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EventThis webinar will feature two presentations on: Lancet article - Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study NMPA report - Ethnic and socio-economic inequalities in NHS maternity and perinatal care for women and their babies There will be a Q&A guest panel featuring: Professor Eddie Morris Clo and Tinuke, Five X more Bell Ribeiro-Addy MP Professor Jacqui Dunkley-Bent Professor Marian Knight Professor Asma Khalil Join the webinar on Microsoft Teams
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Content Article
In this blog, student midwife Sophie Dorman describes some of the issues that have led to a chronic shortage of midwives, including a culture of fear, poor pay and conditions and a lack of basic facilities for maternity staff. She highlights the impact this is having on the safety of maternity services and argues that valuing and looking after midwives will make pregnancy and childbirth safer and better for everyone. -
Content ArticleRepresentatives from Mesh Ireland and Mesh Survivors have this week appeared before the Oireachtas Health Committee, where questions were raised about access to vital diagnostic machines and treament for women who have had vaginal mesh implants put in. Vaginal mesh devices were used to treat issues in women after childbirth, or in their later years, and while it’s not known how many procedures were carried out, it’s believed there were more than 10,000 on the public system alone. Women have experienced painful complications as a result of the procedure and Founder of the Mesh Survivors Ireland Campaign, Melanie Power, who’s a solicitor from Meelick, says many women are unable to work and can’t afford the cost of ongoing treatment. She believes questions need to be answered on why women affected by a post-natal procedure which can cause chronic pain are being means tested for the medical card. Listen to the full interview on Clare FM below.
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Content ArticleThe maternity services at the Royal Devon and Exeter NHS Foundation Trust share their infographic which informs their staff of the 15 Immediate and Essential Actions from the Ockenden report and the action plan needed to implement these.
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Content ArticleDerek Richford shares Harry's Story from last year's HSJ Patient Safety Congress. Derek is grandfather of Harry Richford who died seven days after an emergency delivery at East Kent Hospitals Trust. Derek is joined by Donna Ockenden, Chair of the Independent review of maternity services at Shrewsbury & Telford Hospital, and Sarah-Jane Marsh, Chair of NHS England's Maternity transformation programme, in the 'Actioning recommendations from the Ockenden report' session at the Congress.
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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. -
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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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 ArticleExtreme preterm birth, defined as birth before 28 weeks’ gestational age affects about two to five in every 1000 pregnancies, and varies slightly by country and by definitions used. Severe maternal morbidity, including sepsis and peripartum haemorrhage, affects around a quarter of mothers delivering at these gestations. For the babies, survival and morbidity rates vary, particularly by gestational age at delivery but also according to other risk factors (birth weight and sex, for example) and by country. In this BMJ clinical update, Morgan et al. focuses on high income countries and provide a broad overview of extreme preterm birth epidemiology, recent changes, and best practices in obstetric and neonatal management, including new treatments such as antenatal magnesium sulphate or changes in delivery management such as delayed cord clamping and placental transfusion. The authors cover short and long term medical, psychological, and experiential consequences for individuals born extremely preterm, their mothers and families, as well as preventive measures that may reduce the incidence of extreme preterm birth.
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Content ArticleSarah Louise Dunn was admitted to the Blackpool Victoria Hospital on 10 April 2020. She was suffering from a Group A Streptococus infection following an early medical abortion on 23 March 2020 which by the time of her admission at hospital had produced sepsis and had progressed to toxic shock. Signs of sepsis were apparent before and on her admission given Sarah’s history and symptoms but Sarah was treated upon admission to hospital as a Covid-19 patient. Prior to admission, Sarah had not been seen by a doctor on either 9 or 10 April despite contacting both her GP surgery and the Out of Hours Service. The surgery pharmacist had not read Sarah’s notes properly and was not aware on 9 April that she had recently had undergone an early medical abortion. Her GP on 1 April had not recorded his face to face consultation with her nor noted the possibility of infection. Sepsis was not recognised or treated by the GP surgery, emergency department or Acute Medical Unit and upon Sarah’s arrival at hospital, the sepsis pathway was not followed. Antibiotics were not given to Sarah until 7.5 hours after her arrival at hospital. Sarah suffered a seizure at 6.30pm on the Acute Medical Unit and was transferred to the Intensive Care Unit. These matters in aggregate impacted on her care and Sarah would not have died had she been admitted to hospital sooner. Sarah died on 11 April 2020 on the Intensive Care Unit at Blackpool Victoria Hospital at 2.15am.
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Content ArticleThe Queen’s Speech was debated on Tuesday 17 May 2022. Copied below is Baroness Julia Cumberlege's excerpts on fulfilling the recommendations of the Cumberlege Report for a redress scheme.
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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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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 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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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. -
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 ArticleUnsafe maternity care has cost the National Health Service in England (NHS) £8.2bn in 15 years. How many more surveys of women’s experiences, reports of poor quality care and failings of senior management at NHS maternity units do we need to know that there is still a massive problem with maternity services in England? Judy Shakespeare, Elizabeth Duff and Debra Bick discuss why a joined-up policy and investment in maternity services is urgently needed.
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Content ArticleMidwives, public health nurses and practice nurses are in an ideal position to address mental health and emotional well-being with women in the perinatal period. However, research involving midwives, public health nurses and practice nurses in Ireland indicates that there is considerable variation in perinatal mental health assessment and care. All three groups identify the following issues as barriers to addressing perinatal mental health issues: Lack of knowledge on the range of perinatal mental health problems Lack of skill in opening a discussion and developing a plan of care with women Organisational issues, such as lack of policies, guidelines and care pathways This document produced by the Irish Health Service Executive, aims to provide an evidence-based guidance document for midwives, public health nurses and practice nurses in the area of perinatal mental health care.
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Content ArticleThis is an Early Day Motion tabled in the House of Commons on 5 September 2022, which calls on the Government to implement the recommendations of the Independent Medicines and Medical Devices Safety Review in full, in particular recommendation 4 of the report calling for the establishment of separate schemes to meet the costs of additional care and support to those who have suffered avoidable harm.
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Content ArticleResearch suggests that there is a wide gap in knowledge about how medical conditions affect men and women differently, and about the conditions that only affect women. As a result, women are receiving poorer medical advice and diagnosis, often leading to worse outcomes. This handbook published by digital healthcare provider Livi looks at some of the evidence surrounding sex-based health inequalities and how they are affecting women in the UK.
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Content ArticleIn this article, Maryanne Demasi looks at the continued prescription of Makena, an injectable synthetic hormone approved by the US Food and Drug Administration (FDA) to women who are at high-risk of premature delivery. Makena claims to reduce the risk of pre-term birth and was approved in 2011 on an accelerated pathway by the FDA following an initial trial that showed positive outcomes. However, Demasi explains, the study has been discredited as flawed in its methods and findings, and a confirmatory trial conducted by the manufacturer showed that Makena does not actually prevent preterm birth. In spite of this, and in the face of known risks, Makena is still being prescribed to pregnant women as the manufacturer has refused to withdraw it from the market. She highlights the dangers of the FDA not taking stronger action against the manufacturer of Makena, by looking at the example of Diethylstilbestrol (DES), a synthetic hormone use by women from the 1930's to the 1970s to prevent miscarriages and premature births. DES was later found to cause cancers, immune and cardiovascular disorders and other abnormalities in pregnant women, their children and their grandchildren.
