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Found 404 results
  1. Content Article

    Midwifery during COVID-19: A personal account

    Anonymous

    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.
  2. Content Article
    Shabazz et al. explore incidents of bullying and undermining among obstetrics and gynaecology consultants in the UK, to add another dimension to previous research and assist in providing a more holistic understanding of the problem in medicine.
  3. News Article
    An acute trust in the Midlands has contacted 136 women who received major treatment from a gynaecology consultant, after initial investigations revealed “unnecessary harm” to several patients. Read full story (paywalled) Source: HSJ, 17 April 2020
  4. Content Article
    Radio 4's Women's Hour programme discusses coronavirus and the impact the current pandemic is having on access to cervical screening services. Later in the programme, the discussion turns to the topic of dealing with addiction during the lockdown. Cervical screening (listen from the start of the recording) Speakers, Kate Sanger, Head of Public Affairs at Jo's Cervical Cancer Trust, and consultant gynaecologist Dr Christine Ekechi stress that patients should not hesitate to contact their GP if they have any concerns or symptoms. Symptoms might include: abnormal bleeding, bleeding after sex, bleeding after the menopause, bleeding in between periods, unexplained pelvic pain and in some cases increased vaginal discharge. Addiction (21:45) According to the charity Action on Addiction, one in three people are addicted to something. How difficult can it be to remain sober or clean in lockdown, and what support can you still access? Speakers include Holly Sexton, Substance Misuse Practitioner at We Are With You, and Caroline Turriff, a freelance journalist who is 15 years in recovery. They discuss whether opiate painkillers and methadone being more easily available through pharmacies creates safety issues. Caroline argues that it will reduce the risk of people obtaining opiates online or heroin via street dealers which she says could enable them to obtain life-threatening amounts. 
  5. Content Article
    This 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. 
  6. Content Article
    This 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?
  7. News Article
    Patients in England can now have home abortions during the COVID-19 outbreak, the government in England has said. Abortion policy has changed several times during the current pandemic. Women and girls wanting to terminate an early pregnancy were first told the service would be available but that decision was then retracted. Now, the government has decided patients can take two pills at home instead of going to a clinic to avoid exposure to coronavirus. Charities had been worried that women who want an abortion but have underlying health conditions would put themselves at risk to have the procedure or turn to dangerous alternatives. Read full story Source: BBC News, 31 March 2020
  8. News Article
    Hundreds of thousands of pregnant women face a crisis as maternity and abortion services shut their doors because of the coronavirus outbreak. One MP this weekend warned that pregnant women were being treated like “second-class citizens” with the closure of NHS services and a lack of government guidance for those in need of urgent care. The NHS faces a severe shortage of midwives with the number of unstaffed positions doubling to one in five since the virus arrived in Britain. A fifth (22%) of senior midwives said their local maternity units had shut indefinitely because of staff self-isolating or being deployed elsewhere. Read full story (paywalled) Source: The Times, 29 March 2020
  9. Content Article
    Since April 2018, the Healthcare Safety Investigation Branch (HSIB) has been responsible for initiating over 1000 independent safety investigations in NHS maternity services in England. This report summarises eight prominent themes that have emerged through analysis of completed maternity investigations, and how HSIB will explore these themes in more detail during the coming year. 
  10. Content Article
    This American Society for Reproductive Medicine (ASRM) guidance is in response to the coronavirus (COVID-19) global pandemic. Their goal is to provide practices with recommendations that guard the health and safety of their patients and staff, and recognise our social responsibility, as an organisation and as a community of providers and experts, to comply with national public health recommendations.
  11. News Article
    At least 20 maternity deaths or serious harm cases have been linked to a Devon hospital since 2008, according to NHS reports obtained by the BBC. A 2017 review which was never released raised "serious questions" about maternity care at North Devon District Hospital. The BBC spent two years trying to obtain the report and won access to it at a tribunal earlier this year. Northern Devon Healthcare NHS Trust (NDHT) said the unit was "completely different" after recommended reforms. A 2013 review by the Royal College of Obstetricians and Gynaecologists (RCOG) investigated 11 serious clinical incidents at the unit, dating back as far as 2008. The report identified failings in the working relationships at the unit, finding some midwives were working autonomously and some senior doctors failed to give guidance to junior colleagues. Despite the identified problems with "morale", the subsequent investigation by RCOG in 2017 expressed concerns with the "decision-making and clinical competency" of senior doctors and their co-operation with midwives. An independent review into midwifery in October 2017 noted "poor communication" between medical staff on the ward for more than a decade. The report identified a "lack of trust and respect" between staff and "anxiety" among senior midwives at the quality of care. Read full story Source: BBC News, 16 March 2020
  12. Content Article
    ECRI Institute's Top 10 Patient Safety Concerns for 2020 features new topics, with an emphasis on concerns that have the biggest potential impact on patient health across all care settings. However, the number one topic on this year's list is one revisited from 2019: missed and delayed diagnoses.
  13. News Article
    Incorrect use of menstrual cups could be resulting in some women suffering pelvic organ prolapse, the Victoria Derbyshire programme has been told. The Chartered Society of Physiotherapy wants some manufacturers to include better safety advice. Menstrual cups fit into the vagina and collect period blood. They are not currently regulated in the UK, and there is no safety testing. Menstrual cups, which can last up to 10 years, have grown in popularity as a more sustainable alternative to single-use tampons and pads. But there are claims that more education is needed before women decide to use them. There is limited research on the products, but in a report by the Lancet Public Health journal last year – which looked at 43 studies involving 3,300 women and girls living in rich and poor countries – the authors concluded menstrual cups were a "safe option". But the Chartered Society of Physiotherapy is calling for the cups, which are produced by a growing number of manufacturers worldwide, to be better regulated. Currently they are not safety-tested, and there is no industry standard or body responsible for collating complaints. Read full story Source: BBC News, 11 March 2020
  14. Content Article
    A patient shares her story of how catastrophic complications from a hysterectomy has changed her life forever.
  15. Content Article
    Rates of induction of labour have been increasing globally to up to one in three pregnancies in many high-income countries. Although guidelines around induction, and strength of the underlying evidence, vary considerably by indication, shared decision-making is increasingly recognised as key. The aim of this study, published in Women and birth, was to identify women’s mode of birth preferences and experiences of shared decision-making for induction of labour.
  16. Content Article
    This webpage from the Primary Care Women's Health Forum (PCWHF), contains the latest guidelines, patient materials and articles from the board alongside recommended external resources. Resources include: Intrauterine methods for all indications. How to manage contraceptive provision without face to face consultations. Having a pessary fitted for a vaginal prolapse. Advice following insertion or removal of your contraceptive implant.
  17. News Article
    More than 20 leading NHS doctors and experts back Baby Lifeline demand for safety training for maternity staff to cut £7m a day negligence costs The Independent’s maternity safety campaign goes to Downing Street today as senior figures from across the health service deliver a letter demanding action from prime minister Boris Johnson. Charity Baby Lifeline will be joined by bereaved families, Royal Colleges and senior midwives and doctors in Downing Street to hand in a letter calling on the government to reinstate a national fund for maternity safety training. Baby Lifeline, which has also launched an online petition today, said the government needed to find £19m to support training of both midwives and doctors to prevent deaths and brain damage, which can cost the NHS millions of pounds for a single case. The letter to Mr Johnson has also been signed by Dr Bill Kirkup, who led the investigation into baby deaths at the Morecambe Bay NHS trust and is investigating poor care at the East Kent Hospitals University Trust. He said: “There have been real improvements in maternity services, but as recent events in Kent and Shropshire have shown only too clearly, much more remains to be done. The Maternity Safety Training Fund is badly needed.” Sir Robert Francis QC, Chairman of the public inquiry into poor care at Stafford Hospital, who also signed, said: “The cost in lost and broken lives, not to mention the unsustainable financial burden and the distress of staff caused by these avoidable mistakes, is indefensible.” Other signatories included former health secretary Jeremy Hunt, the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists and a number of senior maternity figures, charities and clinical associations. Read full story Source: The Independent, 6 March 2020
  18. News Article
    An NHS trust at the centre of an inquiry into preventable baby deaths will repay money it received for providing good maternity care. In 2018, Shrewsbury and Telford NHS Trust received almost £1m, weeks before its services were rated inadequate. The BBC revealed in December the trust had qualified for the payment under the NHS's Maternity Incentive Scheme. The trust said an "incorrect submission" had been made and it had ordered an independent review. Shrewsbury and Telford NHS Trust (SaTH) is at the centre of England's largest inquiry into poor maternity care, with more than 900 families contacting a review looking into concerns over preventable deaths and long-term harm. Former health secretary Jeremy Hunt wrote to ministers questioning if improvements to the Maternity Incentive Scheme were needed in light of payments made to both Shrewsbury and Telford and East Kent Hospitals, despite both facing serious questions over the safety of maternity services. The trust in Shropshire was paid £963,391 after certifying it had met the 10 safety standards demanded by the scheme, which is run by NHS Resolution. In the letter, seen by the BBC, Mr Hunt suggested one improvement would be to link payments to CQC maternity and safety ratings. "The whole approach is likely to be discredited if trusts can meet all 10 actions and yet still be delivering poor standards of care," the letter said. Read full story Source: BBC News, 6 March 2020
  19. News Article
    The parents of a baby who nearly died after a series of failings during his birth said they were "heartbroken" mistakes continued to be made East Kent Hospitals told Harry Halligan's parents they would learn lessons from his delivery in 2012. But similar failings recently came to light after the death of Harry Richford in 2017 and the trust is now being probed over up to 15 baby deaths. The trust said it made "many changes to the maternity service" after 2012. Parents Dan and Alison Halligan, from New Romney, said watching news coverage of an inquest into Harry Richford's death earlier this year, which laid bare the failings, had brought back stressful memories. Mr Halligan said the trust "clearly haven't learned from [the] mistakes" made in his son's care, adding that it was "heartbreaking" to see "the same mistakes being repeated". Read full story Source: BBC News, 5 March 2020
  20. Content Article
    These controversial implants are used by medical professionals to treat stress incontinence and pelvic organ prolapse, both of which can occur after childbirth. But there’s a darker side to the mesh story, with many women left in excruciating pain, suffering long-term health problems as a result of being fitted with them. This article in Woman & Home explores the issues around vaginal mesh implants and speaks to women and campaigners.
  21. Community Post
    I have been looking into health campaigns recently. There seems to be many that are affecting womens health that are not being heard or taken seriously. Are there health inequalities at play here?
  22. News Article
    Every week for nearly a year, Lorraine Shilcock attended an hour-long counselling session paid for by the NHS. She needed the therapy, which ended in November, to cope with the terrifying nightmares that would wake her five or six times a night, and the haunting daytime flashbacks. Lorraine, 67, a retired textile worker from Desford, Leicester, has post-traumatic stress disorder (PTSD). Her psychological scars due to a routine NHS medical check, which was supposed to help her, not leave her suffering. In October 2018, Lorraine had a hysteroscopy, a common procedure to inspect the womb in women who have heavy or abnormal bleeding. The 30-minute procedure, performed in an outpatient clinic, is considered so routine that many women are told it will be no worse than a smear test and that, if they are worried about the pain, they can take a couple of paracetamol or ibuprofen immediately beforehand. Yet for Lorraine, and potentially thousands more women in the UK, that could not be further from the truth. Many who have had a hysteroscopy say the pain was the worst they have ever experienced, ahead of childbirth, broken bones, or even a ruptured appendix, commonly regarded as the most agonising medical emergency. Yet most had no warning it would be so traumatic, leaving some, like Lorraine, with long-term consequences. But, crucially, it is entirely avoidable. Do you have an experience you would like to share? Join our conversation on the hub on painful hysteroscopy. We are using this feedback and evidence to help campaign for safer, harm-free care. Read full story Source: Mail Online, 3 March 2020
  23. Content Article
    Do you see female patients? Do they have painful periods? Pain pre or post their periods? Painful sex? Do they suffer chronic pain, which may be intermittent or constant? Do they have pain when passing urine or with bowel movements? Is it painful to place a speculum for a smear test? Have you considered endometriosis? The Royal College of Nursing has provided a factsheet for nurses with guidance on how to recognise symptoms, setting out pathways of care and signposts to useful online resources.
  24. Content Article
    In this article, Berlanda et al. discuss the safety of different medical treatments for endometriosis to relieve pain.
  25. News Article
    Hundreds of women have said they’ve undergone “distressing” diagnostic tests at NHS hospitals which were not carried out in line with recommended practice. Around 520 women who attended NHS hospitals in England to undergo hysteroscopies — a procedure which uses narrow telescopes to examine the womb to diagnose the cause of heavy or abnormal bleeding — have told a survey their doctors carried on with their procedures even when they were in severe pain. This is despite the Royal College of Obstetricians and Gynaecologists advising clinicians should offer to reschedule with the use of general anaesthetic, epidural or sedation if the pain becomes unbearable. The Campaign Against Painful Hysteroscopy patient group has surveyed 860 women who had had the procedure at an English NHS hospital, and shared the results with HSJ. Of them, 750 said they were left distressed, tearful or shaken by the procedure, with around 466 of them saying that feeling remained for longer than a day. Many of the women said their painful hysteroscopies damaged their trust in healthcare professionals, had made cervical smears more painful and had a negative impact on sexual relationships. Patient Safety Learning have connected with the campaigning group 'Hysteroscopy Action' on this issue. We have seen stories and comments posted on the hub from patients who have suffered similar distressing experiences. We are using this feedback and evidence to help campaign for safer, harm-free care. We welcome others to join in the conversation. Read full story (paywalled) Source: HSJ, 2 March 2020
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