Maternity

In September 2021, national guidance was produced, directing all Local Maternity & Neonatal Systems to undertake a programme of work to improve equity and equality within maternity services and consider those wider determinants of health that impact on a pregnancy long before it begins.

We have subsequently developed an Equity and Equality action plan that describes the steps we need to take to address our gaps and improve outcomes for those most in need. The recent MBRRACE-UK reports into maternal and neonatal deaths show different outcomes for women and babies from Black, Asian and Mixed ethnic groups and those living in the most deprived areas. We have also looked at how staff from ethnic minority backgrounds are represented within our workforce and to ensure they have the same opportunities and experience as others.

This year we refreshed our plan to include updates from recent national publications.

Maternity and Neonatal Voices Partnership (MNVP) is partnership that plays an integral role in shaping local maternity and neonatal care across Staffordshire and Stoke-on-Trent.

University Hospitals of North Midlands NHS Trust (UHNM) Perinatal Pelvic Health Services (PPHS) is leading the delivery of the national ambition to improve the prevention, identification, and NICE-recommended treatment, for pelvic health problems during pregnancy and up to a year following birth. The impact on women’s lives can be devastating, affecting the ability to work, sexual and social relationships and mental health. The aim of this service is to reduce the number of women living with pelvic health problems postnatally and in later life.

Research estimates that after pregnancy:

• one in three women experience urinary incontinence three months after birth,
• one in seven experience anal incontinence six months after birth,
• one in twelve experience pelvic organ prolapse.

These problems are often under-reported due to embarrassment, shame, or a belief that problems are a ‘normal’ consequence of childbirth.

All women using maternity services at UHNM will receive information at every antenatal and post-natal contact about pelvic health problems that can arise, and how to prevent them. Women can currently be referred to PPHS through the Care Flow ‘Pelvic health and perineal care’ pathway, with a self-referral option planned. All referrals are triaged by the PPHS team and, depending on the level of need, women will be signposted to self-help information on the UHNM website, workshops, or a one-to-one assessment and tailored treatment.

One of the most important aims of the PPHS is to raise awareness and educate on good pelvic health. For more information visit: Perinatal Pelvic Health Services (PPHS) | University Hospitals of North Midlands or contact the team on 01782 672777 or email pphs@uhnm.nhs.uk.

The NHS wants everyone using maternity services to receive safe, personalised care.  This means that care is centred around the unique needs and circumstances of each individual using maternity services and their baby. It also means that they have had genuine choice about the care they receive, informed by impartial information.

You can read more about this vision in the report of the national maternity review, Better Births. There are a range of choices in maternity services.

Personalised care means people have choice and control over the way their care is planned and received based on ‘what matters’ to them and their individual needs and preferences. The planning is a process to identify what matters to each person using maternity services and makes sure that their care reflects this. With their midwife or obstetrician, they will consider and discuss their life, family situation, health and wellbeing, and preferences, so that their care reflects their needs and wishes.  The result of these conversations is a personalised care and support plan. This will set out the decisions they have made about the care and support to be received throughout pregnancy and birth. The plan will cover antenatal care, labour and birth as well as postnatal care. It should be reviewed by the midwife and/or obstetrician with women at every contact or appointment and updated if anything changes.

Your GP can play a role in referrals if a birth centre is desired, or to simply discuss your preferences and ensure your care is tailored to your needs.

A newborn rests gently on his mothers chest in a diaper and hat, as he bonds with his Mother shortly after birth. The new Mom is wearing a hospital gown and is sitting up in her bed as she meets her new son.Read more about personalised care and support planning:

• Personalised Care and Support Planning | University Hospitals of North Midlands
• How to make a birth plan – NHS

Saving Babies’ Lives Care Bundle Version 3 (SBLCBv3) was implemented in maternity units across the NHS in June 2023. SBLCBv3 aims to provide detailed information for providers and commissioners of maternity care on how to reduce perinatal mortality across England. The third version of the care bundle brings together six elements of care that are widely recognised as evidence-based and/or best practice to improve care and outcome for women and their babies, these are:

• Reducing smoking in pregnancy and A SmokeFree Pregnancy
• Fetal Growth: Risk assessment, surveillance, and management
• Raising awareness of reduced fetal movement (RFM)
• Effective fetal monitoring during labour
• Prediction, prevention and perinatal optimisation of preterm birth
• Management of pre-existing diabetes in pregnancy for women with Type 1 or Type 2 diabetes

In March 2023, the Three-Year Delivery Plan for Maternity and Neonatal Services was published by NHS England.

This plan sets out how the NHS will make maternity and neonatal care safer, more personalised, and more equitable for women, babies, and families. The plan focuses on four high level themes:

Theme 1 – Listening to women and families with compassion

Theme 2 – Supporting our workforce

Theme 3 – Developing and sustaining a culture of safety

Theme 4 – Meeting and improving standards and structures

Read the summary of the three-year plan and the roles and responsibilities of the LMNS and our partners.