Apr 052019

Midwifery is renowned for being one of the most rewarding professions there is; however as so many midwives will testify it is also at times one of the most challenging. It is however incredibly rare to be given the opportunity to take part in quality improvement projects which not only see almost immediate benefits to the women we care for; but which also shape the profession and wider clinical practice. OBS Cymru – the Obstetric Bleeding Strategy for Wales- has been one such project. OBS Cymru is the result of research which began in Cardiff over 10 years ago, and developed over time into an evidence based, highly effective strategy for managing Postpartum Haemorrhage. This approach has now been rolled out to every health board in Wales and has significantly changed practice, seemingly overnight (no mean feat as I’m sure you’ll agree).

Each Consultant Led Unit’s (CLU) OBS Cymru Champion Team have overseen the implementation of the project. I have had the honour of being one of the Champion Midwives in Ysbyty Glan Clwyd in North Wales and I can honestly say it has been more rewarding and equally more influential to my practice than anything I’ve been a part of previously. Simple evidence based interventions with an emphasis on early recognition of PPH through Risk Assessment and measuring blood loss rather than estimating it. This was a major change in practice but one which was adopted by all staff and with remarkable results. Change is inevitable in Maternity care but it is not always so easily achieved!

As Champion Midwives we have encouraged truly multidisciplinary team working and training, generating remarkable and undeniable results for women in our care. The success for OBS Cymru in our unit has been largely due to the engagement of the support workers and midwives. They led the change to measuring blood loss and instigating early recognition and management of PPH.

OBS Cymru as a QI project has now drawn to a close. However, I don’t see this as signifying the end of the OBS Cymru work. Rather, primarily it is an opportunity to reflect on just how far we have come as a nation that is leading the way in effective management of PPH. But in addition it is an opportunity to look to the future and plan our own strategies for ensuring this invaluable work continues and embeds even further into everyday practice.

I feel fortunate to have worked with such an enthusiastic, motivated and knowledgeable team who will help this work continue and who will drive forward change to achieve the best for the women in our care. For us OBS Cymru is here to stay!

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