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  1. News Article
    When pharmacist Ifeoma Onwuka, known to her friends as Laura, went into hospital to have her daughter, she and her husband hoped the delivery would go smoothly, and that they would soon be able to take their new arrival home  to meet her siblings.  Onwuka's labor was induced at James Paget University Hospital in Great Yarmouth in late April 2018. Things progressed quickly and there were soon signs that her baby was in distress, causing staff to begin preparations for an emergency Caesarian section, but Onwuka's daughter was born in the recovery room. Shortly after the birth, Onwuka's condition began to deteriorate. According to the family's lawyer, Tim Deeming, she began to bleed heavily, and was taken into surgery where attempts were made to stem the loss of blood. Hours later, and only after a second consultant had been called in, she was given an emergency hysterectomy. The mother-of-three died three days later. The coroner, Yvonne Blake, said an expert had told Onwuka's inquest that the delay to surgery contributed to her death, since acting early could have controlled the bleeding.  Black mothers have worse outcomes during pregnancy or childbirth than any other ethnic group in England. According to the latest confidential inquiry into maternal deaths (MBRRACE-UK). Black people in England are four times more likely to die in pregnancy or within the first six weeks of childbirth than their White counterparts.  Read full story Source: CNN. 14 January 2021
  2. Content Article
    The majority of recommendations which MBRRACE-UK assessors have identified to improve care are drawn directly from existing guidance or reports and denote areas where implementation of existing guidance needs strengthening. In a small number of instances, actions are needed for which national guidelines are not available. These are included below. To access the report and the full list of recommendations, please click on the link at the bottom of this page. New recommendations to improve care: For professional organisations 1. Develop guidance to ensure SUDEP awareness, risk assessment and risk minimisation is standard care for women with epilepsy before, during and after pregnancy and ensure this is embedded in pathways of care. [ACTION: Royal Colleges of Obstetricians and Gynaecologists, Physicians]. 2. Develop guidance to indicate the need for definitive radiological diagnosis in women who have an inconclusive VQ scan [ACTION: Royal Colleges of Physicians, Radiologists, Obstetricians and Gynaecologists]. 3. Produce guidance on which bedside tests should be used for assessment of coagulation and the required training to perform and interpret those tests [ACTION: Royal Colleges of Anaesthetists, Obstetricians and Gynaecologists, Physicians] 4. Establish a mechanism to disseminate the learning from this report, not only to maternity staff, but more widely to GPs, emergency department practitioners, physicians and surgeons [ACTION: Academy of Medical Royal Colleges]. For policy makers, service planners/commissioners and service managers 5. Develop clear standards of care for joint maternity and neurology services, which allow for: early referral in pregnancy, particularly if pregnancy is unplanned, to optimise anti-epileptic drug regimens; rapid referral for neurology review if women have worsening epilepsy symptoms; pathways for immediate advice for junior staff out of hours; postnatal review to ensure anti-epileptic drug doses are appropriately adjusted [ACTION: NHSE/I and equivalents in the devolved nations and Ireland]. 6. Ensure each regional maternal medicine network has a pathway to enable women to access their designated epilepsy care team within a maximum of two weeks. [ACTION: Maternal Medicine Networks and equivalent structures in Ireland and the devolved nations]. 7. Ensure all maternity units have access to an epilepsy team [ACTION: Service Planners/Commissioners, Hospitals/Trusts/Health Boards]. 8. Establish pathways to facilitate rapid specialist stroke care for women with stroke diagnosed in inpatient maternity settings [ACTION: Service Planners/Commissioners, Hospitals/Trusts/Health Boards]. 9. Provide specialist multidisciplinary care for pregnant women who have had bariatric surgery by a team who have expertise in bariatric disorders [ACTION: Service Planners/Commissioners, Hospitals/Trusts/Health Boards]. 10. Use the scenarios identified from review of the care of women who died for ‘skills and drills’ training [ACTION: Hospitals/Trusts/Health Boards]. 11. Ensure early senior involvement in the care of women with extremely preterm prelabour rupture of membranes and a full explanation of the risks and benefits of continuing the pregnancy. This should include discussion of termination of pregnancy [ACTION: Hospitals/Trusts/Health Boards]. For health professionals 12. Regard nocturnal seizures as a ‘red flag’ indicating women with epilepsy need urgent referral to an epilepsy service or obstetric physician [ACTION: All Health Professionals]. 13. Ensure that women on prophylactic and treatment dose anticoagulation have a structured management plan to guide practitioners during the antenatal, intrapartum and postpartum period [ACTION: All HealthProfessionals]. 14. Ensure at least one senior clinician takes a ‘helicopter view’ of the management of a woman with major obstetric haemorrhage to coordinate all aspects of care [ACTION: All Health Professionals]. iv MBRRACE-UK - Saving Lives, Improving Mothers’ Care 2020 15. Ensure that the response to obstetric haemorrhage is tailored to the proportionate blood loss as a percentage of circulating blood volume based on a woman’s body weight [ACTION: All Health Professionals]. 16. Do not perform controlled cord traction if there are no signs of placental separation (blood loss and lengthening of the cord) and take steps to manage the placenta as retained [ACTION: All Health Professionals]. 17. Be aware that signs of uterine inversion include pain when attempting to deliver the placenta, a rapid deterioration of maternal condition and a loss of fundal height without delivery of the placenta [ACTION: All Health Professionals].
  3. News Article
    More women may suffer pain due to being conscious while undergoing caesareans or other pregnancy-related surgery under general anaesthetic than realised, a troubling new study has found. The report, conducted by medical journal Anaesthesia, found being awake while having a caesarean is far more common than it is with other types of surgery. Researchers discovered that one in 256 women going through pregnancy-related surgery are aware of what was going on — a far higher proportion than the one in every 19,000 identified in a previous national audit. If a patient is conscious at some point while under general anaesthetic, they may be able to recall events from the surgery such as pain or the sensation of being trapped, the researchers said. While the experiences generally only last for a few seconds or minutes, anaesthetists remain highly concerned. Women also felt tugging, stitching, feelings of dissociation and not being able to breathe - with some suffering long-term psychological damage that often involved characteristics of post-traumatic stress disorder. Read full story Source: The Independent, 13 January 2021
  4. News Article
    Thousands of women have had abortions after falling pregnant while having difficulties accessing contraception during the pandemic, healthcare providers have warned. Sexual health clinics have been forced to shut or run reduced services while staff are transferred to work with Covid patients or have to self-isolate – with the profound disruption leaving many women unable to access their usual methods of contraception. Many women are struggling to get the most effective long-acting contraceptive choices of a coil or an implant due to these requiring face-to-face appointments which have largely been suspended as consultations are carried out remotely via phone or video call to curb the spread of COVID-19. British Pregnancy Advisory Service, the UK's largest abortion provider, told The Independent they provided the progestogen-only contraceptive pill to almost 10,000 women undergoing an abortion between May and October last year. Katherine O’Brien, a spokesperson for the service, said: “Many of these women will have fallen pregnant after struggling to access contraception, so there really is a huge unmet need for contraceptive services which will only worsen as lockdown and Covid continues. “We routinely hear from women during the pandemic who simply can’t access their regular method of contraception because of clinics closing or staff being deployed elsewhere or staff self-isolating.” Read full story Source: The Independent, 9 January 2021
  5. News Article
    Rachel Hardeman has dedicated her career to fighting racism and the harm it has inflicted on the health of Black Americans. As a reproductive health equity researcher, she has been especially disturbed by the disproportionately high mortality rates for Black babies. In an effort to find some of the reasons behind the high death rates, Hardeman, an associate professor at the University of Minnesota School of Public Health, and three other researchers combed through the records of 1.8 million Florida hospital births between 1992 and 2015 looking for clues. They found a tantalising statistic. Although Black newborns are three times as likely to die as White newborns, when Black babies are delivered by Black doctors, their mortality rate is cut in half. "Strikingly, these effects appear to manifest more strongly in more complicated cases," the researchers wrote, "and when hospitals deliver more Black newborns." They found no similar relationship between White doctors and White births. Nor did they find a difference in maternal death rates when the doctor's race was the same as the patient's. Read full story Research paper Source: The Washington Post, 9 January 2021
  6. Content Article
    The MHRA safety review examined safety data for risks of major birth defects or abnormalities and concerns with the child’s development including learning and thinking abilities for other key antiepileptic drugs. It found that a number of these epilepsy medicines may be associated with some increased risks in pregnancy. Valproate (Epilim) is already known to be seriously harmful if taken in pregnancy and should only be prescribed to a woman if a pregnancy prevention plan is in place. Importantly, two antiepileptic medicines in particular, lamotrigine (Lamictal) and levetiracetam (Keppra), have both been found to be safer than other antiepileptic drugs in pregnancy. The MHRA advises patients never to stop taking their current epilepsy medicines without first discussing it with a healthcare professional. Dr Sarah Branch, Director of MHRA’s Vigilance and Risk Management of Medicines Division said: "Patient safety is our highest priority, and we are committed to making sure women are aware of the risks of taking certain epilepsy medicines during pregnancy, particularly valproate." "We have shared this important review with doctor and nurses so they can use it to inform discussions with their patients." "If a woman is planning to become pregnant, and is taking a medicine for epilepsy, even if this is some time in the future, it is very important that she should discuss with a healthcare professional the right treatment for her, taking into account the results of this review." "It is vitally important that women don’t ever stop taking any epilepsy medicine without discussing it first with a healthcare professional."
  7. News Article
    Pregnant women should be allowed to have one person alongside them during scans, appointments, labour and birth, under new NHS guidance sent to trusts in England. The chosen person should be regarded as "an integral part of both the woman and baby's care" - not just a visitor. Previously, individual hospitals could draw up their own rules on partners being present. This meant many women were left to give birth alone. The guidance says pregnant women "value the support from a partner, relative, friend or other person through pregnancy and childbirth, as it facilitates emotional wellbeing". Women should therefore have access to support "at all times during their maternity journey". And trusts should make it easy for this to happen, while keeping the risk of coronavirus transmission within NHS maternity services as low as possible. Read full story Source: BBC News, 16 December 2020
  8. Content Article
    Can you tell us a bit about yourself and your role? I am a Consultant Midwife, there are around 100 of us in the UK. I have a relatively unique role in that I spend 50% of my time in the Trust and 50% of my time at the University. I’m currently leading the development and implementation of continuity in Worcestershire. When did you first work in a Continuity of Carer (CoC) model? I became a caseload midwife (CoC) within weeks of qualifying as I knew this was the way that I wanted to practice, and the first team was being set up locally within a designated Sure Start area. Although I have had a number of different roles in the NHS, this was definitely one of the most formative. Can you tell us more about your experience? It was an amazing job. I had a fantastic and supportive team and the families cared about us too. Because of the relationship we had with our women, we could see when things were not well or had deviated from what would be expected. Women never called us in the middle of the night unless they needed us, so when those calls came in, we knew how to react based on the woman herself and navigate the system on her behalf. This was especially important where some of our families could not advocate for themselves as they were new to the country, had limited English or were socially vulnerable. We became a part of that community. How would you describe the CoC model you are rolling out in Worcestershire? We have a mixed risk model, based on postcodes. Midwives work in a small team of no more than eight, organising their own workload and availability. The teams cover 24/7 availability sharing the responsibility of this. How do you think CoC can impact on patient safety? Continuity of carer absolutely impacts patient safety, both physical safety and psychological safety. Pregnancy and childbirth are intense, life changing events and each woman and her family will have different needs as well as perception of risk/safety. The relationship that is built over time gives a platform for women and midwives to work through these together, advocating and working with the multi-disciplinary team (MDT) to ensure the safest care is achieved with the woman in control of her care. CoC midwives also have flexibility in the way that they work to meet the needs of those in their care. If more time is needed with a family, then that is what happens. Do you have any statistics or data to highlight the impact of CoC? Our first year statistics showed an overall decrease in medical intervention and an increased choice to have babies at home and in midwifery led units. Care is wrapped around the women and they drive the choices about their care and their birth. The midwives support them and navigate the system with them. The diagram below shows data for the first two teams at the end of their first year (there is a downloadable version attached at the bottom of this page too). What are the barriers to implementing CoC? There remains significant mythology about what continuity of carer is and isn’t. For this reason, many midwives may be reluctant to work in these models as they perceive that they will be working more than they are now. The relationship established with women actually reduces workload, as when they call you, or are in labour, you know who they are and their history. Also, the NHS has had a fairly prescriptive approach to system set up and this all changes when you work in continuity of carer teams. The team is given the autonomy to self-manage their daily work, their annual leave and how they cover availability. What support do maternity teams and individual staff members need to successfully implement CoC? This needs to be a whole system approach. Individual midwifery CoC teams can support each other, but the wider maternity team need to understand the role of the CoC midwife and how all members of the multi-disciplinary team are involved with care. Teams also need to learn to work together and negotiate their time with each other. There is a learning curve to this. The whole system is learning as well as teams and the individuals within it. Also, there is a 'bedding in' period that can take some time. This is so new and because each team will develop their 'own way' there is no one size fits all (much like the care that they provide!). Do you have any advice for maternity teams considering setting up the CoC model? Do it! It is an incredible way to work. Empowered teams will empower families. Embrace the journey, work together, establish team rules and philosophy at the start and review regularly and most of all, communicate. Any final thoughts? I’m really passionate that we roll out CoC for most women and that we do it in a sustainable and effective way. I think that it is a bold and brave move forward, and is of significant benefit to service users, midwives and the system. I have worked in this way and found that the relationship and trust built with the families and the team was unmeasurable. On a more personal note, I gave birth to all of my children in this model and know first-hand how much this can impact confidence and trust not only in yourself, but those caring for you.
  9. News Article
    A prominent feminist campaigner and writer has described in devastating detail how she was left feeling “humiliated and alone” as she was forced to deal with a miscarriage without her partner. Caroline Criado Perez, the author of Invisible Women, called on NHS trusts to allow partners to attend medical appointments, scans and emergencies in maternity services, because the refusal to do so was “traumatising an already traumatised woman”. She added: “It needs to stop, now.” At the start of the coronavirus crisis, the majority of NHS trusts began preventing partners from accompanying pregnant women to the majority of maternity appointments, and reports suggest this is still the case in many areas. In September the Guardian revealed that three-quarters of NHS trusts were not allowing birth partners to support women throughout their whole labour, despite being told by the NHS and Boris Johnson to urgently change the rules on visiting. According to a November survey by the campaign group Pregnant Then Screwed (PTS), 82% of respondents said their local hospital had restrictions in place (for labour or scans), while 90% said that these restrictions were having a negative impact on their mental health. Read full story Source: The Guardian, 9 December 2020
  10. News Article
    Coronavirus has not caused an increase in stillbirths despite fears it could do so, Government data suggests. The Office for National Statistics (ONS) published data on Monday showing that the stillbirth rate decreased from 4.0 stillbirths per 1,000 total births in 2019, to 3.9 in the first three quarters (January to September) of 2020, in line with the long-term trend. The data comes amid fears that coronavirus can impact pregnancy and the stillbirth rate. Read full story Source: The Telegraph, 8 December 2020
  11. Content Article
    Written Questions are a parliamentary mechanism by which Members of the Senedd can table questions specifically for a written answer by the Welsh Government or the Senedd Commission. Laura Anne Jones MS asked what progress had been made in Wales in implementing the findings of the Cumberlege Review (The Independent Medicines and Medical Devices Review). This review examined how the healthcare system in England responds to reports about the harmful side effects from medicines and medical devices and consider how it could respond to them more quickly and effectively in the future. Vaughan Gething MS, Minister for Health and Social Services, responded as follows: The Cumberlege recommendations are primarily focused on England but they have implications for Wales. I issued a written statement on 15 July about the Cumberlege review: https://gov.wales/written-statement-baroness-cumberleges-announcement-use-surgical-mesh In that statement, I said the principle of high vigilance to ensure mesh use is restricted until the same conditions Baroness Cumberlege identified in her report are met should also apply in Wales. Her recommendations were consistent with those made by the review panel, which I set up at the end of 2019. It is my expectation that sufficient levels of clinical governance, including consent, audit and research are in place in health boards in Wales to ensure all women can be confident that all possible safeguards are in place. The evidence we have already of a significant reduction in the use of vaginal mesh procedures in Wales suggests a “pause” is already largely in place, driven by a change in clinical decision making during recent years. However, it is my expectation that these additional restrictions will be the case until the requirements for increased safeguards can be met. Action has already been taken on some of the recommendations. Specialist mesh centres have been identified in Swansea and Cardiff and work is underway in establishing a UK-wide medical device information system. In addition, the Women’s Health Implementation Group will be tasked with considering many of the recommendations of the Cumberlege review as they pertain to mesh, as this is consistent with work the group is already doing in this area. My officials are examining the other recommendations which relate to Wales and are working with the other UK governments to look at those recommendations with a UK remit. The Medicines and Medical Devices Bill, currently before the House of Lords, will also impact in relevant areas. I will issue a further statement when officials have completed their assessment of the options available and their implications for the future effectiveness of Wales’ healthcare service.
  12. News Article
    BBC News investigation has uncovered failures in the diagnosis of serious medical issues during private baby scans. More than 200 studios across the UK now sell ultrasound scans, with hundreds of thousands being carried out each year. But the BBC has found evidence of women not being told about serious conditions and abnormalities. The Care Quality Commission says there is good quality care in the industry but it has a "growing concern". Private baby scanning studios offer a variety of services. Some diagnose medical issues while others market themselves as providers of souvenir images or video of the ultrasound. Most sell packages providing a "reassurance scan" to expectant mums. Many women BBC News spoke to said they had positive experiences at private studios, but we have also learned of instances where women said they were failed. Charlotte, from Manchester, attended a scan in Salford with one of the biggest franchises, Window to the Womb, to record her baby's sex for a party and check its wellbeing. BBC News has learned the sonographer identified a serious abnormality that meant the baby could not survive, where part or all of its head is missing, called anencephaly. But rather than refer her immediately to hospital and provide a medical report, Charlotte was told the baby's head could not be fully seen and recommended to book an NHS anomaly scan. She was also given a gender reveal cannon and a teddy bear containing a recording of its heartbeat as a present for her daughter. "I was distraught," Charlotte said. "You've bonded with that baby." "It's like a deep cut feeling," she added. "All of it could have just been avoided, we could have processed the news all together as a family because I was with my mum and dad, I would have had the support there." Read full story Source: BBC News, 18 November 2020
  13. Content Article
    The benefits of Continuity of Carer (CoC) within antenatal and postnatal care, and the implications for patient safety are well reported. As a midwife, to know the person from booking to postnatal means I am aware when their mental health may be deteriorating, or when they may be experiencing relationship difficulties. It also makes me feel more confident to challenge situations, including potential safeguarding concerns or welfare issues. If a person trusts in their relationship with their midwife, they are more likely to confide that they are struggling, and we'll be better placed to support their health needs. Supporting people within their wider context Community midwifery is not just caring for a person’s physical needs. It’s knowing their family, their housing situation, their past social history, understanding their vulnerabilities and hearing them when they tell us that something isn’t right – whether that be in relation to their pregnancy, their relationship or their mood. This is incredibly difficult to achieve without CoC and is frustrating for both midwives and pregnant people. Midwives want to offer excellent care and pregnant people deserve excellent care. I recently visited a family who were struggling financially. Although I was aware of their financial predicaments, I had no idea the extent of the issue. I went one afternoon for an antenatal visit. The atmosphere was very tense, and I had heard raised voices upon approaching the house. When I entered the house, their child was crying and shouting, and the parents were distressed. Because of the strength of the relationship we had developed during the pregnancy, I felt able to challenge the couple about what was happening and what I was experiencing with regard to the tension between them. I was informed they had no food and had to get through the weekend with nothing to eat. The mother had been too scared to tell anyone in case her children were taken away from her. This opened up a conversation about their welfare generally and we were able to work together, with other support services, to meet the immediate crisis and attempt to start dealing with the ongoing issues. Monitoring mental health Another person disclosed at booking some historical mental health issues. She had been fine for a few years and had not required treatment recently. During an appointment a few months later, I felt I wasn’t experiencing her like I usually did. It wasn’t anything obvious just a ‘sense’ that she was holding something back. I gently probed her, and she informed me she had been struggling with anxiety in relation to hypervigilance regarding the baby’s movements. We spent some time working on strategies to manage this anxiety and, aware of the clock ticking during a short antenatal appointment, I arranged to see her for a double appointment at my next clinic and referred her to the mental health midwife for ongoing support. In times of loss Something we rarely talk about as midwives is loss. Caring for a family from booking, to finding out the baby had died, to birth and beyond, taught me a lot about the power of CoC. Being present when the couple met their baby and supporting them for as long as they needed postnatally was an enormous privilege. Although challenging because of the depth of grief, knowing I could make a small difference to their experience, because I knew them and they trusted me, meant we were able to discuss very difficult decisions over a cup of tea whilst the other children ran around us bringing a level of normality to a very awful situation. Relationships matter I have received some amazing feedback from families regarding CoC. Recently a woman said that the strength of our relationship was important to her because she trusted my judgement and ability to advocate for her. She said her experience of CoC had made something that was terrifying to her “not so scary”. Thank you cards I have received always comment on the strength of the relationship. Over and above any other element of care a person has received during the pregnancy continuum, the relationship and the patient feeling like I ‘know’ them is what they reflect on when we are saying goodbye (which is the hardest part of this model of care!). As a midwife I get amazing job satisfaction from taking a family from booking to birth to discharge. The privilege of being present during such a life altering time in a family’s life whether it be a first baby or tenth baby, leaves a mark. Every family I look after leaves a footprint. If you'd like to share your thoughts on the Midwifery Continuity of Carer model, you can join the conversation here.
  14. News Article
    Expectant mothers are being warned about potentially confusing guidance on consuming caffeine while pregnant, as research suggests energy drinks could have potentially deadly consequences for their babies. A new report by Tommy’s Maternal and Fetal Health Research Centre claims to have established a 27 per cent rise in the risk of stillbirth for each 100mg of caffeine consumed. Researchers compared stillbirths to ongoing pregnancies among 1,000 women across 41 hospitals from 2014 to 2016 as well as interviewing women about their consumption of caffeinated drinks. They adjusted for demographic and behavioural factors, such as age and alcohol consumption, to determine whether stillbirth was linked to caffeine. One in 20 women were found to have increased their caffeine intake while pregnant in spite of evidence some caffeinated drinks put babies lives at risk. However, experts say that calculating precise intake can be difficult, and guidance on limiting caffeine is not consistent The NHS recommends pregnant women keep their daily caffeine intake below 200mg whereas the World Health Organization stipulates 300mg as the safe amount to consume. Tommy’s, a leading baby charity, called for both the NHS and the World Health Organisation to rethink such guidelines, but refused to outline a specific limit - saying it was the NHS and World Health Organisation’s responsibility to decide the recommendations in light of their new study. Professor Alexander Heazell, an author of the study, said: “Caffeine has been in our diets for a long time, and, as with many things we like to eat and drink, large amounts can be harmful – especially during pregnancy. It’s a relatively small risk, so people shouldn’t be worried about the occasional cup of coffee, but it’s a risk this research suggests many aren’t aware of." Read full story Source: The Independent, 18 November 2020
  15. News Article
    Several NHS trusts are offering a ‘treatment’ for birth trauma which uses a technique which lies outside national guidelines and which is criticised by specialists as potentially causing ‘more harm than good’. The ‘Rewind’ technique is promoted as a fast treatment for post-natal post-traumatic stress disorder (PTSD) – also known as birth trauma - which involves the “reprocessing” of painful memories. HSJ has learned of several trusts, including East and North Herts Trust, Chelsea and Westminster Hospital Foundation Trust and James Paget University Hospital FT, where the therapy is being offered. It is thought there are other trusts which are providing it or have explored it. Typically, it is provided by midwives who have undergone training in the technique. But Nick Grey, a clinical psychologist who was on the National Institute for Health and Care Excellence panel which looked at PTSD, said it was “absolutely clear cut” that it was bad practice to offer the technique as a branded therapy for PTSD, although he said it could be embedded as part of other treatments. He told HSJ: “It should not be offered to mothers with PTSD… they are being done a disservice if they are not given evidence-based treatment. There is no evidence that this [provides] treatment for sub-clinical PTSD or trauma,” he said. Read full story (paywalled) Source: HSJ, 11 November 2020
  16. News Article
    A national review has been launched by regulators because of an increased number of stillbirths during the first wave of covid, HSJ can reveal. The Healthcare Safety Investigation Branch (HSIB) is investigating 40 intrapartum stillbirths which took place between April and June this year, when the country experienced the first wave of COVID-19. During the same three months in the previous year, 24 stillbirths were reported to HSIB. The HSIB has told HSJ it has now launched a thematic review into the stillbirths, which will investigate stillbirths in all settings across England during that time period. The Royal College of Obstetricians and Gynaecologists, which has also launched a national review into perinatal outcomes during the pandemic, estimates that 86 per cent of maternity units reported a reduction in emergency antenatal presentations in April, “suggesting women may have delayed seeking care”. HSIB is aiming to complete the thematic review early next year. It said the stillbirths being investigated are not concentrated on any geographical area or trust. Read full story (paywalled) Source: HSJ, 2 November 2020
  17. News Article
    Poorer mothers are three times more likely to have stillborn children than those from more affluent backgrounds, according to a new study. The wide-ranging research, conducted by pregnancy charity Tommy’s, also found that high levels of stress doubled the likelihood of stillbirth, irrespective of other social factors and pregnancy complications. Unemployed mothers were almost three times more at risk. The government has been urged to take immediate action to address the social determinants of health and halt the rise in pregnant women who face the stress of financial insecurity. Researchers said getting more antenatal care can stop women from having a stillbirth — with mothers who went to more appointments than national rules stipulate having a 72% lower risk. Ros Bragg, director of Maternity Action said, “If the government is serious about combatting stillbirths, it must address the social determinants of health as well as clinical care. Women need safe, secure employment during their pregnancy and the certainty of a decent income if they find themselves out of work. It is not right that increasing numbers of pregnant women are dealing with the stress of financial insecurity, putting them at increased risk of serious health problems, including stillbirth.” Read full story Source: The Independent, 29 October 2020