Objective This service evaluation aimed to collect data on clinical handover on labour ward and compare them with the local guideline. Design and methods This service evaluation was structured in four stages, each using a different design and research methods. Setting The study was undertaken between September 2013 and August 2014 in a maternity unit in a large NHS teaching hospital in London, UK. Findings and conclusion Communication breakdown is widely considered to be a significant factor contributing to poor patient outcomes, with handover being a major risk point. The discrepancy between the local guideline and current clinical practice reinforces the belief that urgent action is needed to improve clinical handover on labour ward. The results of this service evaluation suggest that a drastic overhaul of the communication model during handover should be considered, ie from handover to takeover, and that the mnemonic SBAR may not be fit-for-purpose in maternity care and should be replaced with a different format that reflects the chronological flow of clinical events.

Surgical swabs are routinely used by obstetricians and midwives to absorb blood during caesarean sections or perineal repairs following a vaginal birth. On rare occasions, a surgical swab can be left behind by mistake inside the patient's body. When an incident involving a retained swab occurs, this is declared a ‘never event’. Although a rare occurrence, a retained surgical swab is the source of high morbidity (infection, pain, secondary postpartum haemorrhage and psychological harm). It is also important to mention the financial burden and the legal implications affecting healthcare providers worldwide. Over the years, several strategies have been implemented in clinical practice to reduce such risk. However, none of these seem to provide a definitive answer. Having offered a brief overview of the evidence surrounding retained surgical swabs, this article presents an innovative approach based on creating a physical barrier by introducing an anchoring point linking the swabs together, making it physically impossible to leave one behind. At present, these modified swabs are undergoing development and testing.

Objective: To assess the extent of current knowledge on clinical handover on the labour ward. Methods: Electronic database searching was supplemented by manual searching of the reference lists of retrieved articles. Results: A total of nine studies and articles were identified, reviewed and are presented as a narrative synthesis. Six of these include the use of a mnemonic during handover on labour ward, of which two report a postintervention reduction in serious clinical incidents. Conclusion: The literature available on clinical handover on labour ward is limited. Further research is needed to develop evidence to guide clinical practice in relation to handover of care on labour ward.

This reflection is intended to offer an alternative debate about place of birth. it explores similarities in the arguments regarding place of birth and place of death in the UK, drawing attention to common aspects of these two unique events, both of which now tend to occur in hospital, rather than at home. as made explicit by the Department of Health, everyone has the right to choose where to give birth and where to die. This article touches on the complexity of the right to informed choice to suggest that other more fundamental rights are involved: a safe and positive birthing experience and a ‘good death’.