Article contd. and baby’. This is perhaps illustrated in the failure to fully acknowledge the dehumanising effects of rectal examination in the absence of evidence and visually identified trauma, and the psychosocial effects of labial tears, which increase when using MPP.1 Whilst labial tears have less long-term implications compared to OASI, this does not negate the personal effects of this type of injury. Birth Practices – More work is needed, not only to inform clinicians and birthing women and people around which birth practices are associated with intact perineum or severe tears, but to reach a consensus and to resolve clinical issues. The ongoing debate and conflict serves only to underline the dysfunctional nature of the current system which will benefit very few in the long term. Antenatal Information – It goes without saying that women and birthing people have an absolute right to clear, unambiguous and evidence-based information antenatally to enable informed decision making regarding their care, and this includes the OASI care bundle. Currently the bundle information pack provision extends to advising the content of the bundle rather than the evidence around prevention of tears, and any other options for care. More must therefore be done in terms of the provision of appropriately tailored antenatal education and discussion of perineal tearing including risk factors that extend beyond the individual including mode and place of birth, as well as discussing acceptability of interventions including MPP, rectal examination etc. AIMS would like to remind all clinicians that the birthing person’s wholehearted and fully informed consent is needed for any examination or procedure and they must be aware of all their
Birth Activist Briefing Why it’s important for you to get involved in your local (MVP) Maternity Voices Partnership by the AIMS Campaign Team
Maternity Voices Partnerships (MVPs) are a key element of the landscape for maternity service improvement in England.2 In order for them to function effectively, they require sustained input from committed local ‘service user representatives’, who are willing to work hard for the interests of maternity service improvement in their local area. And that’s where you – or someone you know – might come in. In this article, we will brief you on the key role of Maternity Voices Partnerships and encourage and support you to get involved. England has long prided itself on having a decent national maternity policy, much of that thanks to an impressive maternity service improvement community (of which AIMS – for the last 60 years – has been a key member). But we also know that structural problems persist and that good policy doesn’t always translate well to every encounter that local service users have with the maternity services. This is where local MVPs can be vital. So that there is no postcode lottery when it comes to high-quality maternity services. So that we leave no one behind.3
options before agreeing to any part of the OASI care bundle.
So what are Maternity Voices Partnerships ? Maternity Voices Partnerships are “independent formal multidisciplinary committees” which bring people together “to influence and share in local decisions” about maternity services. Better Births guidance (2017)4 asks Local Maternity Systems to ensure that all service users in their area (and their partners 2 Different arrangements exist in Scotland; Wales and Northern Ireland retain the MSLC structure. 1 Naidu M, Sultan AH, Thakar R (2017). Reducing obstetric anal sphincter injuries using perineal support: our preliminary experience. International Urogynecology Journal 28:381-9 dol:10.1007/s00192016-3176-4.
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3 unsdg.un.org/2030-agenda/universal-values/leave-no-one-behind 4 NHS England (2017), ‘Implementing Better Births: A resource pack for Local Maternity Systems’: https://www.england.nhs.uk/wp-content/ uploads/2017/03/nhs-guidance-maternity-services-v1.pdf.
