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Content ArticleBlack women in the UK are five times more likely to die during pregnancy and after childbirth compared to white women (MBRRACE, 2019). A petition recently called for more research into why this is happening and recommendations to improve healthcare for Black Women as urgent action is needed to address this disparity. The petition exceeded the threshold of 100,000 signatures required in order to be considered for debate in Parliament. The Government issued this written response on 25 June 2020.
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Content ArticleMore than 1 in 10 women will experience postnatal depression within the first year after giving birth. With a recent study showing that postnatal depression is 13% higher among black and ethnic minority women than it is among white women, it raises significant questions around whether these women are receiving the right treatment and support.
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Content Article
RCOG: National Maternity and Perinatal Audit (NMPA)
PatientSafetyLearning Team posted an article in Maternity
The National Maternity and Perinatal Audit (NMPA) is a large scale audit of the NHS maternity services across England, Scotland and Wales undertaken by the Royal College of Obstetricians and Gynaecologists (RCOG). Using timely high-quality data, the audit aims to evaluate a range of care processes and outcomes, in order to identify good practice and areas for improvement in the care of women and babies looked after by NHS maternity services. -
Content ArticleThis data snapshot from Santoli et al. highlights the results of an examination of two data sets (Jan to April 2019 and Jan to April 2020) to assess the impact of the pandemic on pediatric vaccination in the United States. The authors found significant vaccination declines and highlight the importance of childhood vaccination to prevent future disease outbreaks.
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Content ArticleThe Children’s Commissioner’s Office is concerned about the limitations in support offered to new families under lockdown, the reductions in contact with health visitors, and the inability to maintain birth registers. In this briefing paper, they highlight the need for policymakers to put families with young children, and especially those with newborns, at the heart of coronavirus planning. It shows that the risks to babies and young children can be reduced if the government and services think creatively to find ways to bring vital support to new parents, and takes proactive steps to ensure that different agencies routinely share data on these children – now more important than ever.
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Content ArticleThis is the response form the Parliamentary Under-Secretary of State for Health and Social Care, Nadine Dorries MP, to an urgent question from Sir Roger Gale MP on maternity care failings at the East Kent Hospitals University NHS Foundation Trust. It was followed by questions from MPs in the chamber and Ms Dorries’ responses.
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Content ArticleThe Secret Midwife is a heart-breaking, engrossing and important book. Joyful and profoundly shocking, this is the story of birth, straight from the delivery room. The author argues that the system which is supposed to support the midwives and the women they care for is starting to crumble. Short-staffed, over worked and underappreciated – these crippling conditions are taking their toll on the dedicated staff doing their utmost to uphold our NHS, and the consequences are very serious indeed.
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Content ArticleThis question and answer web page from the World Health Organization provides key information about pregnancy, birth and breastfeeding in relation to the Covid-19 outbreak. Questions include:Are pregnant women at higher risk from Covid-19?I’m pregnant. How can I protect myself against Covid-19?Should pregnant women be tested for Covid-19?Can Covid-19 be passed from a woman to her unborn or newborn baby?What care should be available during pregnancy and childbirth?Do pregnant women with suspected or confirmed Covid-19 need to give birth by caesarean section?Can women with Covid-19 breastfeed?Can I touch and hold my newborn baby if I have Covid-19?I have Covid-19 and am too unwell to breastfeed my baby directly. What can I do?
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Content Article
RCOG: Each Baby Counts 2019 progress report
Patient Safety Learning posted an article in Maternity
Each Baby Counts is a national quality improvement programme led by the Royal College of Obstetricians and Gynaecologists (RCOG) to reduce the number of babies who die, or are left severely disabled, as a result of incidents occurring during term labour. The Each Baby Counts programme brings together the results of local investigations into stillbirths, neonatal deaths and brain injuries occurring during term labour to understand the bigger picture, share the lessons learned and prevent babies from dying or suffering brain injuries in the future. This report presents key findings and recommendations based on the analysis of data relating to the care given to mothers and babies throughout the UK, to ensure each baby receives the safest possible care during labour. -
Content ArticleThis resource from Best Beginnings provides information about many national and local charities offering remote support for pregnant families and new paretns during COVID-19. The list includes organisations offering support and advice around: Pregnancy and birth Health conditions in pregnancy Parents of twins, triplets and more Premature Unwell babies Babies with disabilities or health conditions Breastfeeding and infant nutrition Mental health Bereavement Birth trauma.
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Content ArticleThis article is written by Ryan Van Lieshout, Canada Research Chair in the Perinatal Programming of Mental Disorder. He looks at the mental health challenges new mums are facing during the coronavirus pandemic and highlights the importance of self-care, with particular reference to 'NEST-S' (nutrition, exercise, sleep, time for self, supports).
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Content Article
Home births, fears and patient safety amid COVID-19
PatientSafetyLearning Team posted an article in Blogs
The COVID-19 outbreak has had an impact on all areas of health and social care. While understandably the focus of the healthcare system currently rests on the pandemic, it is important that we also consider the impact on non COVID-19 treatment and care. This has been recently highlighted by the UK Chief Medical Officer Professor Chris Whitty, who has warned about the impact that the pandemic will have on other areas as the health system is “reorientated towards COVID”.[1] Patient Safety Learning believe that in this context the need to pay attention to patient safety is now more important than ever. Pregnant women represent a unique patient group, facing very specific challenges. Although early evidence indicates that babies and children are less severely affected by the virus, many are concerned for the safety of their baby within the unfamiliar backdrop of COVID-19. It is understandable that fears persist when there are reports of pregnant women, children and midwives who have tragically lost their lives. This is the first blog where we will look at the impact of the pandemic on maternity services. Here we will focus on the safety implications of both low and high-risk women choosing to birth at home due to fears of contracting the virus in hospital. We also raise questions as to whether a blanket suspension of home birth services is putting some women and babies at greater risk. -
Content Article
Birthrights: COVID-19
PatientSafetyLearning Team posted an article in Good practice and useful resources
Birthrights are working hard to support maternity healthcare professionals to make thoughtful decisions even in these challenging times and to support pregnant individuals and their families. This webpage includes further information about pregnant women's rights, Birthrights position statement in light of the pandemic and a list of FAQs. -
Content ArticleThis briefing, from the Royal College of Midwives, sets out the potential impact of the COVID-19 pandemic on the number of women choosing to birth unassisted (freebirth). It highlights that anecdotal evidence suggests the number of women choosing to have their babies in this way is on the rise, due to a reduction in birth options. This briefing looks at the safety and legal implications, key guidance around freebirthing and lists some important considerations for midwives when caring for women who make this decision.
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Content Article
Midwifery during COVID-19: A personal account
Anonymous posted an article in Blogs
I am a case loading midwife, working during the coronavirus pandemic. This is my personal account of what we are doing in my area to keep our women and ourselves safe, and the barriers we are facing.- Posted
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Content ArticleThis guidance was published on 9 April 2020 by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwifery. It highlights that childbearing women and newborn infants continue to require safe person-centred care during the current COVID-19 pandemic and they represent a unique population. The majority are healthy, experiencing a life event that may bring clinical, emotional, psychological, and social needs. Women and newborn infants therefore require access to quality midwifery care, multidisciplinary services and additional care for complications including emergencies, if needed. When staff and services are under extreme stress there is a real risk of increasing avoidable harm, including an increased risk of infection, morbidity and mortality, and reductions in the overall quality of care. Safety, quality and preventing avoidable harm must be key priorities in decision making. Continuation of as near normal care for women should be supported, as it is recognised to prevent poor outcomes.
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Content ArticleThis video introduces England's 15 Patient Safety Collaboratives (hosted by Academic Health Science Networks) and how they support the NHS Patient Safety Strategy in areas such as COVID-19, managing deteriorating patients, maternal and neonatal safety, medicines safety, mental health and more. Download the slides here
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Content ArticleThe creation of a national network of medical examiners (MEs) was recommended in the Shipman inquiry and was alluded to in the Mid-Staffordshire and Morecambe Bay public inquiries. The Parliamentary Under-Secretary of State for Health, Lord O’Shaughnessy, confirmed in October 2017 that a national system of medical examiners will be introduced from April 2019. The ME reforms set out in the 2009 Coroners Act will be implemented nationally in two phases. By April 2019, NHS trusts should set up non-statutory schemes, based upon the national pilots (particularly in Leicester, Sheffield and Gloucester), funded in part from cremation form fees, in preparation for the commencement of a statutory scheme in 2020/21. A National Medical Examiner will be appointed, reporting directly to the National Director of Patient Safety.
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Content ArticlePrisons and Probation Ombudsman (PPO) Sue McAllister has published the independent investigation into the death of a baby (Baby B) at HMP Styal on 18 June 2020. The PPO was concerned that there were missed opportunities to identify the urgent clinical attention that Ms B, the baby’s mother, needed during that evening. The investigation found gaps in prison nurse training about reproductive health, long-acting reversible contraception and recognition of early labour, and the PPO has made recommendations to remedy these issues in all women’s prisons. View the report
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Content ArticleThe purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) was to help improve patient safety in relation to the instructions 999 call handlers give to women and pregnant people who are waiting for an ambulance because of an emergency during their pregnancy. The HSIB investigation reviewed the case of Amy, who was 39 weeks and 4 days pregnant with her first child. She contacted 999 after experiencing abdominal cramps and bleeding. While waiting for an ambulance to arrive, Amy received pre-arrival instructions which were generated through a clinical decision support system (CDSS) from a non-clinical call handler. Amy was then taken by ambulance to hospital where her baby, Benjamin, was delivered by emergency caesarean section. Amy had excessive blood loss due to a placental abruption and was admitted to the high dependency unit for 12 hours following the birth. Benjamin required resuscitation to help him breathe on his own, he was intubated, and he received 72 hours of therapeutic cooling. He spent 13 days in hospital.
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Content ArticleIn March 2020, the Healthcare Safety Investigation Branch (HSIB) published a national learning report to highlight the themes emerging from the initial investigations carried out as part of their maternity investigation programme. These initial investigations were carried out between April 2018 and December 2019. One of these themes was babies significantly larger than average who were at increased risk of a birth injury, brain damage or very rarely death because their shoulders get stuck during birth (known as shoulder dystocia). This was identified as an area where further analysis could benefit system-wide learning.
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Content ArticleThe British Association of Perinatal Medicine is inviting parents of babies who have spent time in a neonatal intensive care unit (NICU) to submit questions for neonatal research to the Neonatal Priority Setting Partnership. The partnership is made up of healthcare professionals and parent representatives that have come together to oversee a process to identify and prioritise research questions that can be tested in randomised trials in UK neonatal care. Answers to the questions submitted should improve neonatal care and reduce unwanted variations in practice. Questions can be submitted until 28 February 2022.
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Content ArticleThis blog describes the experience of Colonel Steven Coffee, Cofounder of Patients for Patient Safety US, who experienced a series of medical errors following the birth of his son. After a missed diagnosis of galactosemia, his son suffered liver failure and underwent a liver transplant at eight weeks old. Following his operation, the hospital where he was being treated did not have access to the powdered soy milk which was essential for his son's recovery. This experience spurred Colonel Coffee on to become an advocate for patient quality and safety in health care. For the last nine years, he has worked toward improved patient safety as the first community chair of MedStar Health’s Patient and Family Advisory Council for Quality and Safety (PFACQ).
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Content Article
Black and Asian bereaved parents whose baby died during pregnancy or shortly after birth have shared their experiences as part of the Sands Listening Project. The 56 parents who took part shone a light on care that works well, while also highlighting barriers, biases, and poor care. In the report, published by Sands, you can read more about: the findings pregnancy loss and baby deaths among Black and Asian babies in the UK real-life experiences and case studies what needs to change. Follow the link below to access the Listening Project report on the Sands website.
