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Found 461 results
  1. Content Article
    The 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.
  2. News Article
    The UK response to the removal of the constitutional right to abortion in the US has been one of anger, sadness, and disbelief. The US Supreme Court has voted to overturn the 1973 case of Roe vs Wade, so in effect revoking the constitutional right to abortion that American women have had since the landmark decision. It means the 50 individual US states will be able to set their own abortion laws. Half are expected to ban abortions, some already have, and already clinics across the US have been closing down. The ruling has been widely condemned by the UK’s healthcare organisations, including the British Medical Association and the Royal College of Obstetricians and Gynaecologists. The BMA called it "deeply worrying for the future of women’s reproductive health". Dr Zoe Greaves, chair of the BMA’s medical ethics committee said: "Banning or severely restricting abortion prevents only the safe termination of pregnancy, it doesn’t prevent abortions. If women are denied necessary and appropriate care, they will be forced to travel out of their home state to access services, something which is also being suggested will be made illegal. It could also drive abortion services underground and lead to an increase in self-administered abortions, placing the most vulnerable of women at greatest risk of harm. Restricting abortion will harm ‘rural, minority and poor patients’ the most, according to leading health organisations in the US." Dr Helen Munro, vice-chair of the Faculty of Sexual and Reproductive Healthcare (FSRH) said: "Criminalising abortion and hampering access to care only serves to increase the number of unsafe abortions, putting women’s lives at risk. "All women should be able to receive prompt access to abortion services, which should include good pregnancy decision-making support and access to post-abortion contraception by trained healthcare professionals if they choose." Read full story Source: Medscape, 27 June 2022
  3. News Article
    Reproductive health doctors are reacting to the Supreme Court's decision to overturn Roe vs Wade, the 1973 case that allowed people to seek abortions with limited government intervention. On Friday, Justice Samuel Alito delivered his opinion on the case Dobbs vs Jackson Women's Health, saying he favoured the state of Mississippi in the case. Now, Roe vs Wade, which allowed abortion until about 24 weeks of pregnancy, is overruled, and individual states have the power to decide their residents' abortion rights. OBGYNs who provide abortion care and family-planning services told Insider they worry for their patients' health and safety, and the future of all reproductive healthcare including miscarriages, fertility treatments, and birth control. "This decision made by the SCOTUS is one that completely obliterates freedom from reproductive justice and women's health directly," Dr. Jessica Shepherd, a Texas-based gynecologist and Chief Medical Officer at Verywell Health, told Insider. Dr. Stephanie Ros, a Florida-based OBGYN, says she fears most for working-class abortion seekers. "I'm not worried about my wealthy patients – they will have the means to go 'visit an aunt' in Europe or elsewhere, and access abortion care if they so desire. I'm terrified for my middle class and poor patients, who don't have the means to pick up and travel on a moment's notice, and who often don't have access to medical care to even discover they're pregnant until later than their wealthy counterparts." Read full story Source: Insider, 24 June 2022
  4. News Article
    Diminishing rates of measles, mumps, and rubella (MMR) jabs have prompted a Royal College warning over the risks to pregnant women, as the NHS raises concerns over London “lagging” behind the national uptake. The Royal College of Paediatrics and Child Health’s immunisations lead, Dr Helen Bradford, said the falling uptake of the MMR vaccine could present a serious risk to pregnant women and their unborn children. The warning comes as London health authorities are planning a major summer drive to improve uptake in the capital, The Independent has learned. Documents seen by The Independent setting out NHS plans for a summer MMR campaign put the focus on social media, including approaching “influencers” to spread messages. The plans also rely on free publicity, with proposals to approach broadcast media. Risks to increasing uptake, according to the document, included anti-vaxx sentiment towards MMR, apathy towards the vaccine, controversy meaning influencers won’t work with the NHS, and a lack of internal data. Read full story Source: The Independent, 27 June 2022
  5. News Article
    The effects of the Supreme Court's proposed overrule of Roe vs Wade will touch health systems nationwide — leading some clinicians to urge industry leaders to start preparing for potential fallout prior to the decision. "Health systems that view abortion exclusively as a political or partisan issue, perhaps one they'd like to avoid, will soon bear witness to the reality that abortion care, or lack thereof, is a healthcare and health equity issue," Lisa Harris, MD, PhD, wrote in a 11 May for The New England Journal of Medicine. "Avoiding the issue will not be possible, short of abandoning care and equity missions altogether. Thoughtful preparation is needed now." Four leaders at three systems share there insights. Read full story Source: Becker's Hospital Review, 23 June 2022
  6. Content Article
    Derek 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.
  7. News Article
    Women including refugees, asylum seekers, and undocumented migrants are being charged as much as £14,000 to give birth on the NHS in England, a report by Doctors of the World (DOTW) has found. The report, which examined inequalities in maternity care among migrant pregnant women and babies, gathered the experiences of 257 pregnant women accessing DOTW’s services from 2017 to 2021. It found that over a third (38%) who accessed its services had been charged for healthcare, often inappropriately. The women were charged £296 to £14 000, and half of them were billed over £7000. The report said that inequalities in access to antenatal care experienced by migrant women were likely to lead to poorer outcomes for their pregnancy and the health of their children. The evidence highlights the need for urgent action to address the inequalities experienced by migrant pregnant women and their babies. There is a pressing need for immigration status to be considered as part of the ethnic and racial health inequalities agenda and for independent action to be taken to review the impact of NHS charging policy. Read full story (paywalled) Source: BMJ, 20 June 2022
  8. News Article
    More than 80% of UK medical certificates recording stillbirths contain errors, research reveals. More than half the inaccurate certificates contained a significant error that could cause medical staff to misinterpret what had happened. The study, published in the International Journal of Epidemiology, also shows that three out of four stillbirths certified as having an "unknown cause of death" could, in fact, be explained. A team from the Universities of Edinburgh and Manchester examined more than 1,120 medical certificates of stillbirths, which were issued at 76 UK obstetric units in 2018. Of the 421 which were resolved, 195 were re-designated as foetal growth restriction (FGR), and 184 as placental insufficiency. Dr Michael Rimmer, clinical research fellow at Edinburgh University’s MRC Centre for Reproductive Health, said: “This study shows some medical certificates of stillbirths contain significant errors. "Reducing these errors and accurately recording contributing factors to a stillbirth is important in shaping research and health policies aimed at reducing the number of stillbirths. Read full story Source: The Herald, 21 June 2022
  9. News Article
    A clinical trial to test pregnant women for Group B Strep (GBS) – the most common cause of life-threatening infection in newborn babies – will fail unless the Government intervenes, experts have warned. Some 80 hospitals are needed for the trial to go ahead but only 32 have committed to it, with a deadline for registering of September. The trial is being funded by the National Institute for Health Research (NIHR) and will look at whether testing women for Group B Strep reduces the risk of babies dying or suffering harm. Now Dr Jane Plumb, chief executive of Group B Strep Support, who lost her son Theo to the infection, is calling on the Government and NHS England to intervene to make sure the trial goes ahead. She said: “The reality is that unless a further 48 hospitals sign up for this trial, then it will fail. “The Government is waiting for the results from this trial to determine whether to test pregnant women for Group B Strep. “Yet there seems to be little acknowledgement that this trial is heading towards failure. “We need more hospitals on board and we need to make sure that the investment in this trial is not wasted. “This is about saving the lives of babies, and it really is now or never.” Read full story Source: The Independent, 20 June 2022
  10. News Article
    The language used around childbirth should be less judgemental and more personal, a report led by midwives has found. Most women consulted said terms such as "normal birth" should not be used, it says. The report recommends asking pregnant women what language feels right for them. Maternity care has been under the spotlight after a recent review found failures had led to baby deaths. The new guidance "puts women's choices at its heart, so that they are in the driving seat when it comes to how their labour and birth are described", Royal College of Midwives chief executive Gill Walton said. About 1,500 women who had given birth in the past five years gave their views. Most preferred the term "spontaneous vaginal birth" to "normal birth", "natural birth" or "unassisted birth". Words suggesting "failure", "incompetence" or "lack of maternal effort" should also be avoided, they said. They wanted labour and birth to be a positive experience and for the language used to be non-judgemental, accurate and clear. Read full story Source: BBC News, 15 June 2022
  11. Content Article
    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.
  12. News Article
    A woman who suffered six miscarriages lost her seventh baby after doctors delayed her caesarean section, a report has found. Chyril Hutchinson was admitted to hospital in February 2021 with high blood pressure when she was 37 weeks pregnant with her daughter Ceniyah Cienna Carter, and was told by doctors at Mid and South Essex NHS Foundation Trust she would need a caesarean. But the procedure was delayed as a result of staffing pressures and because Ms Hutchinson’s blood pressure stabilised. She was then told she would have to wait another two weeks for it to be carried out. Given her previous miscarriages, Ms Hutchinson said she pleaded for her baby to be delivered earlier, but her concerns were “dismissed” and she was sent home. Days later, a scan revealed that her baby had died. A trust investigation into Ms Hutchinson’s care found that staff had failed to properly monitor the growth of her baby, which could have indicated the need for an earlier delivery. The internal report, seen by The Independent, also revealed that on the day Ms Hutchinson was told she should have a casaerean, the hospital was six midwives short and the department was busy - a situation the trust said “places additional pressures and possible overload on medical staff”. However, the report concluded that staffing levels did not affect Ms Hutchinson’s care, and it did not state whether the wider failings had led directly to her child being stillborn. Read full story Source: The Independent, 5 June 2022
  13. News Article
    A London hospital has launched an investigation after a woman whose baby died in the womb had to deliver her son at home due to lack of beds and keep his remains in her fridge when A&E staff said they could not store them safely. Laura Brody and her partner, Lawrence, said they were “tipped into hell” after being sent home by university hospital Lewisham to await a bed when told their baby no longer had a heartbeat but no beds were immediately available to give birth, the BBC reported. Two days later, after waking up in severe pain, Brody, who was four months into her pregnancy, gave birth in agony on the toilet in their bathroom. “And it was then,” she told the broadcaster, “I saw it was a boy”. The couple, who wanted investigative tests to be carried out at a later time, dialled 999 but were told it was not an emergency. They wrapped their baby’s remains in a wet cloth, placed him in a Tupperware box, and went to A&E where they were told to wait in the general waiting room, they said. She was eventually taken into a bay and told she would require surgery to remove the placenta. But, with the waiting room hot and stuffy and staff refusing to store the remains or even look inside the Tupperware box, they decided as it got to midnight they had no option but for her partner to take their baby’s remains home. Brody said the whole experience “felt so grotesque”. “When things go wrong with pregnancy there are not the systems in place to help you, even with all the staff and their experts – and they are working really hard – the process is so flawed that it just felt like we had been tipped into hell,” she told Radio 4’s Today programme. The case is said to have raised wider concerns among campaigners who argue that miscarriage care needs to be properly prioritised within hospitals including A&E. Read full story Source: The Guardian, 30 May 2022
  14. News Article
    Black and Asian women are being harmed by racial discrimination in maternity care, according to an inquiry. The year-long investigation into "racial injustice" was conducted by the charity Birthrights. Women reported feeling unsafe, being denied pain relief, facing racial stereotyping about their pain tolerance, and microaggressions. The government has set up a taskforce to tackle racial disparities in maternity care. Hiral Varsani says she was traumatised by her treatment during the birth of her first child. The 31-year-old from north London developed sepsis - a potentially life-threatening reaction to an infection - after her labour was induced, which she says was only spotted after a long delay. "I was shivering, my whole body was aching, my heart was beating really fast and I felt terrible. But everyone kept saying everything was normal," she says. "It was almost 24 hours later before a doctor took my bloods for the first time and realised I was seriously ill." She believes her race played a role in her care: "I experienced microaggressions and was stereotyped because of the colour of my skin. "I was repeatedly ignored, they just thought I was a weak little Indian girl, who was unable to take pain." While death in pregnancy or childbirth is very rare in the UK, there are stark racial disparities in maternal mortality rates. Black women are more than four times more likely to die in pregnancy or childbirth than white women in the UK, while women from Asian backgrounds face almost twice the risk. Read full story Source: BBC News, 23 May 2022
  15. Content Article
    Systemic 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.
  16. Content Article
    Extreme 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.
  17. News Article
    Doctors are receiving "inadequate" training about the risk of sepsis after a mother-of-five died following an abortion, a coroner has warned. Sarah Dunn, 31, died of "natural causes contributed to by neglect" in hospital on 11 April 2020, an inquest found. Assistant coroner for Blackpool and Fylde, Louise Rae, said Ms Dunn had been treated as a Covid patient even though the "signs of sepsis were apparent". Her cause of death was recorded as "streptococcus sepsis following medical termination of pregnancy". In her record of inquest, the coroner noted Ms Dunn was admitted to Blackpool Victoria Hospital in Lancashire on 10 April 2020. She was suffering from a streptococcus infection caused by an early medical abortion on 23 March, which had produced sepsis and toxic shock by the time she was admitted to hospital. The coroner said "signs of sepsis were apparent" before and at the time of Ms Dunn's hospital admission but she was instead treated as a Covid-19 patient. "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," she added. Read full story Source: BBC News, 19 May 2022
  18. Content Article
    Sarah 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.
  19. Content Article
    The 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.
  20. Content Article
    Pregnant 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.
  21. News Article
    Women and babies in the UK are “dying needlessly” because of a lack of suitable medicines to use in pregnancy, according to a report that calls for a radical overhaul of maternal health. A “profound” shortage of research and the widespread exclusion of pregnant and breastfeeding women from clinical trials means hardly any new drugs are approved for common medical problems in pregnancy or soon after childbirth, the report finds. Meanwhile, scarce or contradictory information about the safety of existing medicines women may be taking for continuing conditions can make it impossible to reach a confident decision on whether or not to continue them in pregnancy, the experts add. “While pregnancy in the UK is generally considered safe, women and babies are still dying needlessly as a direct result of preventable pregnancy complications,” the authors say. Each year, 5,000 babies in the UK are either stillborn or die shortly after birth, while about 70 women die of complications in pregnancy. The Healthy Mum, Healthy Baby, Healthy Future report draws on evidence from patient groups, clinicians, researchers, lawyers, insurance specialists and the pharmaceutical industry, it proposes “urgent” changes to transform women’s access to modern medicine. The report highlights the “profound lack of research activity” and up-to-date information that leaves pregnant women and their physicians in the dark about whether to continue with certain medicines in pregnancy. Some epilepsy drugs, for example, can increase the risk of birth defects, but coming off them can put the woman at risk of severe seizures, which can also harm the baby. Lady Manningham-Buller said the situation “urgently needs to change”, with the report setting out eight recommendations to prevent needless deaths. Read full story Source: The Guardian, 12 May 2022
  22. News Article
    Three Senegalese midwives involved in the death of a woman in labour have been found guilty of not assisting someone in danger. They received six-month suspended sentences, after Astou Sokhna died while reportedly begging for a Caesarean. Her unborn child also died. Three other midwives who were also on trial were not found guilty The case caused a national outcry with President Macky Sall ordering an investigation. Mrs Sokhna was in her 30s when she passed away at a hospital in the northern town of Louga. During her reported 20-hour labour ordeal, her pleas to doctors to carry out a Caesarean were ignored because it had not been planned in advance, local media reported. The hospital even threatened to send her away if she kept insisting on the procedure, according to the press reports. Her husband, Modou Mboup, who was in court, told the AFP news agency that bringing the case to light was necessary. "We highlighted something that all Senegalese deplore about their hospitals," "If we stand idly by, there could be other Astou Sokhnas. We have to stand up so that something like this doesn't happen again." Read full story Source: BBC News, 11 May 2022
  23. Content Article
    In 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.
  24. News Article
    Covid-19 vaccines are safe for pregnant women to take and can even reduce the risk of stillbirths, according to a new study. Researchers at St George’s University of London and the Royal College of Obstetricians and Gynaecologists collated data from studies and trials involving over 115,000 vaccinated pregnant women. They found that pregnant women – who are more likely to become serious ill if they catch Covid-19 – are 15% less at risk of stillbirth if vaccinated. “We wanted to see if vaccination was safe or not for pregnant women,” said Asma Khalil, professor of obstetrics and maternal fetal medicine at London’s St George’s Hospital in London to The Guardian. “It is safe, but what’s surprising, and it’s a positive finding, is that there was a reduction in stillbirths.” “So far, most of the data on vaccines in pregnancy have been about protecting the pregnant woman herself from Covid. Now we have evidence that the vaccines protect the baby too,” she added. Read full story Source: The Independent, 10 May 2022
  25. News Article
    A woman whose baby died after sustaining severe brain damage during labour was not seen by an obstetrician during her pregnancy, an inquest heard. It meant his mother Eileen McCarthy was unable to discuss her birthing options. Walter German was starved of oxygen during a long labour at the Royal Sussex County Hospital in Brighton. Lawyers at Fieldfisher are pursuing a civil negligence case, claiming a C-section should have been offered due to a previous third-degree tear. Walter was born in December 2020. His life-support was turned off after nine days, as his injuries were unrecoverable. Recording a narrative verdict, coroner Sarah Clarke said Walter died as a result of his brain being starved of oxygen, likely due in part to an umbilical cord obstruction. She said: "Walter's mother was not seen by an obstetrician during her pregnancy and this led to her being unable to discuss birth options regarding delivery given her previous third degree tear. "Walter's mother was in the advanced stages of labour for a prolonged period of time with an indication for an earlier obstetric review being apparent." Read full story Source: BBC News, 4 May 2022
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