NHS commits to better care for expectant and new mums with mental health

The Chief Executive of NHS England has announced four new Mother and Baby Units which will allow women to stay with their babies while receiving the specialist care they need. These new units will provide in-patient support for women and their babies with the most complex and severe needs who require hospital care, who are experiencing severe mental health crisis including very serious conditions like post-partum psychosis

“Having a baby should be one of happiest, most life-changing experiences and every mum should have the opportunity to bond with her baby, while receiving the care she needs and remaining as close to her families as possible”

Simon Stephens, Chief Executive at NHS England

Read the full press release here


Whooping cough vaccination in pregnancy

Whooping cough poster
Image Source: PHE

Public Health England has published an information poster to support the whooping cough vaccination in pregnancy programme. The poster has been designed to promote the need for maternal pertussis vaccination which is now recommended from week 16 of each pregnancy. It is suitable for GP surgeries, hospitals, maternity units, nurseries, child care centres and libraries.

Download the poster from here

Clinical guideline CG156 updated. Fertility problems: assessment and treatment


egg and sperm
Image Source: Flickr

This NICE guideline covers diagnosing and treating fertility problems. It aims to reduce variation in practice and improve the way fertility problems are investigated and managed.

In September 2017, we stood down section 1.7 in this guideline as it has been superseded by publication of the NICE guideline on endometriosis

View the updated guideline here

Female Genital Mutilation (FGM) – April 2017 to June 2017, Experimental Statistics Report

The Female Genital Mutilation (FGM) Enhanced Dataset (SCCI 2026) is an NHS Digital repository for individual level data collected by healthcare providers in England, including acute hospital providers, mental health providers and GP practices.

Key Facts

The Female Genital Mutilation (FGM) Enhanced Dataset (SCCI 2026) supports the Department of Health’s FGM Prevention Programme by presenting a national picture of the prevalence of FGM in England.
•Between April and June 2017 there were 2,288 attendances2 reported at NHS trusts and GP practices where FGM was identified or a procedure for FGM was undertaken.
•There were 1,178 women and girls who had their FGM information collected in the Enhanced Dataset for the first time1. This does not indicate how recently the FGM was undertaken, nor does it necessarily mean that this is the woman or girl’s first attendance for FGM. It is the first time their information has been collected in the FGM Enhanced Dataset.

Download or view the statistics here

NIHR Signals: Drug reduces deaths from bleeding after childbirth

Image Source: NHS Photo Library

Tranexamic acid, given to women who bleed heavily after giving birth, reduced the risk of death by 31% when given within three hours.

This trial included 20,060 women with postpartum haemorrhage who were randomly assigned to receive tranexamic acid or placebo. This is the first large study to indicate that it is safe and implies it should be considered as an early drug option for postpartum haemorrhage. In keeping with other recent research, there was no increase in the risk of blood clots.

Tranexamic acid is a drug that stops clots breaking down. Current guidance recommends giving drugs that cause the womb to contract first, such as oxytocin, and using tranexamic acid if bleeding continues.

Most of the data in this study came from low and middle-income countries, with much higher incidence of postpartum haemorrhage and poorer maternal health outcomes than the UK. This means that reduction in the already low rates of such deaths in the UK might be small.

Read the full Signal here

NICE Clinical Guideline CG192 (update): Antenatal and postnatal mental health

NICE antenatal mental health
Image Source: NICE Pathways

This NICE guideline covers recognising, assessing and treating mental health problems in women who are planning to have a baby, are pregnant, or have had a baby or been pregnant in the past year. It covers depression, anxiety disorders, eating disorders, drug- and alcohol-use disorders and severe mental illness (such as psychosis, bipolar disorder and schizophrenia). It promotes early detection and good management of mental health problems to improve women’s quality of life during pregnancy and in the year after giving birth.

In August 2017, we added footnotes to recommendations 1.2.3, 1.4.27, 1.4.28 and 1.4.29 with a link to the MHRA toolkit on the risks of valproate medicines in female patients. We also updated a crosslink in recommendation 1.8.23 to link to the NICE guideline on violence and aggression. Footnotes were also added to recommendations 1.4.17 and 1.9.9 advising people that the UK Drugs in Lactation Advisory is available as an additional resource when seeking advice about specific drugs.

Download the updated guidance here

First National Maternal and Perinatal Audit publishes, covering care in England, Scotland and Wales

Image Source: NHS Photo Library

A new report finds large increase in midwife-led units co-located with obstetric units, increasing birthplace choice for pregnant women – but also describes variation in availability of staff, facilities and services.

Commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit Programme, the National Maternity and Perinatal Audit (NMPA) is the largest evaluation of NHS maternity and neonatal services undertaken in Britain. It aims to help maternity services to identify good practice and areas for improvement in the care of women and babies.

Only 22% of trusts and boards offer the full range of birth settings (home birth, freestanding midwife-led units, alongside midwife-led units and obstetric units**). These low numbers may be due to geographical factors, such as remote or rural location. Where feasible, commissioners, trusts and boards should ensure that all women have access to all four birth settings either within their own maternity service, or in close collaboration with neighbouring services.

Read the press release here

Download the full report here