This is the second edition of this paper, first published in January 2011 under the same title.
Maternal complications include increased risk of pregnancy-induced hypertension, gestational diabetes, peripartum haemorrhage, operative delivery, postpartum depression, and heightened symptoms of anxiety and parenting stress. Multiple pregnancy is also associated with a six-fold increase in the risk of preterm birth, which is a leading cause of infant mortality and long-term mental and physical disabilities, including cerebral palsy, learning difficulties and chronic lung disease.
This paper describes current knowledge and progress made since the publication of the previous edition to reduce multiple pregnancies following ART in the UK, with reference to more recent data showing a downward trend.
El-Toukhy T, Bhattacharya S, Akande VAon behalf of the Royal College of Obstetricians and Gynaecologists. Multiple Pregnancies Following Assisted Conception. Scientific Impact Paper No. 22. BJOG2018; DOI: 10.1111/1471-0528.14974
The Care Quality Commission has published the results from the Maternity services survey 2017. The results show that women are reporting a more positive experience of maternity care and treatment and highlights improvements in areas such as choice of where to give birth, quality of information and access to help and support after giving birth, when compared to the results from previous years’ surveys.
Compared with the last survey in 2015 a greater proportion of women said that they:
were offered the choice of giving birth in a midwife-led unit or birth centre
saw the same midwife at every antenatal appointment
were ‘always’ treated with dignity and respect during labour and birth
were never left alone during the birth of their baby at a time when it worried them
could ‘always’ get help from a member of staff within a reasonable time while in hospital after the birth
This is a report on NHS-funded maternity services in England for May 2017, using data submitted to the Maternity Services Data Set (MSDS). The MSDS has been developed to help achieve better outcomes of care for mothers, babies and children.
The MSDS is a patient-level ‘secondary uses’ data set that re-uses clinical and operational data for purposes other than direct patient care, such as commissioning and clinical audit. It captures key information at each stage of the maternity service care pathway in NHS-funded maternity services, such as those provided by GP practices and hospitals. The data collected include mother’s demographics, booking appointments, admissions and re-admissions, screening tests, labour and delivery along with baby’s demographics, diagnoses and screening tests.
Of the births that had a recorded delivery method, 57 per cent were spontaneous vaginal births, 11 per cent had instrumental assistance, 13 per cent were elective caesarean sections and 15 per cent were emergency caesarean sections. The proportion of births by emergency caesarean was highest in the London Commissioning Region (17 per cent) and lowest in the Midlands and East of England Commissioning Region (14 per cent).
This short resource summarises the work of NHS Improvement, frontline clinical experts, parents and baby charities to lever system-wide change and improvement by understanding preventable factors leading to full-term babies being admitted to neonatal units.
Admission to a neonatal unit can lead to unnecessary separation of mother and baby. There is overwhelming evidence that separating mother and baby at or soon after birth can affect the positive development of the mother-child attachment process and adversely affect maternal perinatal mental health.
Preventing separation except for compelling medical indications is essential in providing safe maternity services. NHS providers of maternal and neonatal care can use the resources to:
improve the safety of care
keep mothers and babies together whenever it’s safe to do so
identify local improvement priorities
develop an action plan to ensure any relevant resources are introduced into clinical practice
NHS England has announced the winners for the latest round of the Maternity Challenge Fund. Three projects are each being awarded £50,000 to explore innovative ways to use women’s and their partners’ feedback to improve maternity services. The winning trusts are Gloucester Hospitals, Southport and Ormskirk Hospital, and Northumbria Healthcare.
This report published by the Foundation of Nursing Studies describes a project that aimed to set up weekly antenatal information and support group in a Children’s Centre to increase potential for secure attachments between mother and infant, increase confidence, encourage peer support and inform and empower mothers.
This Cochrane Special Collection of systematic reviews on Breastfeeding has been developed to bring the best available evidence on effective care to the attention of decision makers, health professionals, advocacy groups, and women and families, and to support the implementation of evidence-informed policy and practice. The collection focuses on reviews on support and care for breastfeeding women, including treatment of breastfeeding associated problems; health promotion and an enabling environment; and breastfeeding babies with additional needs.