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CONFERENCE PROCEEDING
Supporting out-of-guidance birth choices: Early insights from UK organisations without specialist clinics in the MIROg project
1
City St George's University of London, Nursing and Midwifery Department, London, United Kingdom
2
University of Hertfordshire, Midwifery Department, Hatfield, United Kingdom
3
University of Hertfordshire, Centre for Research in Public Health and Community Care, Hatfield, United Kingdom
Eur J Midwifery 2026;10(Supplement 1):A691
ABSTRACT
BACKGROUND:
Women who consider birth options outside recommended care pathways do not consistently have access to dedicated specialist services within the National Health Service (NHS). The Midwifery Research on Out of Guidance Care (MiROG) project aimed to examine how such services are structured and implemented across the United Kingdom, including settings both with and without Out-of-Guidance (OOG) birth choice clinics.
OBJECTIVES:
To investigate the organisation, delivery, and accessibility of OOG birth choice services across UK maternity care, and to identify referral patterns, care models, professional roles, and barriers to equitable provision.
METHODS:
Thematic analysis was conducted on open-ended responses from participants working in organisations that provide support for OOG birth choices but do not have a designated OOG clinic. These qualitative data were drawn from a national online survey disseminated to NHS midwives and obstetricians involved in the provision of OOG care as part of the MiROG project.
RESULTS:
Among respondents, 65% were based in acute hospital settings, and 35% in community, primary care, health boards, or ambulance services. Eighty-two percent indicated some form of OOG care provision, while 53% reported having written guidelines. Five key themes emerged: multidisciplinary involvement; individualised care and shared decision-making; informed choice and respect for autonomy; use of standardised tools; and ongoing service development.
CONCLUSIONS:
Findings highlight a clear commitment to respectful, individualised care for OOG birth choices, grounded in multidisciplinary collaboration. However, variations in practice underscore the need for consistent use of standardised tools. Emerging service models indicate progress toward more structured and equitable care.
KEY MESSAGE:
Multidisciplinary collaboration, informed choice, and standardised processes are central to safe and equitable OOG maternity care. Ethics approval was granted by the University of Hertfordshire Ethics Committee. The authors declare no conflicts of interest. Poster session 2 (Group A)
Women who consider birth options outside recommended care pathways do not consistently have access to dedicated specialist services within the National Health Service (NHS). The Midwifery Research on Out of Guidance Care (MiROG) project aimed to examine how such services are structured and implemented across the United Kingdom, including settings both with and without Out-of-Guidance (OOG) birth choice clinics.
OBJECTIVES:
To investigate the organisation, delivery, and accessibility of OOG birth choice services across UK maternity care, and to identify referral patterns, care models, professional roles, and barriers to equitable provision.
METHODS:
Thematic analysis was conducted on open-ended responses from participants working in organisations that provide support for OOG birth choices but do not have a designated OOG clinic. These qualitative data were drawn from a national online survey disseminated to NHS midwives and obstetricians involved in the provision of OOG care as part of the MiROG project.
RESULTS:
Among respondents, 65% were based in acute hospital settings, and 35% in community, primary care, health boards, or ambulance services. Eighty-two percent indicated some form of OOG care provision, while 53% reported having written guidelines. Five key themes emerged: multidisciplinary involvement; individualised care and shared decision-making; informed choice and respect for autonomy; use of standardised tools; and ongoing service development.
CONCLUSIONS:
Findings highlight a clear commitment to respectful, individualised care for OOG birth choices, grounded in multidisciplinary collaboration. However, variations in practice underscore the need for consistent use of standardised tools. Emerging service models indicate progress toward more structured and equitable care.
KEY MESSAGE:
Multidisciplinary collaboration, informed choice, and standardised processes are central to safe and equitable OOG maternity care. Ethics approval was granted by the University of Hertfordshire Ethics Committee. The authors declare no conflicts of interest. Poster session 2 (Group A)
| eISSN: | 2585-2906 |
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