This report from MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) looks at the quality of care received by babies who were either still born or who died shortly after birth. It provides a picture of current challenges faced by maternity and neonatal units and an opportunity to improve services for women and families and prevent similar deaths in the future. This type of death occurred in 225 pregnancies in 2015 in the UK. Findings from the report include:
The rate of term, singleton, intrapartum stillbirth and intrapartum-related neonatal death has more than halved since 1993 representing a reduction of around 220 intrapartum deaths per year.
Capacity issues were identified as a problem in over a quarter of the cases undergoing panel review. The majority of staffing and capacity problems were related to delivery suite.
The panel consensus was that in nearly 80% of deaths improvements in care were identified which may have made a difference to the outcome for the baby
There is an increasing proportion of births to mothers who have risk factors associated with an increased risk of perinatal death
As well as the full report available here, you can read a lay summary here
an executive report and lay summary here
an infographic here.
The Royal College of Paediatrics and Child Health (RCPCH) have responded to the report here.
A joint response from the Royal College of Obstetricians and Gynaecologists/Royal College of Midwives is also available here
The Royal College of Nursing has published Clinical nurse specialist in early pregnancy care. This document outlines the key skills and knowledge required to develop the role of the clinical nurse specialist in early pregnancy care. It is intended to provide direction for commissioners and managers when creating roles to support best practice in local service provision for women and their families.
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.
An Royal College of Midwives press release discusses a new report on the threats faced by maternity services.
The report ‘The gathering storm: England’s midwifery workforce challenges’ outlines how issues such as rising levels of complexity in pregnancy, midwife shortages and financial constraints in the NHS are ramping up the pressure on England’s maternity workforce and services.
The report also puts forward solutions to the problems in maternity services. It sets out ways in which decision makers across government and England’s NHS can tackle the situation. These include a more adaptable approach to requests for flexible working, and allowing the NHS Pay Review Body free reign to recommend staff pay wards. This will help retain midwives and not push them into costlier agency work. Implementing other changes will also help too, such as ensuring more low-risk women give birth outside of obstetric units.
The Royal College of Midwifery has published State of Maternity Services Report 2016. The report examines emerging issues and trends in relation to maternity services. It highlights that over a third of the UK’s NHS midwives are nearing retirement age; the increase in births to older mothers, who may require more care throughout their pregnancies; and rates of obesity which are placing additional demands on maternity services.
The National Federation of Women’s Institutes (NFWI) and National Childbirth Trust have published Support overdue: women’s experiences of maternity services 2017. This report presents the findings of the NFWI’s and NCT’s second survey of women’s experiences of maternity care, providing insights into key aspects of the experiences of 2,500 women. Women are generally positive about the maternity care they receive and many praised the professionalism of the staff who cared for them but some findings gave cause for concern.
The National Institute of Health and Clinical Excellence (NICE) published its guideline for safe midwifery staffing in maternity settings (NICE Safe Staffing Guideline NG4 2015) in February 2015. This publication from the Royal College of Midwives supports senior midwives and NHS managers implement the NICE safe midwifery staffing guideline.