concludes that the CMACE Report:

„h

reputation of the Albany Midwifery Practice, and omitted any details about King’s

community midwifery which also achieves excellent outcomes. It is possible that CMACE

was not actually given access to previous reports about the Albany Midwifery Practice.

Reported on the excellent reputation of Kings, but failed to include the excellent

„h

been a chance event, and that the selection of data (including the time frame) may have

contributed to the construction of such a 'cluster'.

Failed to consider the possibility that the 'cluster' of cases presented by King's could have

„h

symptoms and instead uses Hypoxic Ischaemic Encephalopathy (HIE) which implies

cause.

Failed to use the recommended term, Neonatal Encephalopathy (NE), which describes

„h

Midwifery Practice and a group of babies who had a problem who were cared for by

King’s community midwives, but failed to include any babies cared for by the hospital.

Selected groups of babies with and without a problem who were cared for by the Albany

„h

cases in order to help to identify practice changes to improve outcomes. This

methodology was not appropriate for the comparison of small groups of cases.

Used Confidential Enquiry methodology designed to look for trends in large groups of

„h

pressured into having to accept care dictated by protocol and guidelines. The report

contradicts itself saying that the midwives were not directive enough, yet is critical saying

that “the choices the woman makes will to sme extent reflect the preferences of her

midwife”; it seemed that the report had clear medical views about what women should

and should not be ‘directed’ to do.

Misunderstood women’s right to be supported to make their own decisions and not be

„h

provided by them working in the hospital environment and failed to consider that King’s

staff could gain from what the Albany Practice midwives could teach them,

Assumed that the Albany Practice midwives needed further education that could be

„h

hospital protocols and guidelines, and included a suggestion of a homebirth risk

assessment tool. However there is no evidence that place of birth was an issue in any of

the cases considered.

Made unsubstantiated assumptions that outcomes could be improved by adherence to

 

„h

Summary

Authors

SEEK Members

External Authors

Nadine Pilley-Edwards

Publication Details

Sponsor
Association for Improvements in Maternity Services

Publisher
AIMS
LONDON, UK