The National Childbirth Trust (NCT) has published The hidden half: bringing postnatal mental illness out of hiding. The Hidden Half campaign surveyed 1,000 women who had recently had a baby and found that half had a mental health or emotional problem postnatally or during pregnancy. Of these, nearly half hadn’t had their problem identified by a health professional and hadn’t received any help or treatment. Many of these new mothers said they were too embarrassed or afraid of judgement to seek help.
The Royal College of Obstetricians and Gynaecologists has published Each Baby Counts: 2015 Summary Report. This report provides a detailed analysis of all stillbirths, neonatal deaths and brain injuries that occurred during childbirth in 2015 and identifies the key clinical actions needed to improve the quality of care and prevent future cases. These clinical actions include: improving fetal monitoring; enhancing neonatal care; and reducing human factors by understanding ‘situational awareness’ to ensure the safe management of complex clinical decisions.
Click to read the report here Read the RCOG press release here
RCM press release here
Giving corticosteroids to most women who are anticipating labour before completing 37 weeks of pregnancy helps reduce immediate health problems in the baby compared with placebo or no intervention. Deaths around the time of birth were reduced by 28% and babies were a third (34%) less likely to develop respiratory distress syndrome.
A corticosteroid dose is already used for women who go into labour or if waters break before 37 weeks or where delivery is planned for other reasons. The drug accelerates the development of the baby’s lungs and reduces breathing difficulties at birth. This recommendation followed decades of research.
This review supports current practice of using a dose of corticosteroids in high-income settings and was designed to include more recent research and to look in more depth at new questions, such as the risk of infection. Evidence is still lacking in low-income settings and some very high-risk groups, like twins. There is also remaining uncertainty about the best corticosteroid, its dose and timing.
The Royal College of General Practitioners has launched the Women’s Health Educational Framework. This is a new library of resources for women’s health, relevant for continuous professional development for GPs and other primary healthcare professionals. It contains the following sections: maternal health; sexual and reproductive Health; pre-menopause; and peri/post-menopause. The resources include eLearning modules, national guidance, courses, workshops, journal articles and reviews on clinical or managerial topics of relevance to GPs and other primary healthcare professionals.
Visit the Women’s Health Educational Framework here
Inducing labour may halve the risk of infection in the womb when waters break from 37 weeks. The procedure was started within 24 hours and was compared to waiting for labour to start on its own.
Waters breaking at full term without the onset of labour is called pre-labour rupture of membranes. This can increase risks of maternal and neonatal infection and the need for caesarean section. As most women deliver spontaneously within a day, NICE recommend that women are offered an informed choice of either induction 24 hours after premature rupture of membranes or to watch and wait.
This updated Cochrane review included new evidence and suggests that induction before 24 hours may reduce infections without increasing caesarean sections, but there remains some uncertainty. This is due to low study quality, lack of longer term outcomes, and too few participants in trials to compare the numbers of any rare serious events.
These findings may help inform shared decisions about induction by providing more information to help women understand the risks.
Public Health England has published a patient information leaflet Have you had your MMR? This leaflet provides information on the measles, mumps and rubella (MMR) vaccine for mums who have just given birth.
Women who have inherited bleeding disorders may be at significant risk of bleeding following miscarriage, abortion, antenatal procedures and delivery. They require multidisciplinary specialised care tailored to the individual, with cross-specialty communication, including anaesthetists and neonatologists as necessary.
The conditions covered in this guideline are haemophilia A and B, von Willebrand disease (VWD), factor XI deficiency, rare factor deficiencies, fibrinogen disorders, Bernard Soulier Syndrome (BSS), Glanzmann’s thrombasthenia (GT) and other platelet function disorders.
This guideline is intended for both specialist haematologists and obstetricians who have experience in managing pregnant patients with bleeding disorders. In addition, it may be a useful reference text for obstetric anaesthetists and neonatologists. This is the first edition of a combined United Kingdom Haemophilia Centre Doctors’ Organisation (UKHCDO) and Royal College of Obstetricians and Gynaecologists (RCOG) guideline although a previous guideline was written by the UKHCDO in 2006.