Barriers to IA Practice

Media coverage of UK maternity enquiries and the suspension of the normal birth campaign contributed to a defensive practice culture. The physical birth environment was often not optimised for IA. National and regional forces marginalised IA relative to CEFM. Digital documentation barriers forced some midwives to document on paper and upload records later. Staffing escalation from midwifery units to obstetric units undermined IA practice opportunities. Local inconsistency in interpreting national guidelines produced inequitable access to IA. Doppler devices were frequently missing, awaiting repair, or unusable because of battery procedures.