East Lancashire Maternity services underwent a major service reconfiguration in November 2010, moving from two Consultant led units to one consultant unit and 3 midwifery led birth centres. This service now has nearly 7000 births per year, nearly a third of which are born in the birth centres.

This transformational development was achieved through a shared ethos and philosophy about childbirth and through close collaboration between obstetricians, anaesthetists, midwives and neonatologists on clinical guidelines, operational policies and clinical care. The reconfiguration has also led to a doubling of consultant presence time on our labour ward.

Our Caesarean section rates pre and post reconfiguration:

Robson Group analysis of these rates demonstrate the greatest reductions in caesarean sections for term nullip women in spontaneous labour, for nulli- and multiparous women in induced labour, and for women with multiple pregnancies.

As confirmed by the Birthplace study¹, the introduction of birth centres has led to a reduction in caesarean section for low risk women. Furthermore, we postulate that the increased Consultant presence on labour ward has increased confidence in vaginal operative delivery and CTG interpretation, reducing the need for caesarean section.