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Found 844 results
  1. News Article
    Dilshad Sultana was 36 weeks pregnant with her second child in 2019 when she experienced stomach pain and noticed her baby was moving less. Mrs Sultana, from Sutton Coldfield, said she had been due to have a Caesarean section on 8 July but on 20 June she started to feel pain in her abdomen and lower back. She said she was confused but that it did not feel like a contraction and called hospital staff at about 17:00 to say it felt like her baby was moving less. After following advice to rest and take pain relief, she attended hospital at about 22:30 and staff started monitoring Shanto's heart rate. It was not until almost three hours later that Shanto was delivered by emergency C-Section. Shanto suffered severe brain damage and would spent the next 22 days in intensive care, suffering seizures and multiple brain haemorrhages. Shanto now requires around-the-clock care and Mrs Sultana enlisted lawyers to pursue a care of medical negligence against the trust. Birmingham Women's and Children's NHS Foundation Trust has admitted liability and made a voluntary interim payment allowing the family to move to a new home specifically adapted to meet Shanto's extensive care, therapy and equipment needs. Fiona Reynolds, the chief medical officer, said: "We'd like to offer our heartfelt apologies again to the family. "It's clear the standard of care we offered to them fell below those required and expected. For this, we are truly sorry." Now, Mrs Sultana is campaigning for change - she wants to see mothers listened to in maternity care and more attention paid to monitoring babies' heart rates. Read full story Source: BBC News, 27 March 2023
  2. News Article
    Women at risk of dying in pregnancy or childbirth will be treated at a network of specialist NHS centres under a national drive to halve maternal deaths. For the first time, women in England with conditions such as heart disease, epilepsy or cancer will have access to specialist care from doctors trained to treat medical problems in pregnancy. Two thirds of maternal deaths in the UK are due to medical conditions that pre-date or develop during pregnancy, rather than direct complications of birth. Previously there was no dedicated national service for these women. The 17 NHS centres, covering every region of the country, aim to prevent these deaths by bringing together specialist doctors, obstetricians, midwives and nurses under one roof. GPs and A&E staff will also be trained to identify “red flag” symptoms of illnesses in pregnant women and refer patients directly to the centres, where they can be assessed and receive medication or procedures. Read full story (paywalled) Source: The Times, 20 March 2023
  3. News Article
    Unconscious bias in the UK healthcare system is contributing to the stark racial disparity in maternal healthcare outcomes, a conference has heard. The Black Maternal Health Conference UK, also heard that black women not being listened to by healthcare professionals was also a contributing factor. The conference, organised by The Motherhood Group, was arranged to highlight the racial inequality in maternal healthcare and the disparity in maternal mortality between white, ethnic minority and black women in the UK. Black women in the UK are four times more likely to die in pregnancy and childbirth than white women, according to a report published by MBRRACE-UK. Asian women are twice as likely to die in pregnancy or childbirth. Sandra Igwe, who founded the NGO The Motherhood Group in 2016 after the traumatic birth of her daughter, told the PA Media that the event was an opportunity to “bridge the community, stakeholders, professionals, [and] government”, de-stigmatise mental health and bring about change to improve black maternal health. “There are so many stats – so why wouldn’t we have a whole day’s conference dedicated to addressing these, just scratching the surface of some of the stats?” Charities and activists have been raising alarm bells about the dangerous consequences of unconscious bias in maternal healthcare for many years. Igwe co-chaired the Birthrights inquiry, a year-long investigation into racial injustice in the UK maternity services, which heard testimony from women, birthing people, healthcare professionals and lawyers and concluded that “systemic racism exists in the UK and in public services”. Read full story Source: The Guardian, 20 March 2023 Sandra Igwe is our hub topic lead for Black Maternal Health. Read our recent interview with Sandra.
  4. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Isabela shares how her experience of losing her baby daughter to avoidable harm in 2006 led to her involvement in patient safety advocacy. She talks to us about the vital role of patient campaigners in driving the movement to reduce avoidable harm, and why we need to shift from patient inclusion to belonging in order to improve patient safety.
  5. News Article
    The United States remains one of the most dangerous wealthy nations for a woman to give birth. Maternal mortality rose by 40% at the height of the pandemic, according to new data released by the US Centers for Disease Control and Prevention. In 2021, 33 women died out of every 100,000 live births in the US, up from 23.8 in 2020. That rate was more than double for black women, who were nearly three times more likely to die than white women, according to the CDC. Compared to other countries, the maternal mortality rate was twice as high in the US than in the UK, Germany and France; and three times higher than in Spain, Italy, Japan and several other countries, according to the most recent global comparison data kept by the World Bank. "Clearly the US is an outlier," said Joan Costa-i-Font, a professor of health economics at the London School of Economics. "Covid has made [maternal mortality] worse, but it was already a major issue in the US." Read full story Source: BBC News, 18 March 2023
  6. Content Article
    In this Guardian article, Sarah Kendell describes her experience of maternity care in Australia, highlighting the stark difference in care offered before and after a woman has given birth. She says "at the most difficult transition of our lives–after childbirth–the healthcare system leaves us to fend for ourselves," and argues that the impact this can have on the health and wellbeing of women and their babies needs to be considered. She asks whether reallocating some resource from antenatal care to postnatal care would produce health benefits for new mothers and babies.
  7. News Article
    A couple whose baby died after he was starved of oxygen during a home birth are campaigning for risky breech deliveries to be spotted earlier. Arthur Trott was an undiagnosed breech baby, born after a planned home birth in Burgess Hill on 24 May 2021. A breech delivery is when a baby's bottom or feet will emerge first. An inquest into his death found a delay in transfer to hospital "materially contributed" to his brain injury. The South East Coast Ambulance Service Trust said it welcomed "any changes to national breech birth guidance". Arthur's parents believe a breakdown in communication between the paramedics who attended and their control room meant Mrs Trott was kept at home too long. Arthur's father, Matt Trott, said: "You could hear the panic and confusion in everyone's voices. One minute they were told to go to hospital, the next minute to stay." As a result of Arthur's death, all planned home births in Sussex are being offered a presentation scan at 38 weeks. Read full story Source: BBC News, 14 March 2023
  8. Content Article
    In this blog, Sonia Barnfield, Clinical Adviser for Maternity Investigations at the Healthcare Safety Investigation Branch (HSIB), looks at risk assessments during the maternity care pathway, following HSIB's recent national learning report on the same subject. Sonia outlines the need for change in the way that risk during pregnancy is assessed and managed, highlighting that there is currently no single national guidance and that HSIB identified repeated examples of insufficiently robust, continuous risk assessment in the maternity pathway. She lays out six key themes highlighted in HSIB's report and looks at how risk assessments should change to improve safety for pregnant women and their babies.
  9. Content Article
    At least 1 in 5 mothers experience a perinatal mental health (PMH) problem, making mental illness the most common serious health problem that a woman might experience in the perinatal period. This resource was produced by the Institute of Health Visiting (iHV) in partnership with the Maternal Mental Health Alliance (MMHA). It draws together principles collated from a comprehensive desktop evidence review of current policy, research, reports and literature on what good PMH care looks like. It aims to support individuals, services, pathways, multiagency groups and networks across health, public health, social care and non statutory services to consider: Where are we now? Is the care we currently provide good enough? What do families want mental health care in the perinatal period to look like?
  10. News Article
    Bereaved families are having to report maternity blunders because watchdogs and hospitals are unable to spot failings, an expert has warned. Bill Kirkup said avoidable deaths were "a badge of shame" but would continue without urgent change. Eight years on from his report into the Morecambe Bay maternity scandal, he said the failure of officials to act had needlessly cost more lives. "I am very disappointed – and surprised – that we're still where we are", he said. "That's a terrible badge of shame for the health service that it takes families to come and tell us what's wrong. "Yet just about every tragedy that I've ever been involved with investigating has come to light when there's a group of families who say 'You've got a problem here'. "People are lying, they're not being open and they're concealing what's happening. "If we can't bring this change, I'm not confident that there won't be another East Kent, Morecambe Bay or Nottingham, somewhere else." Read full story Source: Mail Online, 10 March 2023
  11. News Article
    A trust has been issued with a warning notice after the Care Quality Commission (CQC) raised concerns about parts of its maternity services. Following a focused inspection at University Hospitals Dorset Foundation Trust in September and November last year, the CQC has rated maternity services at Poole Hospital “inadequate”, down from “good”. The service was also rated “inadequate” in the safety and well-led domains. The CQC report warned that Poole Hospital’s maternity unit did not always have enough midwifery or medical staff to keep mothers and babies safe. The inspectors noted this had led to delays to induction of labour and caesarian sections, including emergency sections. A warning notice was also issued over concerns about the unit’s emergency call bell system, which worked “intermittently” due to poor wireless signal, and processes used to summon help during an emergency. The trust said it had since “taken action to address this risk”. Read full story (paywalled) Source: HSJ, 10 March 2023
  12. News Article
    The government’s response to the East Kent maternity scandal inquiry has been condemned as ‘very disappointing’ by its chair. More than four months on from the inquiry report, ministers this morning issued what they called an “initial response” to it, as a brief written statement to Parliament. It contained few specific proposals, instead saying government was kicking off a series of other reviews, and “working” with various other agencies. Inquiry chair Bill Kirkup, the well-regarded former medic and expert in care failures, told HSJ the response was poor and should have been “wider and deeper”. Dr Kirkup said the response showed government had “not grasped how fundamental” some of the issues outlined in his report were, and “what sort of initiative” was needed to address them. Read full story (paywalled) Source: HSJ, 7 March 2023
  13. Content Article
    Statement from Maria Caulfield, Parliamentary Under Secretary of State (Minister for Mental Health and Women's Health Strategy) on the Government’s initial response to the report of the independent review into the maternity and neonatal services at East Kent University NHS Foundation Trust that was published on the 19 October 2022. NHS England commissioned Dr Bill Kirkup to undertake this review following concerns about the quality and outcomes of care.
  14. News Article
    Hospital trusts must only remove gas and air on maternity wards as a “last resort”, NHS England has said. Several hospitals temporarily suspended the use of gas and air following concerns that midwives and staff are being exposed to too-high levels of gas over prolonged periods of time. Some pregnant women have posted on social media, saying the decisions have left them feeling anxious and worried about their pain relief options. Some NHS trusts have also come under fire for the way they communicated the message that gas and air would be suspended. In new guidance to trusts, NHS England said it had looked at the health impacts for staff of levels of nitrous oxide exceeding prescribed levels, “drawing upon relevant legislation and existing guidance on the safe management of gas and air in healthcare settings”. It said trusts must ensure they are compliant with legislation and national guidance on the use of gas, but must only remove it for women as a last resort and must tell them about other pain relief. “Where, following the meeting of the (medical gas) committee, there is concern that the trust is not compliant, then this should be formally reported by the trust to the NHS England regional operations centre for the attention of the regional chief midwife,” the guidance said. Read full story Source: The Independent, 3 March 2023
  15. News Article
    April Valentine planned to have a complication-free delivery and to enjoy her life as a first-time parent to a healthy baby girl. Instead, California’s department of health and human services is investigating the circumstances of the April's death during childbirth. April, a 31-year-old Black woman, went to Centinela hospital in Inglewood on 9 January and died the next day. Her daughter Aniya was born via an emergency caesarean section. Her family and friends say that staff at the hospital ignored the pregnant woman’s complaints of pain, refused to let her doula be in the hospital room during the birth and neglected Valentine as her child’s father performed CPR on her. “It’s hard to even sleep, to even look at my child after seeing what I saw in that hospital that night,” said Nigha Robertson, Valentine’s boyfriend and Aniya’s father, to the Los Angeles county board of supervisors during its 31 January meeting. “I’m the only one who touched her, I’m the one who did CPR. Nobody touched her, we screamed and begged for help … they just let her lay there and die.” During the 31 January board of supervisors meeting, people who spoke in support of Valentine said that Centinela hospital is known around the community for being one of the “worst hospitals in the county” for Black and Latina mothers and their infants. Since 2000, the maternal mortality rate in the US has risen nearly 60%, with about 700 people dying during pregnancy or within a year of giving birth each year. More than 80% of the deaths are preventable, according to the US Centers for Disease Control and Prevention. The US has the highest maternal mortality rate among industrialized countries and Black women are three times more likely to die during childbirth than white women. Read full story Source: The Guardian, 3 March 2023
  16. Content Article
    Risk assessment during the maternity pathway relies on healthcare professionals recognising a change in a pregnant woman/person’s circumstances that may increase the level of risk. Risk assessments are undertaken during the numerous contacts pregnant women/people have with a team of healthcare professionals throughout the maternity pathway. This thematic review draws on findings from the Healthcare Safety Investigation Branch's (HSIB's) maternity investigation programme to identify key issues associated with assessing risk during pregnancy, labour and birth (known as the ‘maternity pathway’). It examined all reports undertaken by the HSIB maternity investigation programme from April 2019 to January 2022, with the aim of identifying key learnings about risk assessment. A total of 208 reports that had made findings and recommendations to NHS trusts about risk assessment during the maternity pathway were included. The review identified an overarching theme around the need to facilitate and support individualised risk assessments for pregnant women/people to improve maternity safety. Within this, seven specific ‘risk assessment themes’ within the maternity care pathway were identified as commonly appearing in HSIB reports. These seven themes require a focus from the healthcare system to help mitigate risks and enable NHS trusts and clinicians to deliver safe and effective maternity care to pregnant women/people.
  17. Content Article
    Victoria Vallance, Director of Secondary and Specialist Care, provides an update on the Care Quality Commission (CQC)’s ongoing national maternity inspection programme and offers early insight into the emerging themes, including good practice examples to support wider learning across all trusts.
  18. News Article
    A criticised maternity service needs 37 more midwives, about a fifth of its total midwifery workforce. The Care Quality Commission has said Northampton General Hospital did not always have enough qualified and experienced staff to keep women safe from avoidable harm. Figures obtained by the BBC show that 49 serious incidents have occurred in its maternity services in four years. The hospital said it had undertaken "a lot of work" in the past 18 months and a recruitment process was under way. According to a Freedom of Information Act response, between November 2018 and November 2022, the hospital had 278 serious incidents, with the highest level coming across maternity services, including gynaecology and obstetrics. There are currently 37 vacancies for midwives but the trust said it manages staffing levels "closely and ensure that all shifts are covered by bank or midwives working altered shift patterns, to ensure that we are able to provide a safe maternity experience". Read full story Source: BBC News, 27 February 2023
  19. News Article
    When Amy Fantis gave birth to her first child two years ago, the labour was rapid, lasting only about four hours, and she was reliant on gas and air. Her second baby is due in just a few days — but the hospital has, like others around Britain, imposed a ban on the popular form of pain relief. Fantis, 36, from Broxbourne, Hertfordshire, is one of many women affected by the decision of several NHS trusts to suspend the use of the gas because of fears that midwives and doctors have been exposed to unsafe levels for prolonged periods. In some hospitals, levels of the nitrous oxide and oxygen mix are more than 50 times higher than the safe workplace exposure limits. In a survey of more than 16,600 women who gave birth last year, the Care Quality Commission found that 76% of respondents used gas and air at some point during labour. Although short-term use of the gas in childbirth is harmless to women and their babies, long-term exposure for midwives and doctors can affect the body’s ability to absorb vitamin B12, damaging nerves and red blood cells and causing anaemia. It is not believed that any NHS staff have become ill as a result of long-term exposure to gas and air. NHS England and the Health and Safety Executive recently warned other hospitals that they need to check the ventilation on maternity wards and ensure staff are kept safe. NHS England is planning to send out new guidance to trusts on the issue after a series of hospitals had to stop using the gas. Read full story (paywalled) Source: The Times, 25 February 2023
  20. Content Article
    The OptiBreech project is a research study exploring the feasibility of evaluating a new care pathway for women with a breech pregnancy. About 1 in 25 babies are born bottom-down (breech) after 37 weeks of pregnancy. Women who wish to plan a vaginal breech birth have asked for more reliable support from an experienced professional. This aligns with national policy to enable maternal choice. In this video, Dr Shawn Walker explains why the combination of meconium and tachycardia, particularly in the first stage of labour, indicates increased risk in breech births.
  21. News Article
    Progress to cut the number of women dying in pregnancy or childbirth has stalled or even reversed in recent years, with a death recorded every two minutes, the United Nations has said. Years of gains had begun to plateau even before the pandemic and there had been “alarming setbacks for women’s health,” according to a new report from several UN agencies, including the World Health Organization (WHO). Maternal mortality rates had fallen widely in the first 15 years of the century, but since 2016, they had only dropped in two UN regions: Australia and New Zealand, and in Central and Southern Asia. The rate went up in Europe and North America by 17% and in Latin America and the Caribbean by 15%. Elsewhere it stagnated. Read full story (paywalled) Source: The Telegraph, 23 February 2023
  22. Content Article
    Every day in 2020, approximately 800 women died from preventable causes related to pregnancy and childbirth - meaning that a woman dies around every two minutes. Sustainable Development Goal (SDG) target 3.1 is to reduce maternal mortality to less than 70 maternal deaths per 100 000 live births by 2030. This report presents internationally comparable global, regional and country-level estimates and trends for maternal mortality between 2000 and 2020.
  23. News Article
    Three women who died under the care of a hospital's maternity unit may have survived if earlier recommendations had been implemented, a report has said. The cases occurred at University Hospitals of Derby and Burton (UHDB) NHS Foundation Trust over 16 months. A review by the Healthcare Safety Investigation Branch (HSIB) also found a culture of intimidation and bullying. The report found that although there was no common theme to the deaths - and four other life-threatening cases that occurred in the same period - processes and leadership had been inconsistent and fragmented. HSIB said "robust action planning and prompt addressing of the learning" from previous recommendations from other investigations "may have had an impact on the outcome for the women who received care during the seven events included in this thematic review". Read full story Source: BBC News, 22 February 2023
  24. News Article
    The trust at the centre of a maternity scandal has been ordered to report on urgent improvements in services for women and babies, amid ‘significant concerns’ about the risk of harm. The Care Quality Commission (CQC) used its enforcement powers to issue the conditions on East Kent Hospitals University Foundation Trust, after it carried out an unannounced inspection last month. However, the “section 31” warning letter has just been made public, and the first deadline for the trust to report back to the CQC is Monday (20 February). The CQC said some of the problems it found were due to the labour ward environment – but others involved monitoring of women and babies whose conditions deteriorate and the risk of cross-infection due to poor cleanliness standards. “We have significant concerns about the ongoing wider risk of harm to patients and a need for greater recognition by the trust of the steps that can be taken in the interim to ensure safety and an improved quality of care,” Carolyn Jenkinson, CQC’s deputy director of secondary and specialist healthcare, said in a statement today. Read full story (paywalled) Source: HSJ, 17 February 2023
  25. News Article
    Two health watchdogs have issued safety warnings after junior staff were left to work unsupervised on maternity wards previously criticised after a baby’s death. Training regulator, Health Education England (HEE), criticised the “unacceptable” behaviour of consultants who left junior doctors to work without any superiors at South Devon and Torbay Hospital Foundation Trust’s wards. The maternity safety watchdog Healthcare Safety Investigation Branch (HSIB) also raised “urgent concerns” over student midwives and “unregistered midwives” providing care without supervision. The latest criticism comes after the trust was condemned over the death of Arabella Sparkes, who lived just 17 days in May 2020 after she was starved of oxygen. According to a report from December 2022, seen by The Independent, the HEE was forced to review how trainees were working at the trust’s maternity department after concerns were raised to the regulator. It was the second visit carried out following concerns about the department, and reviewers found there had been “slow progress” against concerns raised a year earlier. Read full story Source: The Independent, 16 February 2023
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