Securing the future workforce supply: Obstetrics and gynaecology stocktake – Centre for Workforce Intelligence [UK] – January 2015
“The Centre for Workforce Intelligence (CfWI) was commissioned by the Department of Health (DH) and Health Education England (HEE) to conduct a stocktake review of the obstetrics and gynaecology (O&G) workforce in England. The review has a particular focus on fully trained obstetricians and gynaecologists with a certificate of completion of training (CCT holders), typically employed as consultants.
The CfWI has estimated the future level of workforce supply that would be needed to maintain current levels of O&G service on a per-patient basis. It has also considered the number of higher specialty training numbers required to ensure supply is broadly in balance with expected patient demand by the end of the projection period (2028). Additionally, the CfWI has also provided an estimate about the O&G workforce that would be required to deliver a robust consultant-led seven-day service.”Read Full Post | Make a Comment ( Comments Off on Securing the future workforce supply: Obstetrics and gynaecology stocktake – Centre for Workforce Intelligence [UK] – January 2015 )
The costs of perinatal mental health problems – Centre for Mental Health and London School of Economics – October 2014
“This report sets out the findings of a project on the economic and social impact of maternal mental health problems in the perinatal period, defined as the period during pregnancy and the first year after childbirth.”Read Full Post | Make a Comment ( Comments Off on The costs of perinatal mental health problems – Centre for Mental Health and London School of Economics – October 2014 )
Guidelines for the Identification and Management of Substance Use and Substance Use Disorders in Pregnancy – WHO – 2014
These guidelines contain recommendations on the identification and management of substance use and substance use disorders for health care services which assist women who are pregnant, or have recently had a child, and who use alcohol or drugs or who have a substance use disorder. They have been developed in response to requests from organizations, institutions and individuals for technical guidance on the identification and management of alcohol and other substance use and substance use disorders in pregnant women, with the target of healthy outcomes for both pregnant and their fetus or infant.”
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Smoking Cessation Interventions in Pregnancy and Postpartum Care – Agency for Healthcare Research and Quality (US) – February 2014
The Vanderbilt Evidence-based Practice Center systematically reviewed evidence about smoking cessation interventions in pregnant and postpartum women.
We searched MEDLINE®, CINAHL®, and PsycINFO® for randomized controlled trials (RCTs) on interventions and prospective studies on patient characteristics published in English.
We dually reviewed abstracts and full texts. Studies were excluded if they did not address a Key Question, were not an eligible study design, or did not report biochemically validated smoking cessation outcomes. Data were extracted into evidence tables and summarized qualitatively. A meta-analysis of effectiveness data assessed relative impact of components in smoking cessation interventions.
We included 59 unique studies reported in 72 publications. Of the 56 RCTs, 13 were good, 15 fair, and 28 poor quality. Studies evaluated counseling-based interventions, educational materials, nicotine replacement therapy (NRT), peer support, multicomponent interventions, and other unique interventions. Multicomponent approaches were most likely to be effective, but results were inconsistent. In the meta-analysis, incentives demonstrated the strongest effect; other components with a greater than 80-percent likelihood of success were feedback about biologic measures, information, personal followup, NRT, and quit guides. Findings regarding infant outcomes were inconsistent or did not reach statistical significance. No serious harms were identified in four studies that reported adverse events.
Across interventions, data are sparse to evaluate sustained cessation among pregnant and postpartum women. This review suggests that approaches that combine multiple components will have the best likelihood of success. Selecting which components to include is more complex and should be based on the particular considerations of the clinical setting, including patient characteristics and resource allocation, but incentives demonstrated the greatest effect among components studied. Infant outcomes are limited to data collected at time of birth; no studies assessed longer term or child outcomes. Harms data were rarely reported.”
AMA Position Statement on Women’s Health 2014 – 5 March 2014Read Full Post | Make a Comment ( Comments Off on AMA Position Statement on Women’s Health 2014 – 5 March 2014 )
“This toolkit includes resources for hospitals that wish to improve safety when newborns transition home from their neonatal intensive care unit (NICU) by creating a Health Coach Program, tools for coaches, and information for parents and families of newborns who have spent time in the NICU.
Infants born preterm or with complex congenital conditions are surviving to discharge in growing numbers and often require significant monitoring and coordination of care in the ambulatory setting.
This manual is designed to be adapted for any institution that cares for fragile newborn infants.
Health Coaches who want to print materials to create customized Family Information Packets should select PDF files for the Cover Page and each relevant topic. These fact sheets can then be assembled into a packet for each family.”Read Full Post | Make a Comment ( Comments Off on Transitioning Newborns from NICU to Home: A Resource Toolkit – AHRQ – December 2013 )
Reconfiguration of women’s services in the UK – Royal College of Obstetricians and Gynaecologists – 18 December 2013
“The standards needed to provide high quality, safe health care when reconfiguring women’s services are laid out in a new paper published today by the Royal College of Obstetricians and Gynaecologists (RCOG).
The Good Practice paper, Reconfiguration of women’s services in the UK, is based around recommendations made in several RCOG reports and guidance from other relevant organisations. It focuses on workforce planning including obstetric staffing, size of unit, geographical access to units, education and training, and discusses the NHS reforms and changes.”
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ISBN 978-478-39397-2 (online)
“The New Zealand Maternity Clinical Indicators are the result of collaboration between the Ministry of Health and maternity stakeholders, representing consumer, midwifery, obstetric, general practice, paediatric and anaesthetic perspectives. Building on previous work undertaken across Australasia, an expert working group has established a set of 12 maternity clinical indicators that are relevant to the New Zealand setting and can be measured using available data collections.
This third report presents data for 2011 using the same standardised definitions as in the previous two reports (2009 and 2010). This is also the third report using the standard primipara definition which allows the separate assessment of a group of women for whom interventions and outcomes should be similar. In addition to eight indicators for standard primiparae, there are three indicators for all women giving birth in hospital and one indicator covering all babies born in hospital.”
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Patterns of Maternity Care in English NHS Hospitals 2011 / 12 – Royal College of Obstetricians and Gynaecologists – May 2013
“The Clinical Indicators Project is a programme of work that aims to develop clinically relevant, methodologically robust performance indicators for obstetric and gynaecological care using currently available data. This information will be used to inform quality improvement initiatives and provide comparative benchmarking for women’s health services across the UK.
This project is being carried out in collaboration with the London School of Hygiene and Tropical Medicine.
The report presents a series of eleven indicators that can be used to compare the performance of English maternity units. It is the first of what will be an annual account by the RCOG of variation in care delivered to women during childbirth.
The report uses Hospital Episode Statistics (HES) data from 2011/12 that is routinely submitted by each NHS hospital. For the first time, this data has been analysed in a way that enables fairer comparisons to be made between hospitals. The researchers have risk-adjusted for factors which are beyond the control of the hospital, such as the age and medical history of the mother.
The indicators reveal considerable variation among maternity units in England.”
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National core maternity indicators – AIHW – 7 March 2013
Author: AIHW National Perinatal Epidemiology and Statistics Unit
“This is the first report of ten national core maternity indicators for monitoring the quality of maternity care in Australia. National rates have decreased for smoking in pregnancy, episiotomy among women having their first baby and giving birth vaginally and the proportion of babies born weighing less than 2,750 grams at or after 40 weeks. However for some indicators, including induction of labour, caesarean section and instrumental vaginal birth, rates have increased and point to areas for possible further attention.”
ISBN 978-1-74249-398-5; Cat. no. PER 58; 56ppRead Full Post | Make a Comment ( Comments Off on National core maternity indicators – AIHW – 7 March 2013 )
Maternal mental health pathway aims to provide a structured approach [UK] – 9 August 2012
“New guidance provides a structured approach on common issues associated with maternal mental health and wellbeing, from pregnancy through the early months after the birth.
The Maternal mental health pathway, focuses on the role of the health visitor but also recognises the essential contributions of partners in midwifery, mental health, general practice and third sector, and also supports professional practice.”
… continuesRead Full Post | Make a Comment ( Comments Off on Maternal mental health pathway aims to provide a structured approach [UK] – 9 August 2012 )
“We should empower frontline staff to innovate and improve their services, according to a new study.
It says it is possible to deliver high-quality, safe and effective care when midwives are engaged and lead on innovation.
The study has been launched by the RCM and the Involvement and participation Association (IPA).
It features examples of innovative practice from across England, including a pioneering apprenticeship programme for maternity support workers at Basildon and Thurrock University Hospitals NHS Foundation Trust.”
… continues on the siteRead Full Post | Make a Comment ( Comments Off on Innovation and Improvement in Maternity Services – Royal College of Midwives – 30 July 2012 )
Healthy Women, Healthy Lives? Report from the first Inquiry by the All-Party Parliamentary Group on Sexual and Reproductive Health in the UK (APPG) – 10 July 2012
All-Party Parliamentary Group is chaired by Baroness Gould of Potternewtown in the House of Lords and administered by FPA
‘Shocking findings’ says first APPG Inquiry into contraceptive restrictionsRead Full Post | Make a Comment ( Comments Off on Healthy Women, Healthy Lives? Report from the first Inquiry by the All-Party Parliamentary Group on Sexual and Reproductive Health in the UK (APPG) – 10 July 2012 )
Perinatal depression: data from the 2010 Australian National Infant Feeding Survey – AIHW – 3 July 2012
“Data from the 2010 Australian National Infant Feeding Survey showed that 1 in 5 (20%) mothers of children aged 24 months or less had been diagnosed with depression. More than half of these mothers reported being diagnosed with depression during the perinatal period. Perinatal depression was more commonly reported among mothers who were younger (aged under 25), smokers, overweight/obese and from lower income households.”
ISBN 978-1-74249-320-6; Cat. no. PHE 161; 20pp.Read Full Post | Make a Comment ( Comments Off on Perinatal depression: data from the 2010 Australian National Infant Feeding Survey – AIHW – 3 July 2012 )
Digital service launched for new parents – NHS – 18 May 2012
“The NHS Information Service for Parents, launched today by the Prime Minister, will give new parents information and advice they can trust covering a wide range of issues related to staying healthy in pregnancy, preparing for birth and looking after their baby.
By signing up to the service, parents-to-be and new parents will receive regular emails and text messages containing relevant and timely NHS approved advice as their pregnancy develops and as their child grows.
Links to videos showing midwives demonstrating practical advice such as bathing your baby, and parents discussing issues that affected them and how they supported each other, will also be sent at appropriate times.”
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NQF Endorses Perinatal Measures – National Quality Forum [US] – 2 April 2012
…”the National Quality Forum (NQF) Board of Directors has approved for endorsement 14 quality measures on perinatal care. The measures address a wide range of care concerns, including childbirth, pregnancy and post-partum care, and newborn care.”
For this project, NQF endorsed measures related to elective delivery, episiotomy, and caesarean section rates, as well as prophylactic antibiotic rates for women undergoing cesarean sections. NQF also endorsed measures dealing with hepatitis B vaccination rates for newborns, neonatal bloodstream infection rates, and exclusive breastfeeding rates during hospitalization. In all, 22 measures were evaluated against NQF’s endorsement criteria by a panel of providers, measurement experts, and consumer representatives; 14 measures were endorsed.”
0469: PC-01 Elective Delivery (Joint Commission)
0470: Incidence of Episiotomy (Christiana Care Health System)
0471: PC-02 Cesarean Section (Joint Commission)
0472: Appropriate Prophylactic Antibiotic Received Within One Hour Prior to Surgical Incision– Cesarean Section (Massachusetts General Hospital/Partners Health Care System)
0473: Appropriate DVT Prophylaxis in Women Undergoing Cesarean Delivery (Hospital Corporation of America)
0475: Hepatitis B Vaccine Coverage Among All Live Newborn Infants Prior to Hospital or Birthing Facility Discharge (Centers for Disease Control and Prevention)
0476: PC-03 Antenatal Steroids (Joint Commission)
1746: Intrapartum Antibiotic Prophylaxis for Group B Streptococcus (GBS) (Massachusetts General Hospital)
0477: Under 1500g infant Not Delivered at Appropriate Level of Care (California Maternal Quality Care Collaborative)
0478: Neonatal Blood Stream Infection Rate (NQI #3) (Agency for Healthcare Research and Quality)
1731: Health Care-Associated Bloodstream Infections in Newborns (Joint Commission)
0304: Late Sepsis or Meningitis in Very Low Birth Weight (VLBW) Neonates (risk-adjusted) (Vermont Oxford Network)
0480: PC-05 Exclusive Breast Milk Feeding (Joint Commission)
0483: Proportion of Infants 22 to 29 Weeks Gestation Screened for Retinopathy of Prematurity (Vermont Oxford Network)
The safety of maternity services is of paramount importance. Maternity teams face many challenges in delivering safe care to mothers, babies and families. The King’s Fund launched an independent inquiry into the safety of maternity services in 2006. The report from that inquiry, Safe Births: Everybody’s business, made a series of recommendations about how the safety of maternity care could be improved.
Building on the recommendations from our inquiry and in partnership with the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the NHS Litigation Authority, Centre for Maternal And Child Enquiries and the National Patient Safety Agency, The King’s Fund launched the Safer Births Improvement Programme, providing customised support to 12 multidisciplinary maternity teams in England. This toolkit shares the experiences and lessons from those teams.
Improving Safety in Maternity Services: a toolkit for teams is organised around five key areas for improvement in maternity care on which the teams focused:
information and guidance
staffing and leadership.”
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Australia’s mothers and babies 2009 – AIHW – 21 December 2011
“In 2009, 294,540 women gave birth to 299,220 babies in Australia. The increase in births continued, with 2,295 more births (0.8%) than reported in 2008. The average age of women who gave birth in Australia has increased gradually in recent years, from 29.0 years in 2000 to 30.0 years in 2009.”
ISSN 1321-8336; ISBN 978-1-74249-265-0; Cat. no. PER 52; 114ppRead Full Post | Make a Comment ( Comments Off on Australia’s mothers and babies 2009 – AIHW – 21 December 2011 )
State of Maternity Services Report – Royal College of Midwives – November 2011
“The Royal College of Midwives has released its first State of Maternity Services report. The report looks at a number of indicators of the pressures on maternity care and the resources available to cope in each of the four United Kingdom countries.
The report finds that a significant increase in the number of births in each of the four countries, and a trend towards older mothers, is increasing the pressures on maternity care throughout the UK. In England, and in the last few years Wales, this has led to a substantial deficit in the workforce needed to provide a safe level of care to women and their babies. Furthermore, the existing midwifery workforce is rapidly ageing in each country, except for Wales. From this we can anticipate an even greater strain on services over the next 15 years.
While greater investment in maternity care is certainly part of the solution, the current financial limits on the NHS mean that innovative ways to address the workforce shortages need to be considered. As such, the report recommends providing more midwife-led units and appropriately integrating maternity support workers as two ways to make better use of the financial resources available.
The report also recommends at least maintaining, and in some regions increasing, the number of student midwives, to ensure that more midwives are available to meet future needs.”
“In 2009, there were 70,541 assisted reproductive technology (ART) treatment cycles undertaken in Australian and New Zealand. Of these cycles, 17.2% resulted in a live delivery (the birth of at least one liveborn baby). In total, 13,114 liveborn babies were born following ART treatment in 2009. The most important trend in ART treatment has been the increase of single embryo transfer, from 48.3% in 2005 to 69.7% in 2009. This trend has resulted in significant reduction of multiple delivery rate from 14.1% in 2005 to 8.2% in 2009.
ISSN 1038-7234; ISBN 978-1-74249-221-6; Cat. no. PER 51; 74pp”Read Full Post | Make a Comment ( Comments Off on Assisted reproductive technology in Australia and New Zealand 2009 – AIHW – 9 November 2011 )
“A resource pack ‘Preparation for birth and beyond: a resource pack for leaders of community groups and activities’, has been developed to help the NHS, local authorities and the voluntary sector in planning or leading preparation for parenthood groups and activities. It aims to improve outcomes for babies and parents through a refreshed approach to antenatal education.”Read Full Post | Make a Comment ( Comments Off on Preparation for Birth and Beyond: resource pack to help parenthood groups – NHS – 19 October 2011 )
Suffering in silence. 70,000 reasons why help with postnatal depression has to be better – Give Me Strength UK – September 2011
“4Children calls for an end to the neglect of 35,000 mothers with untreated postnatal depression each year
A report from the national charity, 4Children, says a chronic lack of awareness of the symptoms of postnatal depression is leading to as many as 35,000 women suffering in silence from the condition each year with devastating effects on their families.
New figures, published today, show that a staggering half of women suffering from postnatal depression do not seek any professional treatment. Thousands more are not getting their postnatal depression treated quickly or effectively enough because of serious shortcomings in the system of screening and referral, an over-reliance on the use of antidepressants and because of a sense of stigma attached to admitting to experiencing the symptoms.
The report – the first of three looking at ways of preventing family crisis as part of the charity’s Give Me Strength campaign – highlights the terrible toll that untreated maternal depression has on families leading to relationship difficulties and breakdown, pressure on older siblings to step in to look after babies and children living with the long term consequences of poor early bonding.
The report also reveals that many healthcare professionals – including GPs – need to do more to diagnose postnatal depression early and ensure mothers are being provided with appropriate and timely treatment.” … continuesRead Full Post | Make a Comment ( Comments Off on Suffering in silence. 70,000 reasons why help with postnatal depression has to be better – Give Me Strength UK – September 2011 )
Why Should we Consider a Life Course Approach to Women’s Health Care? – Royal College of Obstetricians and Gynaecologists – 14 October 2011
“Women have predictable long-term reproductive healthcare needs and more frequent interactions with health services than men. Optimal health care for women as they age requires a level of service integration that contrasts with the fragmentation of current services. Nonetheless, a life course perspective is evident in the government’s white paper Healthy Lives, Healthy People, which emphasises the importance of environmental influences in pregnancy and early postpartum life. This paper considers the rationale for a life course approach to women’s health care more broadly and the implications for health service delivery.”Read Full Post | Make a Comment ( Comments Off on Why Should we Consider a Life Course Approach to Women’s Health Care? – Royal College of Obstetricians and Gynaecologists – 14 October 2011 )
Updating the USDA National Breastfeeding Campaign – Workshop Summary – Institute of Medicine – 21 September 2011
“Support for breastfeeding has been a priority of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) – which provides 9.2 million Americans with nutritious food, nutrition education, support, and healthcare referrals – since the program began in the 1970s. The Loving Support Makes Breastfeeding Work campaign, which the U.S. Department of Agriculture’s (USDA) Food and Nutrition Services (FNS) launched in 1997, emphasizes that the support of family and friends, the healthcare system, and the community are essential for a breastfeeding mother to be successful. More than a decade after the campaign began, USDA is seeking to update it using an evidence-based social marketing strategy, taking into account the socioeconomic and demographic changes among WIC participants, changes in the WIC program, and the appearance of interactive, democratized communication created by new technology.
As one of the first steps in the campaign’s update, FNS asked the IOM to host a workshop on April 26, 2011 to convene experts for a discussion on what has changed since Loving Support began in 1997. Speakers examined changes in today’s millennial moms, laws and the emergence of new technologies, evaluated lessons learned from other public health campaigns, and provided thoughts on where to take the campaign in the future. Suggestions for the future included updating the market research, the use of modern communications tools, strategic community-based partnerships, and the use of ongoing evaluation tools. This document summarizes the workshop.”Read Full Post | Make a Comment ( None so far )
Maternity data in Australia: a review of sources and gaps – AIHW – 13 September 2011
“This bulletin presents the results of a review of the depth and breadth of maternal data capture in Australia. Gaps in national data were identified, as well as opportunities for future improvements, A key output of the review is the Maternity Information Matrix, an electronic inventory of maternity data collections and data items.”
ISSN 1446-9820; ISBN 978-1-74249-182-0; Cat. no. AUS 136; 12ppRead Full Post | Make a Comment ( None so far )
Guidelines for consultation with obstetric and related medical services (Referral Guidelines) – NZ Ministry of Health – July 2011
Guidelines for consultation with obstetric and related medical services (Referral Guidelines) – NZ Ministry of Health – July 2011
“Summary of publication
This publication outlines the criteria and processes for guiding LMC referral to primary care, referral for specialist consultation, referral for the transfer of clinical responsibility for care, transfer of clinical responsibility for care in an emergency, and emergency transport.”
ISBN numbers: 978-0-478-37318-9 (print), 978-0-478-37319-6 (online)
HP number: 5391
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A set of standards to guide the planning, funding and monitoring of maternity services by the Ministry of Health and District Health Boards
ISBN number: 978-0-478-37310-3 (Online)
HP number: 5386
Summary of publication
Background: The Maternity Quality Initiative
The development of the New Zealand Maternity Standards is part of the Maternity Quality Initiative.
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National breastfeeding indicators: workshop report – AIHW – 26 July 2011
“This report presents the outcomes of a consensus workshop held on 8 December 2010 in Canberra, regarding core national breastfeeding indicators to support the monitoring of the Australian National Breastfeeding Strategy 2010-2015 and related policies and programs.”
ISBN 978-1-74249-189-9; Cat. no. PHE 146; 12ppRead Full Post | Make a Comment ( None so far )
Management of Women with Mental Health Issues during Pregnancy and the Postnatal Period – Royal College of Obstetricians and Gynaecologists – June 2011
Mental illness makes a significant contribution to maternal deaths. This document highlights the role of maternity services in the early identification of high-risk women and assessment of current illness, and describes principles of service organisation for health providers to meet these needs.” … continues
“What do we know about associations between registered midwife staffing levels and better care for women?
Growing research evidence suggests that there is a strong link between nurse staffing and patient outcomes in the acute sector. However, there is limited empirical evidence on the relationship between maternity staffing, maternity workforce characteristics and birth outcomes. Such evidence is much needed, given current policies aimed at improving maternity care. In this Policy+ we draw on work undertaken by the National Nursing Research Unit that sought to assess the feasibility of using routinely available data to measure the impact that maternity staffing has on birth outcomes in maternity services at trust level in England.”
“The Confidential Enquiry into Maternal and Child Health (CEMACH) (2007) highlighted that obesity in pregnancy carries significant risks and identified that over half the women who died either directly or indirectly from pregnancy related causes were overweight or obese. Babies born to obese women also face several health risks including a higher risk of fetal death, stillbirth, congenital abnormality, shoulder dystocia, macrosomia and subsequent obesity.
The resulting NHS costs attributable to being overweight and obese are projected to reach £9.7 billion by 2050, with wider costs to society estimated to reach £49.9 billion per year. The NICE costing report for NICE public health guidance PH27 highlights that additional costs are incurred when complications arise in pregnancy, during delivery and following childbirth. Increased risks of complications during pregnancy and after childbirth include impaired glucose tolerance and gestational diabetes, miscarriage, pre-eclampsia, thromboembolism and maternal death.
Weight management includes assessing and monitoring body weight, preventing someone from becoming overweight (body mass index [BMI] 25–29.9 kg/m2) or obese (BMI greater than or equal to 30 kg/m2), and helping them to achieve and maintain a healthy weight before, during and after pregnancy by eating healthily and being physically active and gradually losing weight after the baby is born. NICE public health guidance PH27 recommends that pregnant women have their weight and height measured and BMI calculated and recorded at the first contact with the health professional. This is important because obesity will have a greater influence on the pregnant woman’s health and the health of her unborn child than the amount of weight she may gain during pregnancy. Calculating and recording BMI will help with care planning and with the aim of preventing or managing any complications related to obesity. It is also important to commission weight management services to help women lose weight before they become pregnant.”
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Customer insight work on maternity and early years – Department of Health [UK] – 7 April 2011
“The following documents are a synthesis of three pieces of qualitative research undertaken by the Department of Health about the experience of expectant and new parents. The three projects explored how parents feel about the pregnancy and parenthood journeys and their expectations of the health service.
The research summary is available either as a PFD or in Powerpoint for presentation purposes and gives valuable insights from parents on pregnancy and early parenthood services – and how these might be improved.”Read Full Post | Make a Comment ( None so far )
National Perinatal Mental Health Project Report – UK – 8 March 2011
“The remit of this report and related studies is to facilitate a better understanding of how, and to what extent current and planned perinatal provision is capable of meeting the needs of BME [black and minority ethnic] women.”Read Full Post | Make a Comment ( None so far )
Staffing in maternity units. Getting the right people in the right place at the right time – The King’s Fund – 6 March 2011
Jane Sandall, Caroline Homer, Euan Sadler, Caroline Rudisill, Ivy Bourgeault, Susan Bewley, Pauline Nelson, Luke Cowie, Chris Cooper, Natasha Curry
Maternity services – in common with the rest of the NHS – need to focus on new ways of working to maintain and increase levels of safety and quality of care within the resources available. There are particular pressures on maternity services because of the rise in birth rates and the increasing complexity of many births.
Following on from its previous inquiry into the safety of maternity services, The King’s Fund commissioned further research to answer a fundamental question: Can the safety of maternity services be improved by more effectively deploying existing staffing resources?” …continues on the siteRead Full Post | Make a Comment ( None so far )
Saving Mothers’ Lives report – reviewing maternal deaths 2006-2008 – Eighth Report of the Confidential Enquiries into Maternal Deaths (UK) – 1 March 2011
“The overall number of maternal deaths in the UK has fallen over the last three years despite a rise in the number of women dying from infection, says the Eighth Report of the Confidential Enquiries into Maternal Deaths, Saving Mothers’ Lives, published today as a supplement in BJOG: An International Journal of Obstetrics and Gynaecology.
The maternal mortality rate was 11.39 per 100,000 maternities compared to 13.95 per 100,000 maternities for the previous triennium, 2003-05. As this enquiry is far more inclusive than in other countries, for direct comparison with international figures, the UK maternal death rate was 6.7 per 100,000 live births.”
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Surgical Safety Checklist for Maternity – NHS National Patient Safety Agency – 25 January 2011
“Increasing safety for maternity services by using the surgical checklist
The National Patient Safety Agency (NPSA) has released a Surgical Safety Checklist for Maternity aimed at improving patient safety and reducing harm in maternity care across the NHS.
A recent study* shows the unequivocal benefits of using a checklist during any surgical procedure. Successful implementation of a checklist enhances communication between all members of the surgical team and their patients and can reduce the level of patient safety incidents.
Produced in conjunction with the Royal College of Obstetricians and Gynaecologists (RCOG), the Surgical Safety Checklist for Maternity is an adaptation of the World Health Organization (WHO) Surgical Safety Checklist.
Created in response to requests from NHS maternity services, the checklist is for women having a caesarean section or other surgical procedure related to childbirth, for example, the removal of the placenta.
In addition to the checks provided by the surgical checklist, the maternity checklist requires staff to:”
National Women’s Health Policy 2010 – 29 December 2010
“The Government’s National Women’s Health Policy 2010 aims to continue to improve the health and wellbeing of all women in Australia, especially those at greatest risk for poor health.
The policy recognises the solid foundation of the first National Women’s Health Policy: Advancing Women’s Health in Australia which was released in 1989. It continues the commitment to building an environment where more can be done to ensure that all Australian women have better health and health care.
The policy adopts a dual priority approach that recognises the importance of addressing immediate and future health challenges while also addressing the fundamental ways in which society is structured that impacts on women’s health and wellbeing. It reflects the equal priorities of:
Maintaining and developing health services and prevention programs to treat and avoid disease through targeting health issues that will have the greatest impact over the next two decades; and
Aiming to address health inequities through broader reforms addressing the social determinants of health.”
Postnatal care: still a Cinderella story? National Childbirth Trust NCT (UK) – 2010
This report summarises findings of survey of 1260 first-time mothers’ experiences of NHS postnatal care and makes 10 recommendations for improvement of services.Read Full Post | Make a Comment ( None so far )
Normal birth as a measure of the quality of care – National Childbirth Trust – 28 September 2010
Safeguarding normal birth
In order to help maternity healthcare professionals improve outcomes for parents, NCT, the UK’s largest parenting charity, has published a report drawing together evidence that highlights how giving birth without major medical procedures can be used as a measure of good midwifery care.
The report, entitled ‘Normal birth as a measure of the quality of care’, by Miranda Dodwell and Mary Newburn, gives practical actions to guide the planning of service developments which increase opportunities for normal birth – whether at home, in a birth centre or in a hospital setting – without compromising safety or women’s experiences.
…continues Full text of the reportRead Full Post | Make a Comment ( None so far )
Midwifery 2020: Delivering expectations – UK Department of Health – 9 September 2010
Document type: Report
Author: Chief Nursing Officers of England, Northern Ireland, Scotland and Wales
Product number: ISBN 978 0 85791 003 5
“The Midwifery 2020 programme was commissioned in 2008 by the Chief Nursing officers for England, Wales, Northern Ireland and Scotland.
This document is the programme’s final report. It underpins the vision of how midwives can lead and deliver care in a changing health care environment, reflecting policy and service direction. It also identifies the changes required to the way that midwives work, their role, responsibilities, education and/or professional development to meet the vision.
Please note that the PDF file below is available for print only and has not been tagged for accessibility”
Download Midwifery 2010 delivering expectations (PDF, 3428K)
Challenges and Opportunities in Using Residual Newborn Screening Samples for Translational Research – IOM – released 8 September 2010
Challenges and Opportunities in Using Residual Newborn Screening Samples for Translational Research – IOM – released 8 September 2010
Type: Workshop Summary
Note: Workshop Summaries contain the opinion of the presenters, but do NOT reflect the conclusions of the IOM. Learn more about the differences between Workshop Summaries and Consensus Reports.
“Newborn screening programs test blood samples from more than 4 million infants each year for life-threatening disorders, such as phenylketonuria and sickle-cell disease, that are treatable if identified at birth. The blood that remains after screening can be an invaluable resource for public health and biomedical research and has been used previously to study childhood leukemia, the prevalence of HIV infection, and exposure to environmental toxins. However, recent legal challenges have brought to light that most parents are unaware that samples can be stored for years afterward and that they can be used for purposes other than screening.
On May 24, 2010, the IOM held a workshop to examine the issues surrounding the use of newborn screening samples for translational research, including autonomy, confidentiality, privacy, informed consent, and consent to future use of samples originally taken for a different purpose. Participants discussed the benefits of making samples available for research; ways to ensure the privacy of individuals while allowing scientists to make use of samples; and strategies for making samples available for additional uses without compromising the main function of the newborn screening program. This document summarizes the workshop.”Read Full Post | Make a Comment ( None so far )
“What is meant by ‘community engagement’? This report looks at how we define communities and addresses barriers that some communities face when accessing health services.
There is a key focus on maternity, which seems to have specific obstacles around engagement.
The report contains a number of recommendations including:
Understand and define ‘community engagement’. Being clear about the group you are working with and the aspects of engagement you wish to use is essential for success.
Make sure you have an authentic community: those who belong to it should identify with each other and recognise themselves as a community or group with shared activities and aspirations.
Find and work with leaders, or those with leadership potential, in that community.
The report notes that pregnant women often become part of a community of pregnant women and new mothers. This community is separate from their usual community which might be based on family, friends, locality, faith or ethnicity.
This means that when engaging pregnant women and new mothers with healthcare services, you must consider the other communites that they might be part of.”Read Full Post | Make a Comment ( None so far )
The role of GPs in maternity care – what does the future hold? – The King’s Fund’s Inquiry into the Quality of General Practice in England – August 2010
The role of GPs in maternity care – what does the future hold? – The King’s Fund’s Inquiry into the Quality of General Practice in England – August 2010 Report in pdf (pdf 397 kb)
“To inform its work, the Inquiry panel commissioned a discussion paper to examine what good-quality maternity care looks like and the implications for general practice. The [report] assesses the current state of general practice involvement in maternity care, what GPs can do to stimulate and maintain care quality, and how care quality can be measured. The paper’s authors are Alex Smith, former Health Policy Researcher, The King’s Fund, and Judy Shakespeare, GP.”Read Full Post | Make a Comment ( None so far )
Report of the Regulation and Quality Improvement Authority (RQIA) review of interpartum care – Northern Ireland – 2010
Report of the Regulation and Quality Improvement Authority (RQIA) review of interpartum care – Northern Ireland – 2010
This report evaluates the quality of care in maternity services across Northern Ireland and it highlights the need for a maternity services strategy to be developed. The report provides direction and recommendations for improvements in the quality and safety of care for women in labour and during delivery.Read Full Post | Make a Comment ( None so far )
Draft National Guidance on Collaborative Maternity Care – NHMRC – 26 March 2010
“The National Health and Medical Research Council (NHMRC) has released for public comment a draft of the National Guidance on Collaborative Maternity Care.
NHMRC was commissioned by the Department of Health and Ageing to undertake this work as part of the national maternity reform activities.
Clarity about how to establish and maintain collaborative practice for all maternity care providers will be essential in ensuring the success of new arrangements. It will be of particular relevance for the newly defined eligible midwives. Successful collaboration should improve access, choice, quality and safety for all pregnant women and their communities.
Submissions are invited from interested individuals, organisations and colleges.
The closing date for submissions is Friday 27 April 2010.”
“Washington, DC – Planned Parenthood in Mississippi and the Sexuality Information and Education Council of the United States (SIECUS) released Sex Education in Mississippi: Why ‘Just Wait’ Just Doesn’t Work, which outlines the status of sex education and failed abstinence-only-until-marriage programs in Mississippi. The report found that young people in Mississippi are currently experiencing some of the worst sexual health outcomes in the country, and are also subjected to ineffective abstinence-only-until-marriage programs and restrictive laws that limit the ability of teachers and school districts to implement comprehensive sexuality education.”
…continues on the websiteRead Full Post | Make a Comment ( None so far )
Reproductive health: Findings from the Australian Longitudinal Study on Women’s Health – January 2010
Reproductive health: Findings from the Australian Longitudinal Study on Women’s Health – January 2010
Authors: Deborah Loxton and Jayne Lucke, on behalf of the Australian Longitudinal Study on Women’s Health
“This report focuses on the reproductive health of women from the Australian Longitudinal Study on Women’s Health (ALSWH). The report was developed on the basis of discussions between the ALSWH research team and the staff of the Australian Government Department of Health and Ageing and has the broad aim of examining reproductive health among Australian women of child bearing
The ALSWH is a longitudinal cohort study funded by the Department of Health and Ageing and conducted by a team of researchers and staff based at the Universities of Newcastle and Queensland. The ALSWH first collected data in 1996, from three cohorts of women then aged 18-23, 45-50 and 70-75. While some descriptive information concerning birthing patterns of the latter two cohorts is included in the current report, the focus of analyses is on data collected from the youngest cohort, who were born 1973-1978 (See Table 1-1). The ALSWH collects data by mailed surveys at regular intervals. The 1973-1978 cohort completed surveys in 1996, 2000, 2003, and 2006. Over 14 000 women completed Survey 1 of the 1973-1978 cohort, and 9145 of these women completed Survey 4 in 2006, which reflects an acceptable level of participant retention.” … continues on the websiteRead Full Post | Make a Comment ( None so far )
More critique of the homebirth study and its reporting by the media – from Croakey – 20 January 2010
More critique of the homebirth study and its reporting by the media
January 20, 2010 – 7:58 pm, by Croakey
“Even if you’ve had only half an ear or eye on the media in recent days, you would have heard of a new study, published in the current edition of the Medical Journal of Australia showing that “babies are seven times more likely to die during home births”.
The most horrifying aspect of the study is the way it’s been reported by the media and promoted by sections of the medical profession, and I’ve written more about this in the Crikey bulletin today.
Associate Professor Hannah Dahlen, Vice President of the Australian College of Midwives, and an academic at the University of Western Sydney, and Professor Caroline Homer, Professor of Midwifery at the University of Technology Sydney, also had a critical look at the study and the way its findings are being portrayed.
…continues on the website
Further commentary from Croakey:
The AMA says we are “shooting the messenger” re homebirth critique
January 21, 2010 – 2:45 pm, by Croakey
“Further to the posts below on the homebirth study, the AMA has sought right of reply.
Dr Andrew Pesce, for those who haven’t been following the story thus far, is the president of the AMA (which opposes homebirth), an obestetrician and gynaecologist, one of the reviewers of the new study, and also the author of the MJA editorial on the study.” …continues on the website
Medical Journal of Australia editor responds to homebirth study concerns
January 21, 2010 – 2:26 pm, by Croakey
“Following yesterday’s Crikey and Croakey pieces on the homebirth study which has been hitting the headlines, I thought it only fair to ask the editor of the Medical Journal of Australia, Dr Martin Van Der Weyden, for comment.
I had raised concerns about the MJA (which is the Journal of the AMA) asking the AMA president, Dr Andrew Pesce, to do its editorial on the study, given the AMA’s opposition to homebirth and the heated politics of maternity services reform.
Below are the questions I put to him by email and in subsequent conversations, and his responses.” … continues on the webRead Full Post | Make a Comment ( None so far )
Birth and beyond: a review of the evidence about antenatal education – 8 December 2009
Author: England, Department of Health
Published date: 8 December 2009
“The aim of this study was to synthesise published evidence concerning the cost and effectiveness of antenatal education, alongside evidence about stakeholder perspectives.
The views expressed in this report are the authors’ and do not necessarily reflect those of the Department of Health.”Read Full Post | Make a Comment ( None so far )
Toolkit for high quality neonatal services – UK Department of Health – 4 Nov 2009
Document type: Guidance
Author: UK Department of Health
Published date: 4 November 2009
“The Department of Health has published new guidance to help the NHS improve the care provided for premature and sick babies during their first days.
Babies who are born prematurely or have a low birth weight require very specialised care in their first hours and days. A Neonatal Taskforce was established to identify ways of further improving services to offer the best neonatal care possible. Experts from baby charity Bliss and NHS staff have helped to develop the Neonatal Toolkit to share its findings and guidance with the NHS.
While England remains one of the safest places in the world to give birth, the Taskforce has recommended that neonatal care become more family-centred to ensure the psychological as well as physical needs of babies and families are considered. The Toolkit created for the NHS provides practical advice on how to improve on the areas that really matter to parents including:
* making sure the right staff are on hand at the birth
* managing high-risk pregnancies to make sure babies are born in the best place
* improving transfers between services where necessary
The Toolkit includes a set of eight principles for quality neonatal services and a framework to assist commissioners. The principles aim to establish the following standards in neonatal care:
* Organisation of neonatal services
* Staffing of neonatal services
* Care of the baby and family experience
* Professional competence, education and training
* Surgical services
* Clinical governance
* Data requirements”
Weight Gain During Pregnancy: Reexamining the Guidelines
Authors: Kathleen M. Rasmussen and Ann L. Yaktine, Editors; Committee to Reexamine IOM Pregnancy Weight Guidelines; Institute of Medicine; National Research Council, June 2009
“As women of childbearing age have become heavier, the trade-off between maternal and child health created by variation in gestational weight gain has become more difficult to reconcile. Weight Gain During Pregnancy responds to the need for a reexamination of the 1990 Institute of Medicine guidelines for weight gain during pregnancy. It builds on the conceptual framework that underscored the 1990 weight gain guidelines and addresses the need to update them through a comprehensive review of the literature and independent analyses of existing databases. The book explores relationships between weight gain during pregnancy and a variety of factors (e.g., the mother’s weight and height before pregnancy) and places this in the context of the health of the infant and the mother, presenting specific, updated target ranges for weight gain during pregnancy and guidelines for proper measurement. New features of this book include a specific range of recommended gain for obese women.
Weight Gain During Pregnancy is intended to assist practitioners who care for women of childbearing age, policy makers, educators, researchers, and the pregnant women themselves to understand the role of gestational weight gain and to provide them with the tools needed to promote optimal pregnancy outcomes.”Read Full Post | Make a Comment ( None so far )
Weight Gain During Pregnancy: Reexamining the Guidelines – Institute of Medicine (US) Released On: May 28, 2009
“It has been nearly two decades since guidelines for how much weight a woman should gain during pregnancy were issued by the Institute of Medicine (IOM). In that time, more research has been conducted on the effects of weight gain in pregnancy on the health of both mother and baby. There have also been dramatic changes in the population of women having babies. American women are now a more diverse group; they are having more twin and triplet pregnancies, and they tend to be older when they become pregnant. Women today are also heavier; a greater percentage of them are entering pregnancy overweight or obese, and many are gaining too much weight during pregnancy. Many of these changes carry the added burden of chronic disease, which can put the mother and her baby’s health at risk.
Given these changes, the IOM’s 2009 report Weight Gain During Pregnancy: Reexamining the Guidelines examines weight gain during pregnancy from the perspective that factors that affect pregnancy begin before conception and continue through the first year after delivery.
The new weight gain guidelines are based on revised Body Mass Index (BMI) categories and now have a recommendation for obese women. To meet the recommendations of the report, women need to gain within the weight gain ranges for their BMI category. Achieving the recommended gain will require individualized attention and support from a woman’s care providers as well as her family and community.”Read Full Post | Make a Comment ( None so far )
“A unique new training tool to help maternity and community health services achieve the training standards for staff required by the UNICEF Baby Friendly Initiative (BFI), has been developed by Health Behaviour Research Ltd, a spin-out company from Coventry University.
Health Behaviour Research Ltd uses research conducted at the university to produce new interventions which help improve health, making them accessible to the public and healthcare professionals.
As the only evidence base available worldwide in this area CUBA (Coventry University Breastfeeding Assessment) uses research into breastfeeding practice and the BFI standards to assess the knowledge and skills of health professionals supporting breastfeeding in maternity services and in the community.
CUBA is an online, multiple-choice questionnaire addressing all key topics of the BFI training standards to successful breastfeeding, including video clips and photograph-based questions for more realistic scenarios. Upon completion of the questionnaire instant individual feedback is given to the healthcare practitioner, along with recommendations for further study and areas to improve.
This assessment is fully compatible with the Breastfeeding Workbook and DVD from Health Behaviour Research Ltd, which provide essential knowledge of the principles and practice of breastfeeding support. Healthcare workers can easily identify areas in which they need to develop their knowledge and skills, studying in their own time and at their own pace using the workbook and DVD. When staff undertake a further CUBA assessment, this can show them, and their managers, what impact the workbook has had on their breastfeeding knowledge and skills.
Professor Louise Wallace, from Coventry University and Health Behaviour Research Ltd, said: “For healthcare trusts it is a massive commitment of staff and time to try and reach the standards of the Baby Friendly Initiative. We wanted to develop a tool that would easily assess the training needs of the staff as individuals and provide resources to develop the necessary knowledge and skills, but in a way that was flexible and convenient for the workforce.”
CUBA will be piloted by maternity, community and children’s services in Dudley, Walsall and Solihull in a joint funded initiative by the Department of Health West Midlands and NHS West Midlands. The pilot was launched in Solihull and the Black Country during the National Breast Feeding Awareness week beginning 10th May. Up to 900 members of staff from the three healthcare economies are expected to take part.
“It is really important that we address inequalities in health through breastfeeding capacity building whilst achieving UNICEF BFI standards. This pilot may show how we can create a step change in our levels of breastfeeding, particularly gaining skills to support those least likely to breastfeed,” Caroline Mansell, Regional Infant Feeding Coordinator, Department of Health West Midlands.
The UNICEF Baby Friendly Initiative was launched in the UK in 1994 to encourage maternity hospitals to implement the 10 steps to successful breastfeeding; in 1998 this was extended to cover 7 steps for community health workers.”Read Full Post | Make a Comment ( None so far )
Recertification in obstetrics and gynaecology and CPD Programme – Royal College of Obstetricians and Gynaecologists April 2009
Recertification in obstetrics and gynaecology – Royal College of Obstetricians and Gynaecologists April 2009 (pdf)
RCOG CPD Programme – continuing professional development guide – January 2009 (pdf)Read Full Post | Make a Comment ( None so far )
This guidance describes the differences between seasonal, swine and avian influenza, including information on symptoms, avoiding infection, and what advice to give women and their families.Read Full Post | Make a Comment ( None so far )
“The new UK-WHO growth charts for children from birth to 4 years of age are now available. The charts have been developed as a project undertaken within the Science and Research Department led by Professor Charlotte Wright from University of Glasgow and funded by the Department of Health.
The charts are available in an A4 format and as 6 separate charts for insertion in the Personal Child Heatlh Record (PCHR). There is also a new specialist low birthweight A4 chart for births from 23 weeks gestation .
The charts have been endorsed by the following organisations:
Breastfeeding Manifesto Coalition
British Dietetic Association
Child Growth Foundation
Royal College of Midwives
Royal College of Nursing
Why do we need new growth charts?
The new charts are based on the World Health Organization (WHO) Child Growth Standards which describe the optimal growth of healthy breast fed children. Previous UK growth charts were based on data from studies on breast- and formula-fed children so do not reflect normal weight fluctuations of breast-fed infants in the first few weeks.
The new charts combine UK90 and WHO data. There are clear instructions on how to measure, plot and interpret the chart. New features include an adult height predictor, a body mass index (BMI) conversion chart, and guidance on gestational age correction. Read about a summary of the differences and new features in the new charts.” … continues on the siteRead Full Post | Make a Comment ( None so far )
Commonwealth Chief Nurse and Midwifery Officer
Fetal alcohol spectrum disorders (FASD) – November 2008 – from the Health Services Assessment Collaboration (HSAC), NZ
Fetal alcohol spectrum disorders (FASD) ( PDF 4MB ) 2008
Systematic reviews of prevention, diagnosis and management
This report contains a systematic review of primary, secondary and tertiary interventions that aim to reduce the burden of FASD, and a systematic review of screening tools. A top-level review of FASD diagnosis and management strategies was also performed. In addition, there is a brief overview of the literature on the economics of FASD.
Summary – Key Findings ( PDF 88kB )Read Full Post | Make a Comment ( None so far )
What is Safer Births?
Safer Births is a service improvement programme run by The King’s Fund with national and local partners. It aims to improve the safety of maternity services by supporting frontline professionals.Read Full Post | Make a Comment ( None so far )
It has been produced by the Steering Committee for the Review of Government Service Provision (SCRGSP). The report has been published in two volumes. Also released with the report are attachment tables, which are not part of the printed report but are available in the report sections.
Primary and Community Health
Breast cancer detection and management
Aged care services
Services for people with a disability
Supported accommodation and assistance services
Government services and Indigenous people (PDF – 99 Kb)
Gestational diabetes mellitus in Australia, 2005-06
Diabetes series no. 10
This is the first national report on the incidence of gestational diabetes mellitus among Australian women. The report uses data from the National Diabetes Services Scheme and the National Hospital Morbidity Database to determine the number of cases of GDM among Australian women of child-bearing age. Trends in the incidence of the condition over time, changes in insulin treatment status and differences by high-risk groups-including women aged over 30 years, women who identify as Aboriginal or Torres Strait Islander and women born overseas-are also included in the report.
Authored by Pieris-Caldwell I & Templeton M.
Published 3 December 2008; ISSN 1444-8033; ISBN-13 978 1 74024 859 4; AIHW cat. no. CVD 44; 49pp.Read Full Post | Make a Comment ( None so far )