A national survey in England of the routine examination of the newborn baby.
OBJECTIVE
To identify current practices for the initial routine examination of healthy newborn babies, and determine the extent to which midwives are carrying out this examination.


METHODS
Postal questionnaires were sent to consultant paediatricians and midwifery managers in all maternity units in England. Questionnaires were also sent to the 12 universities in England which run the N96 post-registration course in the examination of the newborn baby.


RESULTS
Questionnaires were returned from 197 (86%) maternity units. Senior house officers examined in 83% (160/193) a median of 92% of babies; 44% (74/167) had at least one midwife (median of two) with qualifications to carry out the examination and in 31% (51/167) some examinations were conducted by a midwife. However, a third of midwives with this qualification carried out no examinations, and nationally only about 2% of babies were examined by a midwife. Rates of referral by midwives and senior house officers were similar. Examinations were carried out between four and 48 hours from birth; most units considered six hours an acceptable minimum. An estimated 1% of babies were transferred home without routine examination; the GP was responsible for most (83-93%) of these babies' examinations; midwives for 10-23%; and senior house officers in hospital for 4-7%. Twelve per cent (23/194) of units carried out a second examination prior to discharge. Most respondents were in favour of midwives carrying out the examinations provided they were adequately trained.


CONCLUSIONS
Many of the consultant paediatricians and midwifery managers stated that suitably trained midwives could routinely examine the healthy newborn baby; however, many currently N96 trained midwives were examining few or no babies. An extension of training would be needed were midwife examination to become general policy.
Hayes
Julie
J
Cancer Services Collaborative, I Block, Watford General Hospital, Vicarage Road, WD18 0HB Watford, UK.
Dave
Shreya
S
Rogers
Catherine
C
Quist-Therson
Emmanuel
E
Townsend
Joy
J
D000739:Anecdotes as Topic; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003266:Continuity of Patient Care / Q000592:standards; D003955:Diagnostic Tests, Routine / Q000592:standards / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005194:Family Practice / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007224:Infant Care / Q000592:standards*; D007231:Infant, Newborn; D008297:Male; D008505:Medical Staff, Hospital / Q000592:standards / Q000706:statistics & numerical data; D008880:Midwifery / Q000592:standards* / Q000706:statistics & numerical data*; D015997:Neonatal Screening / Q000592:standards / Q000706:statistics & numerical data*; D010351:Patient Discharge; D010372:Pediatrics / Q000592:standards / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires; D013997:Time Factors