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Content Article
Royal College of Midwives: Re:Birth summary report 2022
Patient Safety Learning posted an article in Maternity
In every aspect of our lives, language matters – and in health and care settings, it’s even more important. How we communicate with each other can determine the quality and impact of the care given and received, which is why developing a shared language is so important. Pregnancy and birth are extraordinarily personal, and personalising care is central to good outcomes and experience. There has been a great deal of debate in recent years about the language around birth, and the impact it can have. During this project from the Royal College of Midwives, for example, women said terms such as ‘failure to progress’ or ‘lack of maternal effort’ can contribute to feelings of failure and trauma. There has been particular debate around the term ‘normal birth’. Despite being the term used by organisations including the International Confederation of Midwives and the World Health Organization, it has often taken on negative connotations in the UK, and particularly in England. In 2020, the Royal College of Midwives, which counts the majority of midwives practising in the UK among its membership, took the decision to address this, and to try to develop an agreed shared language, working with maternity staff, users of maternity services and others involved in the care and support of pregnant women and families. Over the course of 18 months, the consultation has involved nearly 8,000 people from across all four UK nations. How we use language inevitably evolves over time, but the Re:Birth project will help to embed a shared, respectful way of discussing labour and birth.- Posted
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Content ArticleMidwives and other healthcare professionals are an integral part of many bereaved parents’ birth story and can play an important role in caring for parents when their baby dies. In this blog, Clare Worgan, Head of Training and Education at the charity Sands, talks about the importance of bereavement care to parents, and how training helps healthcare professionals to better provide this care. She outlines five principles of bereavement care and talks about why Sands is calling for bereavement care training to be provided to all staff who come into contact with bereaved parents.
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Content ArticleIn this article for The Guardian, Dr Kara Thompson, an obstetrician and gynaecologist working in the public hospital system in Geelong and Melbourne, Australia, argues that women must be given clear and unbiased information in order to make informed decisions about their birth preferences. She highlights the case of an information brochure about caesarean birth published on the website of a hospital in New South Wales, which presented incorrect claims about the relative risks presented by vaginal and caesarean birth. She outlines how the leaflet indicates that the way women are informed about birth choices is still subject to fear-mongering and shaming, and highlights the need for healthcare workers to respect maternal choice and autonomy.
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Content ArticleThis action plan to implement the recommendations of the Neonatal Critical Care Transformation Review outlines how the NHS will further improve neonatal care with the support of funding set out in the NHS Long Term Plan. It includes information on capacity, staffing and support for parents.
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Content ArticleIn April 2022, Whose Shoes were invited to run a workshop in Croydon in support of the HEARD campaign - Health Equity and Racial Disparity in Maternity. Women and families from Croydon came together to talk to healthcare professionals about what makes a difference in maternity care, and raising awareness of some of the issues faced by people from Black, Asian and Minority Ethnic communities - not just the 'service users' but staff experiences too.
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Content ArticleIn this Editorial for the journal Midwifery, maternity experts come together to respond to the Ockenden review and discuss what went wrong and what needs to happen now.
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Content ArticleSir David Sloman, Chief Operating Officer NHS England and NHS Improvement, has sent a letter to the families involved in the Nottingham Maternity Inquiry announcing that Donna Ockenden will taking over the Inquiry. A copy of the letter is below and attached.
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- Maternity
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Content ArticleSierra Leone has one of the highest rates of maternal mortality in the world. The risks are even greater for teenage girls who become pregnant, with up to one in ten dying in childbirth. In this blog, Lucy November, co-founder of 2YoungLives, a mentoring project for pregnant teenagers, describes the risks faced by teenage girls in Sierra Leone and the barriers they face to accessing maternity care. She talks about how 2YoungLives is making pregnancy and birth safer for this vulnerable group through mentoring, building community and equipping young mothers to support themselves and their babies.
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Content ArticleMaternal outcomes for Black women are significantly worse than for white women - Black women are four times more likely to die during pregnancy, labour, or postpartum and are twice as likely to have their baby die in the womb or soon after birth. They are also at an increased risk of readmission to hospital in the six weeks after giving birth. This report by the organisation Five X More presents the findings of a survey into black women's experiences of maternity services in the UK. The survey aimed to understand how maternity care is delivered from the perspective of women from the Black community, and 1,340 Black and Black mixed women responded, sharing their experiences. It seeks to highlight the real life encounters behind the known disparities in maternal care. Women reported far more negative experiences than positive, and most of these experiences centred around interactions with healthcare professionals. The authors highlight three factors related to healthcare professionals that contribute to damaging interactions, to do with their attitudes, knowledge and assumptions. The report includes many quotes from Black women about their experiences of NHS care and the damaging long-term consequences of this, such as fear of having another baby, reluctance to engage with health services and mental health issues.
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Content ArticleIn this three-year strategy, NHS Resolution outlines its strategic priorities to 2025. The four priority areas in the new strategy are: Deliver fair resolution – focussing our resources to avoid patients and healthcare staff having to go through formal processes that can be distressing and costly Share data and insights to improve services – sharing our unique data and insights to reduce risk and help improve the healthcare system Collaborate to improve maternity outcomes – working with others in the maternity care system to reduce neonatal harm Invest in our people and systems – building up our corporate capacity and capabilities internally to support the health and legal systems. These priorities aim to help the organisation contribute to: a reduction in harm to patients. a reduction in the distress caused to patients and healthcare staff involved when a claim or concern arises. a reduction in the cost required to deliver fair resolution. This will release public funds for other priorities, including healthcare. ensuring indemnity arrangements are a driver for positive change across the healthcare system. NHS Resolution has also produced a video summary of the strategy.
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Content ArticleIn Sierra Leone, 34% of pregnancies and 40% of maternal deaths are amongst teenagers and risks are known to be higher for younger teenagers. This qualitative study in Reproductive Health aimed to explore the causes of this high incidence of maternal death for younger teenagers, and to identify possible interventions to improve outcomes. Through focus groups and semi-structured interviews, the authors identified transactional sex - including sex for school fees, sex with teachers for grades and sex for food and clothes - as the main cause of high pregnancy rates for this group. They also identified gendered social norms for sexual behaviour, lack of access to contraception and the fact that abortion is illegal in Sierra Leone as factors meaning that teenage girls are more likely to become pregnant. Key factors affecting vulnerability to death once pregnant included abandonment, delayed care seeking and being cared for by a non-parental adult. Their findings challenge the idea that adolescent girls have the necessary agency to make straightforward choices about their sexual behaviour and contraceptives. They identify a mentoring scheme for the most vulnerable pregnant girls and a locally managed blood donation register as potential interventions to deal with the high rate of maternal death amongst teenage girls.
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- Children and Young People
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Content ArticleSystemic racism in maternity care is an urgent human rights issue. For too long, evidence and narratives about why racial inequities in maternal outcomes persist have focussed on Black and Brown bodies being the problem – ‘defective’, ‘other’, a risk to be managed. Birthrights’ year-long inquiry into racial injustice has heard testimony from women, birthing people, healthcare professionals and lawyers outlining how systemic racism within maternity care – from individual interactions and workforce culture through to curriculums and policies – can have a deep and devastating impact on basic rights in childbirth. This jeopardises Black and Brown women and birthing people’s safety, dignity, choice, autonomy, and equality. The inquiry’s report, Systemic Racism, Not Broken Bodies, uncovers the stories behind the statistics and demonstrates that it is racism, not broken bodies, that is at the root of many inequities in maternity outcomes and experiences.
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Content ArticleThis article examines the lasting impact of the tragic case of Daksha Emson, a 34-year old psychiatrist who took her own life and that of her baby daughter in an episode of postpartum psychosis. Daksha had a history of bipolar disorder and had attempted suicide before, and the inquiry into her death found that she received “significantly poorer standard of care than that which her own patients might have expected.” The authors highlight the impact of her story on the development in the UK of both specialist perinatal mental health services and specialised confidential services for health professionals, which remove some of the stigma attached to help-seeking.
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- Maternity
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Content ArticleIn a UK-first report launched in the House of Commons, leading figures from charity, healthcare, industry, law and academia have outlined a collaborative vision for UK leadership to improve maternal health. The Healthy Mum, Healthy Baby, Healthy Future: The Case for UK Leadership in the Development of Safe, Effective and Accessible Medicines for Use in Pregnancy report proposes a clear roadmap to improve the lives of millions of people, not just for women while they are pregnant, but for future generations. Over the past year, a Birmingham Health Partners led Policy Commission – co-chaired by Baroness Manningham-Buller, Co-president of Chatham House and Professor Peter Brocklehurst, University of Birmingham – has heard from key stakeholders on how best to develop safe, effective and accessible medicines for use in pregnancy. Compelling evidence gathered throughout the process has informed eight critical recommendations which, if implemented by government, will successfully prevent needless deaths and find new therapeutics to treat life-threatening conditions affecting mothers and their babies.
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Content ArticlePregnant women seeking asylum in the UK face many challenges in accessing healthcare and support during pregnancy and after birth. In this blog, Ros Bragg, director of Maternity Action, highlights evidence the organisation recently gave to the Women and Equalities Select Committee as part of their inquiry into equality and the UK asylum system. She highlights the inadequate level of financial support given to pregnant women seeking asylum, which means they are not able to eat healthily or buy necessary equipment during the perinatal period. She also draws attention to the fact that recent updates to the Home Office policy on dispersal for pregnant women - that state that they should not be moved more than once during pregnancy, and should be moved to suitable accommodation - are not being followed in practice. This prevents women seeking asylum from accessing consistent healthcare and building trust and relationships with midwives and other healthcare professionals.
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Content ArticleMaternity services shouldn’t be waiting for whistle-blowers or inquiries to alert them to problems, says Dr Mark Ratnarajah, a practising paediatrician and managing director of C2-Ai. Instead systematic transdisciplinary reviews and real-time data should support a culture of shared learning, that helps ensure patient safety is everybody’s responsibility.
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Content ArticleThe International Confederation of Midwives (ICM) aims to strengthen Midwives Associations and advance the profession of midwifery globally. These resources from the ICM provide guidance for midwives on: Policy and practice Advocacy Education Regulation Association Covid-19 Respectful maternity care Mentoring
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Content ArticleThe Mental Health Foundation proudly support Black Maternal Mental Health Week in this blog for The Motherhood Group on the experiences of Black mothers.
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- Mental health
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Content Article
Top tips: Maternal mental health (26 September 2022)
Patient Safety Learning posted an article in Maternity
As part of maternal mental health awareness week, The Motherhood Group asked Sandra Igwe for her tips to look after your mental health and wellbeing.- Posted
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Content ArticleIn general approximately 1 in 5 women from all different backgrounds experience perinatal mental health difficulties – that is mental health challenges during the perinatal period which is defined as one year after the birth of a baby. However, for black women perinatal mental health difficulties often go unidentified, and thus untreated, placing them at a disadvantage when it comes to seeking professional help. For this year's Black Maternal Mental Health Week, Global Black Maternal Health is proud to support The Motherhood Group as they continue to raise awareness on black maternal mental health, with a focus on equity and inequality for black mothers.
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Content ArticleAn open letter to Brandon Lewis, the justice secretary, and the Sentencing Council for England and Wales warns that pregnant women in jail suffer severe stress and highlights evidence suggesting they are more likely to have a stillbirth. The signatories include the Royal College of Midwives and Liberty.
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Content ArticleThis guide is designed to support healthcare providers when talking to patients about the use of of oxytocin to start or advance labour.
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Content ArticleIn this article for The Guardian, journalist Sirin Kale speaks to Janet Williams about the impact the epilepsy drug sodium valproate has had on her family. Janet took the medication to treat her epilepsy throughout her two pregnancies in 1989 and 1991, but had never been warned about the potential risks to her babies. Foetal valproate syndrome can cause spina bifida, congenital heart defects and developmental delays and is believed to have affected around 20,000 children in the UK. Both of Janet's sons were affected by the medication and require full time care as a result. Janet describes how being told about the risks would have enabled her to make an informed decision about whether to have children, and how her experience led her to help set up In-FACT (the Independent Fetal Anti Convulsant Trust) in 2012.
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Content ArticleThe Ockenden review into the failings in maternity care at Shrewsbury and Telford Hospital NHS Trust in the UK makes for sobering reading. The review focuses predominantly on the period from 2000 to 2019 and estimates that there were significant or major concerns in the care of nine women and more than 200 babies who died while receiving care at the Trust. Many more women and babies suffered serious injuries. It was clear that the Shrewsbury and Telford Hospital NHS Trust did not investigate, learn, change, or listen to families when adverse events occurred. The conclusions of the Ockenden review make it clear that safe staffing levels, a well trained workforce, an ability to learn from incidents, and a willingness and ability to listen to families are all crucial for safe maternity care.
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- Maternity
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Content Article
Patient Safety Now: safety II and maternity (September 2022)
Patient-Safety-Learning posted an article in Maternity
Safety II moves away from simply looking at what went wrong, and aims to understand the realities of everyday work in a constructive and positive way. It focuses on the system as a whole, rather than the end result of the work done. In this blog, Professor Suzette Woodward, Professional and Clinical Advisor in Patient Safety, looks at the role of the Safety II approach in making maternity services safer. She outlines the importance of asking and listening to staff about how to reduce complexity and reform areas of the system that are prone to error.