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Found 456 results
  1. Content Article
    A vision for improving the care and support available to families when baby loss occurs before 24 weeks' gestation.
  2. Content Article
    This story is part one of a series by AP News, examining the health disparities experienced by Black Americans across a lifetime.
  3. Content Article
    Postpartum hypertensive disorders pose a serious health risk to new mothers; nearly 75 percent of maternal deaths associated with hypertensive disorders occur in the postpartum period. For the past decade, the obstetrics department at the Hospital of the University of Pennsylvania (HUP) has tried to lower these risks by checking patients’ blood pressure after they are released from the hospital. Their initial efforts to have patients return to the office for an in-person blood pressure check shortly after discharge yielded disappointing results, so the team revamped their approach and ultimately developed an extremely successful program called Heart Safe Motherhood. The programme started when the team at HUP gave a small group of women a blood pressure cuff each. They told them they would receive text messages after discharge instructing them to take their blood pressure at 8am, and that they would need to send in the reading. At 1pm, they would get another text requesting that they send their blood pressure again. This article describes how Heart Safe Motherhood evolved to improve the likelihood of mothers submitting their readings, and how the programme was scaled up to five hospitals in the group. It looks at how the approach has helped tackled health inequalities and improved the safety of postpartum mothers.
  4. Content Article
    Visits from loved ones are vital to the health and wellbeing of people receiving care in care homes, hospitals and hospices. There have been concerns about visiting restrictions in health and care settings for several years, and the restrictions introduced in response to the COVID-19 pandemic exacerbated these concerns. While those restrictions were in place at the time to control the risk of transmission and keep people safe, it was detrimental for loved ones to have been kept apart or not to have had someone supporting them in hospital. Guidance is now clear that visiting should be encouraged and facilitated in all circumstances. This consultation seeks views on introducing secondary legislation to protect visiting as a fundamental standard across CQC-registered settings so that no one is denied reasonable access to visitors while they are resident in a care home, or a patient in hospital or a hospice. This includes accompanying people to hospital appointments (outpatients or diagnostic visits). Related reading on the hub: Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative
  5. Content Article
    Race and ethnicity have been associated with poor pregnancy outcomes in many countries. In the UK, the rates of baby death and stillbirth among Black and Asian mothers are double those for White women. Most studies examine trends for individual countries. This large database study explored how race and ethnicity is linked to pregnancy outcomes in wealthy countries. Key findings Black women consistently had worse outcomes than White women across the globe.  Hispanic women were three times more likely to experience baby death compared with White women.  South Asian women had an increased risk of early birth and having a baby with an unexpectedly low weight (small for the length of pregnancy) compared with White women.  Racial disparities in some outcomes were found in all regions. The researchers call for a global, joined-up approach to tackling disparities. Breaking down barriers to care for ethnic minorities, particularly Black women, could help. More research is needed to understand why outcomes are for worse for ethnic minorities. The researchers recommend routine collection of data on race and ethnicity. The link below takes you to the Plain English summary of the research, you can also view the full research study.
  6. Content Article
    In March 2019, NHS England published Saving Babies Lives version 2, which included information for providers and commissioners of maternity care on how to reduce perinatal mortality across England. One element of this recommends the appointment of a fetal monitoring lead with the responsibility of improving the standard of fetal monitoring. The aim of the fetal monitoring lead is to support staff working on the labour ward to provide high quality intrapartum risk assessments and accurate CTG interpretation and should contribute to building and sustaining a safety culture on the labour ward with all staff committed to continuous improvement. The importance of fetal monitoring was highlighted again in the Ockenden Report, published December 2020. The report recommended, as an essential action, that all maternity services must appoint a dedicated lead midwife and lead obstetrician, both with demonstrated expertise, to focus on and champion best practice in fetal monitoring. Monitoring May is a month long learning event based around fetal monitoring, human factors, maternity safety and shared learning. The East Midlands Academic Health Sciences Network has shared the recording of Monitoring May’s discussions and presentations.
  7. Content Article
    To support patients to understand the risks of taking sodium valproate during pregnancy, NHS England has launched two new shared decision-making tools. This is part of an NHS-wide effort to reduce the use of valproate in people who can get pregnant, and to help those that do continue with valproate to prevent pregnancies.
  8. Content Article
    Healthcare systems rely on self-advocacy from service users to maintain the safety and quality of care. Systemic bias, service pressures and workforce issues often deny agency to patients at times when they need to have most control over representation of their story. This drives diagnostic error, treatment delay or failure to treat important conditions. In maternal care, perinatal mental health and thrombosis are significant challenges. With funding from SBRI Health care, Ulster University and Southern Health and Social Care Trust are developing an NLP powered platform that will empower mothers to be more active agents in their perinatal care. Download the poster below.
  9. Content Article
    A new report presents the preliminary findings of the Care Post-Roe Study, and shows how US healthcare providers have been unable to provide the standard of care in states with abortion bans since the Supreme Court struck down Roe v. Wade ten months ago, leading to harm and negative health outcomes for patients. The report shows that healthcare providers have seen increased morbidity, exacerbated pregnancy complications, an inability to provide time-sensitive care, and increased delays in obtaining care for patients in states with abortion bans. This has impacted both patients and providers and has deepened the existing inequities in the health care system for people of colour.
  10. Content Article
    Pregnancy in women with aortic disease can be high risk. However, the risk can be reduced with the right care and planning. This leaflet developed by Aortic Dissection Awareness UK & Ireland, provides advice and guidance for women with aortic disease who are planning on having a baby.
  11. Content Article
    In 2022 the charities Sands and Tommy’s came together to form a Joint Policy Unit. Together they are focussed on achieving policy change that will save more babies’ lives during pregnancy and the neonatal period and on tackling inequalities in loss, so that everyone can benefit from the best possible outcomes. This first report from the Unit brings together a range of evidence to identify the key changes needed to save more babies’ lives and reduce inequalities in pregnancy and baby loss. None of the individual data it contains is new, but it gives decision makers a clear view of where we are now, and where action is required to make progress.
  12. News Article
    Geneticists have warned the public against buying polygenic risk score analyses, which some private fertility clinics claim can help parents using in vitro fertilisation in selecting embryos that carry the least risk of future disease. It appears that at least one child has been born after such a procedure, but the use of polygenic risk score analysis in this respect is severely limited. No evidence shows that these tests can predict the likelihood of an unborn child being liable to a specific disease in the future, representatives from the European Society of Human Genetics wrote in the European Journal of Human Genetics. Polygenic risk score analysis is mainly offered by fertility clinics in the US, although the practice is also being promoted in the UK. Patients need to be properly informed on the limitations of its use and a societal debate, focused on what should be considered acceptable with regard to the selection of individual traits, should take place before any further implementation of the technique in this population. Read full story (paywalled) Source: BMJ, 26 January 2022
  13. News Article
    An NHS England letter has warned of “significant variation” in the uptake of the COVID-19 vaccine amongst pregnant women, and called on systems to enable more “spontaneous” antenatal vaccination. In the letter, sent to integrated care system vaccination programme leads, ICS maternity leads and other NHS clinical directors, NHS England said that while the rates of women who had received at least two doses of the vaccine before giving birth was on the rise, there was “significant variation in uptake between regions and systems and in every system, between women of different ethnicities, decile of deprivation in their local area, and age groups”. The letter asks that covid vaccines are made available within antenatal clinics “to maximise uptake” and that partially vaccinated women “are offered vaccine confidence conversations and advised antenatally on the nearest available walk-in vaccinations”. Vaccination programme and maternity service leads have also been told to make use of resources and funding available to drive uptake in at-risk groups. It said: “Vaccination and maternity leads should discuss how this resource could be used to provide in-reach clinics within every maternity service, without creating additional burden on midwifery staff.” Read full story (paywalled) Source: HSJ, 26 January 2022
  14. News Article
    A woman has spoken of her "devastation" after losing a baby delivered while she was in an induced coma with Covid. Rachel, from Wolverhampton was admitted to hospital over the summer in the 19th week of pregnancy. She said uncertainty about whether pregnant women should have the Covid vaccine had put her off getting it. Her condition deteriorated and she said she was so ill she did not realise at first son Jaxon was stillborn. "I was heavily sedated a lot of the time and from what I'm told by my family, my chances weren't looking very good," the 38-year-old said. "They were trying to get the baby to survive to 28 weeks but unfortunately, at 24 weeks, my son was born stillborn." Rachel, who said she had planned to have the vaccine after giving birth, is now urging others to get the jab, particularly women from minority backgrounds, for whom uptake is lower. Read full story Source: BBC News, 15 January 2022
  15. News Article
    A new study has linked COVID-19 to complications during pregnancy. Scottish researchers found that women who catch the virus near the end of pregnancy were more vulnerable to birth-related complications. They are more likely to suffer them than women who catch Covid in early pregnancy or not at all. The researchers say getting vaccinated is crucial to protect pregnant women and their babies from life-threatening complications. The latest findings come from the Covid in Pregnancy Study (Cops), which carried out research across Scotland to learn about the incidence and outcomes of Covid-19 infection and vaccination in pregnancy. It is one of the first national studies of pregnancy and Covid. They found that preterm births, stillbirths and newborn deaths were more common among women who had the virus 28 days, or less, before their delivery date. The majority of complications occurred in unvaccinated women. The results, which have been published in Nature Medicine, come after recent data showed 98% of pregnant women admitted to UK intensive care units with coronavirus symptoms were unvaccinated. Researchers are now calling for measures to increase vaccine uptake in pregnant women. Read full story Source: BBC News, 13 January 2022
  16. News Article
    Pregnant women are being urged not to delay getting their Covid jab or booster in a government campaign. More than 96% of pregnant women admitted to hospital with Covid symptoms between May and October last year were unvaccinated, according to the UK Obstetric Surveillance System. The campaign will share testimonies of pregnant women who have had the jab on radio and social media. The government said the vaccine was safe and had no impact on fertility. In December, the Joint Committee on Vaccination and Immunisation added pregnant women to the priority list for the vaccine, saying they were at heightened risk from Covid. Around one in five pregnant women admitted to hospital with the virus needed to be delivered pre-term to help them recover, and one in five of their babies needed care in the neonatal unit, the Department of Health and Social Care (DHSC) said. Prof Lucy Chappell, chief scientific adviser to the DHSC, told BBC Radio 4's Today programme that a third of unvaccinated pregnant women with COVID-19 needed help with breathing and one in six were admitted to intensive care. "We've also seen stillbirths and neonatal deaths in the latest wave," she said. Prof Chappell said the vaccine causes pregnant women to produce antibodies against the virus, which cross over to their babies and give them protection too. Dr Jen Jardine, from the Royal College of Obstetricians and Gynaecologists, who is seven months pregnant and has had her booster jab, said: "Both as a doctor and pregnant mother myself, we can now be very confident that the Covid-19 vaccinations provide the best possible protection for you and your unborn child against this virus." Read full story Source: BBC News, 10 January 2022
  17. News Article
    A mum-of-four said she felt "fat-shamed" at a pregnancy scan and during follow-up appointments. Alexandra Dodds said her weight was raised at every appointment, and circled with a pen so vigorously in her notes that she wanted to lose them. "It was just kind of jokes, like 'hope you've stopped the Christmas snacks', or 'make sure you've thrown the box of chocolates away'," said Ms Dodds. "I didn't feel like it was said in a spiteful way to try to upset me, it was like banter, but I don't feel like you can banter about that," she added. Baby Brianna was born healthy at home before a midwife could arrive in July, last year. Alexandra said she only felt able to speak out about what she wanted during her pregnancy and labour because of three previous pregnancies. "If I feel any level of shame, that's just a clear indication that I have to talk about it, because it means I'm not the only person and other people will understand," she added. Joint research by Cardiff University and the British Pregnancy Advisory Service (BPAS) found women with higher BMIs felt stigmatised by risk messaging in maternity care. The Wrisk Project, which surveyed more than 7,000 women, looked at how risk is communicated in pregnancy following concerns it didn't always "reflect the evidence base". Clare Murphy, director of BPAS, said the work showed they hadn't got it right. "Pregnant women are often infantilized, and it feels like sometimes decisions are made about them, for them," she said. The Royal College of Midwives (RCM) said care should be based on respect and understanding of women's needs. Read full story Source: BBC News, 3 January 2021 Related resources My ob-gyn kept shaming me for my weight gain during pregnancy - patient video
  18. News Article
    Pregnant women say they are queuing for hours at busy vaccination centres for a booster jab, despite being at greater risk from Covid-19 if seriously ill. All adults in England, Scotland and Wales have been offered a booster by the end of 2021. Pregnant women have not been prioritised, but doctors say they should be first in line to protect them and their babies against Omicron. The NHS is urging people to book a jab appointment to avoid waiting in queues. And the UK's vaccine advisory committee, the JCVI, said women who were pregnant and already had two vaccine doses were included in the accelerated booster programme. However, the charity Pregnant Then Screwed said thousands of pregnant women had "encountered unnecessary barriers" which had "left many without the protection they need". Read full story Source: BBC News, 16 December 2021
  19. News Article
    "You hear his heartbeat and the next thing you know, you've got nothing." A woman whose son was stillborn has said she wants to change the law to enable an inquest to investigate the circumstances surrounding his death. Katie Wood's son Oscar was stillborn on 29 March 2015, but under law in England and Wales, inquests for stillborn babies cannot take place. A consultation was put out by the UK government in March 2019, but the findings have yet to be published. The UK government said it would set out its response in due course, but this delay was criticised by the House of Commons justice committee in September. Katie and her family said they have never received satisfactory answers about why Oscar died. Her pregnancy, while challenging, had not given any serious cause for concern. An investigation by the Aneurin Bevan health board found a number of failings in Katie's care. A post-mortem examination suggested a condition known as shoulder dystocia, where the baby's shoulder becomes stuck during birth, may have contributed, but this is rarely fatal. The health board said it conducted a serious incident investigation into Oscar's death and added: "Whilst we seek to find answers during any investigation, in some cases, a full understanding around the cause of death may not always be achieved and we accept the unavoidable distress this may pose for families." Clinical negligence and medical law specialist, Mari Rosser, says allowing coroners to look into the reasons for a baby's death is long overdue. "Currently parents who suffer a still birth can have the circumstances investigated, but the circumstances are investigated by the health board and of course that's less independent," she said. Read full story Source: BBC News, 9 December 2021
  20. News Article
    Women in prison are five times more likely to have a stillbirth and twice as likely to give birth to a premature baby that needs special care, new data collected by the Observer shows. Following two baby deaths in prisons since 2019 there have been increasing concerns about safety for pregnant women and their babies. Figures obtained through freedom of information requests made to 11 NHS trusts serving women’s prisons in England show 28% of the babies born to women serving a custodial sentence between 2015 and 2019 were admitted to a neonatal unit afterwards – double the national figure, according to data from the National Neonatal Research Database. The findings come as the House of Lords prepares to vote this week on proposed changes to bail and sentencing laws that would improve the rights of pregnant women and mothers facing criminal charges. A report published in September examined the circumstances of a baby’s death at Bronzefield prison in Surrey where an 18-year-old was left to give birth alone in her cell. When Anita rang her cell bell at 5.30am when she went into labour the guards said they would send somebody. It was only during the morning rounds at 7.30am that a nurse was called. She was transferred to hospital at 10.30am. Anita said: “Despite being in active labour the guards would not remove my handcuffs and ignored me when I asked them to call the baby’s father and my mum – who were eventually contacted by a doctor.” Read full story Source: The Guardian, 5 December 2021
  21. News Article
    The UK's Health Security Agency says its analysis of English data shows Covid vaccines are safe in pregnancy, reinforcing international evidence. The agency found similar rates of stillbirths and preterm births for vaccinated and unvaccinated mothers. Researchers say women should feel confident the jabs will help protect them and urge more to take them. Their report shows just 22% of women who gave birth in August had had at least one jab. Since mid-April, mothers-to-be have been offered the Pfizer-BioNTech or Moderna jab, with the second dose recommended eight weeks after the first. But women first eligible for vaccination were more likely to be older or have an underlying medical condition - putting them at higher risk of premature births, researchers say. Meanwhile, studies suggest about one in five women admitted to hospital with the virus have their babies delivered early and some of these babies need special intensive care. And evidence suggests the risks of stillbirths are higher if a woman has Covid in pregnancy. UKHSA immunisation head said the new information on safety was reassuring. "Every pregnant woman who has not yet been vaccinated should feel confident to go and get the jab and that this will help to prevent the serious consequences of catching Covid in pregnancy," she said. Read full story Source: BBC News, 26 November 2021
  22. News Article
    When the UK’s jab programme began, expectant mothers were told to steer clear – so Samantha decided to wait until she had had her baby. Two weeks after giving birth, she died in hospital from Covid. Samantha was unvaccinated – she had received advice against getting jabbed at an antenatal appointment. When the Covid vaccine programme began in the UK on 8 December 2020, pregnant women were told not to get vaccinated. But in October 2020, the Royal College of Obstetricians and Gynaecologists (RCOG) published guidance warning that “intensive care admission may be more common in pregnant women with Covid-19 than in non-pregnant women of the same age” and that pregnant women with Covid were three times more likely to have a preterm birth. Further evidence emerged in 2021 indicating that pregnant women were particularly vulnerable to Covid, especially in their final trimester. Research from the University of Washington, published in January, found that pregnant women were 13 times more likely to die from Covid than people of a similar age who were not pregnant. But throughout February and March, the JCVI’s scientists did not appear especially concerned about examining the case for vaccinating pregnant women. Priority in the early stages of the vaccine programme was being given to older people, so many pregnant women remained towards the back of the queue. The maternity campaign group Pregnant Then Screwed said: “If you look at who was on the Covid war cabinet and leading the daily briefing, it was nearly all men,” says Joeli Brearley, its founder. “Pregnant women were treated as if they were very similar to the general population, rather than being seen as a special cohort that needs special consideration. They were just not a priority.” Read full story Source: The Guardian, 23 November 2021
  23. News Article
    Women who experience bleeding in early pregnancy and have had at least one miscarriage should be treated with the hormone progesterone. The new guidance, from the National Institute for Health and Care Excellence (NICE), is based on research suggesting the treatment could lead to 8,450 more births each year in the UK. The more miscarriages a woman had, the more effective progesterone was, the trial found. The naturally occurring hormone helps prepare the womb for the growing baby. About one in five women experience bleeding, or spotting as it is sometimes called, in the first 12 weeks of pregnancy. It often causes no problems but they are advised to have it checked out with their doctor or midwife to be sure. Some may experience a "threatened miscarriage", where bleeding continues along with the pregnancy. Most are told to go home and wait and see what happens next. The new (NICE) guidance recommends inserting progesterone pessaries into the vagina twice a day. A trial carried out by researchers at the Tommy's National Centre for Miscarriage Research which the new guidance is based on, found that progesterone didn't make much of a difference for women who just had bleeding and no previous miscarriages. But the more miscarriages a woman had suffered, the more effective progesterone was. One of those behind the Tommy's National Centre for Miscarriage Research research, Prof Arri Coomarasamy, from the University of Birmingham, said: "This is a very significant moment. "We have an intervention that works that can stop a miscarriage. This gives hope to thousands of couples throughout UK." "But it's really important to appreciate that only some miscarriages can be prevented by progesterone." "There are other causes for miscarriages." "We still need to study them. We need to find other effective treatment." Read full story Source: BBC News, 24 November 2021
  24. News Article
    The increased risk of black and minority ethnic women dying during pregnancy needs to be seen as a whole system problem and not limited to just maternity departments, according to experts on an exclusive panel hosted by The Independent. Professor Marian Knight, from Oxford University told the virtual event on Wednesday night that the health service needed to change its approach to caring for ethnic minority women in a wider context. Campaigners Tinuke Awe and Clotilde Rebecca Abe, from the Fivexmore campaign, called for changes to the way midwives were trained and demanded it was time to “decolonise the curriculum” so it recognised the physiological differences between some ethnic minority women and white women. Dr Mary Ross-Davie, from the Royal College of Midwives, said work was underway to ensure the voices of black women and other minorities were represented in its work and it was examining how it could deliver better training to midwives. The data on maternity deaths in the UK show black women are four times more likely to die during pregnancy in the UK than white women. For Asian women, they are twice as likely to die. Read full story and watch video of event Source: The Independent, 18 November 2021
  25. News Article
    Researchers are to use artificial intelligence (AI) in the hope of reducing risk to pregnant black women. Loughborough University experts are to work with the Healthcare Safety Investigation Branch (HSIB) to identify patterns in its recent investigations. Research has suggested black women are more than four times more likely to die in pregnancy or childbirth than white women in the UK. The researchers plan to look at more than 600 of HSIB's recent investigations into adverse outcomes during pregnancy and birth. The research team will develop a machine learning system capable of identifying factors, based on a set of codes, that contribute to harm during pregnancy and birth experienced by black families. These include biological factors, such as obesity or birth history; social and economic factors such as language barriers and unemployment; and the quality of care and communication with the mother. It will look at how these elements interact with and influence each other, and help researchers design ways to improve the care of black mothers and babies. Dr Patrick Waterson, from the university, who is helping to lead the project, said: "Ultimately, we believe the outcomes from our research have the potential to transform the NHS's ability to reduce maternal harm amongst mothers from black ethnic groups." He added that in the longer term, the research could improve patient safety for all mothers. Read full story Source: BBC News, 17 November 2021
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