It is clear that English maternity care is currently in crisis with multiple reviews, reports and research reflecting complex challenges. Consistently, these reports have highlighted a failure to listen to women and birthing people and woman-centred, personalised care, a key policy priority since Changing Childbirth in 1993, is still not being met consistently or equitably. Within this context, Dr Claire Feeley and Dr Carol Kingdon will explore an important aspect of the conversation, that of ‘evidence-based maternity care’. The concept of ‘evidence-based’ practice has been widely accepted within healthcare and is integrated into regulatory expectations for qualified health professionals. However, our talks will address the tensions that have arisen since over the last 30 years, the misnomers and misunderstandings that give rise to the current reality – that staff and service users alike are not getting their needs met. Through our talks, we will demonstrate that what is currently conceived and practiced as ‘evidence-based maternity care’, has drifted from its founding principles. We will look back and recentre the original principles of evidence-based care to situate how we, as a maternity service, can move forward.

In this talk, Dr Carol Kingdon, medical sociologist with experience of bringing the core principles of evidence-based medicine into maternity care, will explore historical and contemporary issues and solutions. Dr Claire Feeley, midwife and researcher, will revisit the notion of ‘guideline-centre care’, the worst of both worlds for all concerned, to call for a return to authentic evidence-based practice as a key solution to improving maternity care.

This talk is being held in collaboration with the Midwifery and Maternity Collective, a multidisciplinary group with >350 members all concerned about care quality, escalating medical intervention and complication rates, rising birth trauma, growing public distrust in maternity services and the reduction in midwifery-led care and birthplace options.

Please note this will be recorded and sent out after the event so do sign up if you just wish to receive the recording.

Dr Claire Feeley

Dr Claire Feeley is a Senior Lecturer of Midwifery at King’s College London with an emphasis on research within her role. As an experienced clinical midwife, educator and researcher, Claire specialises in physiological birth across the risk spectrum, water immersion, human rights framework, midwifery practice, skill and competence - all within a sociocultural-political lens. Claire’s personal research has included freebirthing, midwives supporting out of guidelines normal birth care with numerous collaborations in a wider range of topic areas i.e. assisted vaginal birth, experiences of pharmacological/non-pharmacological pain relief methods, water immersion outcomes and experiences, parents' psychosocial needs during neonatal unit care, patient and public involvement during innovation and continuity of care implementation. Central to all of Claire’s work – education, research and practice is the improvement of maternity service delivery to meet the needs of all those within our care.

Dr Carol Kingdon

Carol is a medical sociologist in the Department of Women’s and Children’s Health, University of Liverpool and the School of Nursing & Midwifery, University of Central Lancashire. Her research interests include mode of birth, stillbirth and bereavement, and qualitative sub-studies of intrapartum trials. She began her career in NHS operational research. She was awarded a Doctoral Fellowship to undertake the UK’s first longitudinal study on birth mode choice. From 2016–2021, she worked with WHO on optimising caesarean use, including instrumental vaginal birth. She led qualitative sub-studies for the WOMAN (UK) and MOLI (India) trials. She also led the NHS component of the ASPIRE-COVID-19 study. Between 2021–2023, she returned to NHS management to develop Wirral University Teaching Hospitals’ Research and Innovation Strategy. Her global portfolio includes a co-investigator role on the MRC-funded C-Safe programme, and as an advisory group member of QUALI-DEC both of which are focused on caesarean use in Low- and middle-income countries. She is currently a member of the NIHR MATREP qualitative data monitoring group. Her contributions to ongoing research led by University of Liverpool include BirthOptions, Birth Preparedness through Antenatal Education (B-Prep), and Strengthening Reproductive Health and Childbirth Research Alliances through Patient and Public Involvement (SHAPE).

About Midwifery and Maternity Health Research Group

The Midwifery & Maternal Health Research Group is developing a programme of high-quality research to foster improvements to the delivery, outcomes and experiences of maternity care services. Our research is underpinned by the Lancet’s Midwifery framework for quality maternal and newborn care (QMNC). The QMNC is based on a definition of midwifery which encompasses skills, attitudes and behaviours, rather than specific professional roles. Therefore, while rooted in midwifery practice, our work goes beyond professional boundaries to centre childbearing women, people and their families. We bring together our diverse but inter-related fields of interest. These have previously included modifiable risk factors for stillbirth, maternity care experiences for those who have experienced childhood sexual abuse, midwifery practices in facilitating complex physiological birth and improving maternity care for women with pre-existing medical conditions. Together, our work will continue to consider the outcomes and experiences of those receiving care, and those delivering care to address some of the key issues facing maternity services today.