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Found 471 results
  1. News Article
    The government must stop treating women “like children” and permanently allow at home early medical abortions, MPs and health professionals have said. Abortion rules changed after Covid hit the UK in March 2020, with the government allowing abortion pills to be sent via post to be taken at home after a phone consultation. The new system - referred to as “telemedicine” - was due to run out on 25 March but the government declared a six-month extension for at home early medical abortions earlier in the month. MPs are now set to vote on whether to make telemedicine abortion services permanent on Wednesday. Clare Murphy, chief executive of the British Pregnancy Advisory Service (BPAS), told The Independent: “We welcome the vote. MPs have the opportunity to prevent the recriminalisation of women who use Stella Creasy, a Labour MP and campaigner for abortion rights, is one of many MPs calling for telemedicine abortion services to be made permanent. “Despite the best attempts to scare, telemedicine has been shown to be safe, secure and preferable for many patients for a variety of reasons - it’s time to trust women and ensure they can make the right choices for themselves when it comes to their own medical care”, she said. Read full story Source: The Independent, 29 March 2022
  2. Content Article
    A woman who experiences pain during caesarean section under neuraxial anaesthesia is at risk of adverse psychological sequelae. Litigation arising from pain during caesarean section under neuraxial anaesthesia has replaced accidental awareness under general anaesthesia as the most common successful medicolegal claim against obstetric anaesthetists. Generic guidelines on caesarean section exist, but they do not provide specific recommendations for this area of anaesthetic practice. This guidance aims to offer pragmatic advice to support anaesthetists in caring for women during caesarean section. It emphasises the importance of non-technical skills, offers advice on best practice and aims to encourage standardisation. The guidance results from a collaborative effort by anaesthetists, psychologists and patients and has been developed to support clinicians and promote standardisation of practice in this area.
  3. News Article
    The Royal College of Obstetricians and Gynaecologists (RCOG) has called for the immediate suspension of charging for NHS maternity care for migrant women because members say this government policy is harming the health of pregnant women and their babies. It is the first time the health professionals’ body has issued a position statement on this issue. The charity Maternity Action and the Royal College of Midwives have long expressed concern about the impact of NHS charging on this group of women. Charging forms a key plank of the Home Office’s hostile environment for migrants. The government says the charging policy is in place to deter health tourism but medics treating migrant pregnant women say there is little evidence that previously free NHS maternity care for all attracted health tourists. According to the 2019 MBRRACE-UK confidential inquiry into maternal deaths, three women were found to have died between 2015 and 2017 who may have been reluctant to access maternity care due to fears about charging and impact on their immigration status. Dr Brenda Kelly, an NHS consultant obstetrician working in Oxford, treats many pregnant migrant women. She is calling for the barriers to them accessing maternity care to be removed urgently. She described the case of one migrant woman who arrived in A&E shortly before delivering a stillborn baby. The woman had been fearful of coming forward for antenatal care although she was suffering from multiple, pregnancy-related health problems. “I hope I never have to hear cries like that woman’s cries ever again,” said Kelly. “The way to safeguard these women is to build up trust. If they are landed with a bill of several thousand pounds they will disengage. They are not health tourists, they are desperate. The commitment to maternal health equity means ending charges for maternity care. The time for action is now.” Read full story Source: The Guardian, 27 March 2022
  4. Content Article
    1 in 5 women are affected by maternal mental health problems, which are the leading cause of maternal death in the first postnatal year. This report by the Maternal Mental Health Alliance (MMHA) estimates the costs and benefits of a model of care which could give women’s mental health the same priority as their physical health during the perinatal period. The model focuses on the essential role of midwives and health visitors and would allow for women’s mental wellbeing to be accurately assessed at every routine contact and suitable treatments to be offered. It is based on research commissioned by MMHA and conducted by the London School of Economics and Political Science (LSE), which estimates that making changes to standard practice could mean £52 million in NHS savings and quality of life improvements worth £437 million.
  5. News Article
    Pregnant women with suspected pre-eclampsia will now be offered a test on the NHS to detect the condition. Pre-eclampsia affects some women, usually during the second half of pregnancy or soon after their baby is born. It can lead to serious complications if it is not picked up during maternity appointments, with early signs including high blood pressure and protein in the urine. In some cases, women can develop a severe headache, vision problems such as blurring or flashing, pain just below the ribs, swelling and vomiting. Tests have been available to help rule out the condition but midwives will now use tests designed to pick up a positive diagnosis. In new draft guidance, the National Institute for Health and Care Excellence (NICE) said midwives could use one of four blood tests to help diagnose suspected preterm pre-eclampsia. Jeanette Kusel, the acting director for medtech and digital at NICE, said: “These tests represent a step-change in the management and treatment of pre-eclampsia. New evidence presented to the committee shows that these tests can help successfully diagnose pre-eclampsia, alongside clinical information for decision-making, rather than just rule it out. “This is extremely valuable to doctors and expectant mothers as now they can have increased confidence in their treatment plans and preparing for a safe birth.” Read full story Source: The Guardian, 25 March 2022
  6. Content Article
    In Sierra Leone, 34% of pregnancies and 40% of maternal deaths are amongst teenagers and risks are known to be higher for younger teenagers. This qualitative study in Reproductive Health aimed to explore the causes of this high incidence of maternal death for younger teenagers, and to identify possible interventions to improve outcomes. Through focus groups and semi-structured interviews, the authors identified transactional sex - including sex for school fees, sex with teachers for grades and sex for food and clothes - as the main cause of high pregnancy rates for this group. They also identified gendered social norms for sexual behaviour, lack of access to contraception and the fact that abortion is illegal in Sierra Leone as factors meaning that teenage girls are more likely to become pregnant. Key factors affecting vulnerability to death once pregnant included abandonment, delayed care seeking and being cared for by a non-parental adult. Their findings challenge the idea that adolescent girls have the necessary agency to make straightforward choices about their sexual behaviour and contraceptives. They identify a mentoring scheme for the most vulnerable pregnant girls and a locally managed blood donation register as potential interventions to deal with the high rate of maternal death amongst teenage girls.
  7. News Article
    Banning home abortions could increase risks to women and waste NHS resources, leading doctors have warned. The “pills by post” system is set to be dismantled in England by September, having been introduced as a temporary measure at the start of the pandemic. However, the plans, disclosed by The Telegraph last month, have sparked outrage from medical organisations and women’s groups. The decision by ministers to return to pre-pandemic abortion systems in England has sparked fierce debate and could be subject to a vote in Parliament on Wednesday. Writing for The Telegraph, the leaders of the Academy of Medical Royal Colleges, the British Medical Association and the Royal College of Obstetricians and Gynaecologists have urged ministers to reconsider their intentions. They said that the current system has meant terminations take place earlier in the pregnancy, reducing the risk of complications, and that the most vulnerable women, including domestic abuse victims, are able to get help. Baroness Sugg of Coldharbour, a former operations chief to David Cameron, said that the UK should “stand strongly against the rollback of women’s rights”. She has also tabled an amendment to the Health and Care Bill seeking to maintain the current system in England. Read full story (paywalled) Source: The Telegraph, 15 March 2022
  8. News Article
    Women and NHS staff have warned that mothers are being “forgotten” after giving birth, with a staff crisis only making matters worse. Kate, a 32-year-old from Leeds, says she has been left in “excruciating” pain for nine years after horrifying postnatal care. Other women have told The Independent stories of care ranging from “disjointed” to “disastrous”. It comes as midwives warn there are “horrendous” shortages in community services, which have prevented women from accessing adequate antenatal and postnatal care. Mary Ross-Davie, the Royal College of Midwives’ director for professional midwifery, said that with each Covid wave midwifery staffing has been hit worse than the last. To provide safe care during labour, antenatal and postnatal care, teams are sent into wards putting “huge pressure on care”. She said this could mean clinicians end up “missing things”, such as women struggling emotionally after birth. The warnings over poor antenatal and postnatal care come after experts at the University of Oxford said in November there were “stark” gaps in postnatal care, despite the highest number of deaths being recorded in the postnatal period. Dr Sunita Sharma, lead consultant for postnatal care at Chelsea and Westminster Trust, said that when NHS maternity inpatient staffing overall is in crisis “often the first place staff are moved from is the postnatal ward, which is clinically very appropriate, but it can come at a cost of putting more pressure on postnatal care for other mothers”. Dr Sharma said postnatal teams were doing their best to improve services but need national drivers and funding to sustain improvement. Read full story Source: The Independent, 16 March 2022
  9. News Article
    Pregnant women should be asked how much alcohol they are drinking and the answer recorded in their medical notes, new "priority advice" for the NHS says. The advice, from the National Institute for Health and Care Excellence (NICE), is designed to help spot problem drinking that can harm babies. Infants with foetal alcohol spectrum disorder (FASD) can be left with lifelong problems. The safest approach during pregnancy is to abstain from alcohol completely. The more someone drinks while pregnant, the higher the chance of FASD - and there is no proven "safe" level of alcohol. But the risk of harming the baby is "likely to be low if you have drunk only small amounts of alcohol before you knew you were pregnant or during pregnancy", the Department of Health says. An earlier draft of the recommendations for NHS staff in England and Wales suggested transferring data on a woman's alcohol intake to her child's medical notes - but this has now been dropped, following concern women who needed help might hide their drinking. The Royal College of Midwives spokeswoman Lia Brigante said: "As there is no known safe level of alcohol consumption during pregnancy, the RCM believes it is appropriate and important to advise women that the safest approach is to avoid drinking alcohol during pregnancy and advocates for this. "We are pleased to see that the recommendation to record alcohol consumption and to then transfer this to a child's record has been reconsidered. "This had the potential to disrupt or prevent the development of a trusting relationship between a woman and her midwife." Read full story Source: BBC News, 16 March 2022
  10. News Article
    The World Health Organization has published new guidelines on abortion aimed at tackling the unsafe care that leads to up to 39 000 maternal deaths and millions of women being admitted to hospital with complications every year. When carried out using a method recommended by WHO, abortion is a safe procedure. Tragically, however, only half of all abortions take place under such conditions, with unsafe abortions causing around 39 000 deaths globally. Most of these deaths are in lower-income countries – with over 60% in Africa and 30% in Asia – and among those living in the most vulnerable situations. “Being able to obtain safe abortion is a crucial part of health care,” said Craig Lissner, acting Director for Sexual and Reproductive Health and Research at WHO. “Nearly every death and injury that results from unsafe abortion is entirely preventable. That’s why we recommend women and girls can access abortion and family planning services when they need them.” Evidence shows that restricting access to abortions does not reduce the number of abortions that take place. In fact, restrictions are more likely to drive women and girls towards unsafe procedures. In countries where abortion is most restricted, only 1 in 4 abortions are safe, compared to nearly 9 in 10 in countries where the procedure is broadly legal. “It’s vital that an abortion is safe in medical terms,” said Dr Bela Ganatra, Head of WHO’s Prevention of Unsafe Abortion Unit. “But that’s not enough on its own. As with any other health services, abortion care needs to respect the decisions and needs of women and girls, ensuring that they are treated with dignity and without stigma or judgement. No one should be exposed to abuse or harms like being reported to the police or put in jail because they have sought or provided abortion care." “The evidence is clear – if you want to prevent unintended pregnancies and unsafe abortions, you need to provide women and girls with a comprehensive package of sexuality education, accurate family planning information and services, and access to quality abortion care,” Dr Ganatra added. Read full story (paywalled) Source: BMJ. 9 March 2022
  11. Content Article
    The World Health Organization (WHO) has released new guidelines on abortion care in a bid to protect the health of women and girls and help prevent over 25 million unsafe abortions that currently occur each year around the world. Based on the latest scientific evidence, these consolidated guidelines bring together over 50 recommendations spanning clinical practice, health service delivery, and legal and policy interventions to support quality abortion care. When carried out according to WHO guidelines, abortion is a simple and safe health intervention. The new guidelines will support access to comprehensive and quality abortion care within national health systems in the WHO European Region and globally.
  12. Content Article
    In this blog, we take a look at why women have been historically underrepresented in clinical trials and medical research, and the ongoing implications this has on medication safety for women.
  13. Content Article
    In this opinion piece, hub topic lead Saira Sundar looks at the culture of misogyny we have inherited in the medical profession, particularly in the obstetrics and gynaecology area of medicine. We hear time and time again women speaking up about being mistreated and/or disbelieved by medical professionals, resulting in delays in diagnosis and serious harm. However, there is a real change being forced by women themselves, with the public increasingly questioning and insisting on improvement and the right to be heard.
  14. Content Article
    In this episode of the Institute of Economic Affairs (IEA) Podcast, IEA Head of Political Economy Dr Kristian Niemietz discusses the findings of the Independent Medicines and Medical Devices Safety Review, and how the healthcare system in England responds to reports about harmful side effects from medicines and medical devices. Kristian speaks with Simon Whale, panel member and communications lead for the Independent Medicines and Medical Devices Safety Review and Dr Sonia Macleod, lead researcher, Independent Medicines and Medical Devices Safety Review. They discuss how the NHS, and other health bodies, could improve their services to address poor care and prevent harm.
  15. News Article
    Tens of thousands of new mothers have been left feeling “hopeless” and “isolated” during the pandemic, with the NHS seeing record numbers of referrals to mental health services. Requests for help from new, expectant and bereaved mothers jumped by 40% in 2021 compared with 2019, analysis by The Independent has revealed. NHS data shows mental health referrals hit an all-time high of 23,673 in November last year, with average monthly referrals for the whole of 2021 running 21% higher than the year before, jumping from 17,226 to 21,990. Among those affected when support systems were “suddenly” removed in March 2020 was Leanne, a woman who had her second child just before the pandemic and experienced a mental health crisis. She told The Independent how she had struggled following the first lockdown. “I just thought, Oh God, my recovery is going to stop, how am I going to get better now because I’ve got no support – I’m on my own with it,” she said. “I was [also] anticipating the lockdown … in addition to the nursery closing, and I was getting quite anxious about that, and feeling quite hopeless. The pressure piled on me was enormous, and I had no one who could see me or support me." Dr Rosena Allin-Khan MP, the shadow minister for mental health, said the figures uncovered by The Independent were “extremely concerning” and that pregnant women had been “forgotten about through the pandemic”. The Royal College of Psychiatrists’ lead for perinatal mental health services, Dr Joanne Black, said the NHS pandemic recovery plan had lost sight of women in pregnancy and children under two years old, who have been “disproportionately affected”. Read full story Source: The Independent, 28 February 2022
  16. News Article
    A new pregnancy screening tool cuts the risk of baby loss among women from black, Asian and ethnic minority backgrounds to the same level as white women, research suggests. The app calculates a woman's individual risk of pregnancy problems. In a study of 20,000 pregnant women, baby death rates in ethnic groups were three times lower than normal when the tool was used. Experts say the new approach can help reduce health inequalities. The screening tool is already in use at St George's Hospital in London and is being tried out at three other maternity units in England, with hopes it could be rolled out to 20 centres within two years. Researchers from Tommy's National Centre for Maternity Improvement, led by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives, developed the new tool. Professor Basky Thilaganathan, who led the research team at St George's Hospital, said the new approach could "almost eliminate a large source of the healthcare inequality facing black, Asian and minority ethnic pregnant women". "We can personalise care for you and reduce the chances of having a small baby, pre-eclampsia and losing your baby," he said. The current system of a tick-box checklist to assess pregnancy risk has been around for 70 years, and is limited. The new digital tool, which uses an algorithm to calculate a woman's personal risk, can detect high-risk women more accurately and prevent complications in pregnancy, the researchers say. Both pregnant women and maternity staff can upload information on their pregnancy and how they are feeling to the app during antenatal appointments and at other times. Dr Edward Morris, president of the Royal College of Obstetricians and Gynaecologists, said it was "unacceptable" that black, Asian and minority ethnic women faced huge inequalities on maternity outcomes. "The digital tool provides a practical way to support women with personalised care during pregnancy and make informed decisions about birth. Read full story Read Tommy's press release Source: BBC News, 28 February 2022
  17. Content Article
    The aim of this study from Liu et al. was to assess the impact of the Fetal Medicine Foundation (FMF) first trimester screening algorithm for pre-eclampsia on health disparities in perinatal death among minority ethnic groups.
  18. Content Article
    This article by the National Institute for Health Research (NIHR) summarises recent evidence about the information and support pregnant women need to make decisions about their maternity care, and any interventions they may need. It discusses the following areas: The importance of continuity of carer and personalised care in maternity services Women need clear information and better access to mental health care Helping women with complicated pregnancies make informed decisions about their care Supporting shared decision-making when there are problems with the baby
  19. News Article
    Pregnancy-related deaths among US mothers climbed higher in the pandemic’s first year, continuing a decades-long trend that disproportionately affects Black people, according to a new government report. Overall in 2020, there were almost 24 deaths per 100,000 births, or 861 deaths total, numbers that reflect mothers dying during pregnancy, childbirth or the year after. The rate was 20 per 100,000 in 2019. Among Black people, there were 55 maternal deaths per 100,000 births, almost triple the rate for white people. The report from the National Center for Health Statistics does not include reasons for the trend and researchers said they have not fully examined how Covid-19, which increases risks for severe illness in pregnancy, might have contributed. The coronavirus could have had an indirect effect. Many people put off medical care early in the pandemic for fear of catching the virus, and virus surges strained the healthcare system, which could have had an impact on pregnancy-related deaths, said Eugene Declercq, a professor and maternal death researcher at Boston University School of Public Health. He called the high rates “terrible news” and noted that the US has continually fared worse in maternal mortality than many other developed countries. Reasons for those disparities are not included in the data, but experts have blamed many factors including differences in rates of underlying health conditions, poor access to quality healthcare and structural racism. Read full story Source: The Guardian, 23 February 2022
  20. Event
    until
    All healthcare professionals have a responsibility to make every contact count in informing and encouraging pregnant women to get vaccinated against Covid-19. On 2 March Professor Jacqueline Dunkley-Bent, Chief Midwife for England, is hosting a second masterclass for midwives and other interested NHS professionals, to give objective advice on vaccination, based on the best available evidence. Join national experts from the UKHSA, MHRA, NHSEI, RCM and more for talks on: the risks of Covid-19 infection in pregnancy. the science behind vaccination; common questions and concerns. what midwives and other professionals can do to safeguard women, parents and babies from Covid-19. There will also be an opportunity to raise questions and concerns in a Q&A with our expert panel. Please register to attend by 5pm on Tuesday 1 March.
  21. News Article
    The NHS has abandoned targets that encouraged hospitals to pursue “normal births”, over fears for the safety of mothers and babies. Maternity units were told in a letter to stop using caesarean section rates to assess their performance. It comes after repeated scandals in maternity units, blamed in part on a focus on pursuing natural births at the expense of safety. The letter from Jacqueline Dunkley-Bent, NHS England’s chief midwife, and Dr Matthew Jolly, the national clinical director for maternity, instructed “all maternity services to stop using total caesarean section rates as a means of performance management”. It added: “We are concerned by the potential for services to pursue targets that may be clinically inappropriate and unsafe in individual cases." A final report into the deaths of dozens of babies at the Shrewsbury and Telford Hospital NHS Trust will be published next month. It is expected to be highly critical. The midwife leading the inquiry, Donna Ockenden, has said women “felt pressured to have a normal birth” at the trust, adding: “There was a multi-professional, not midwife-led, focus on normal birth pretty much at any cost.” Hayley Coates, 29, lost her son Kaylan after staff at Nottingham University Hospitals NHS Trust ignored her pleas for a caesarean section in March 2018. A coroner ruled that neglect contributed to Kaylan’s death. He suffered a fractured skull when he was delivered with forceps and was starved of oxygen. Coates, a mother of three, said she welcomed the NHS England letter, adding: “I was just ignored when I asked multiple times for a caesarean section. I was told repeatedly: ‘You will have this baby naturally, you don’t want to go to theatre.’ If I had gone to theatre many hours before, my baby wouldn’t have died. They have a duty of care, and the mother’s wishes are supposed to be priority.” Read full story (paywalled) Source: The Times, 20 February 2022
  22. Content Article
    This joint letter calls on Maria Caulfield MP, Parliamentary Under Secretary of State for Patient Safety and Primary Care, to implement in full the recommendations of the Independent Medicines and Medical Devices Safety (IMMDS) Review on behalf of those harmed by the side effects of Primodos, Mesh and Sodium Valproate. It is signed by Marie Lyon from the Association for Children Damaged by Hormone Pregnancy Tests, Kath Sansom from Sling The Mesh and Emma Murphy and Janet Williams from In-Fact.
  23. News Article
    Campaigners found to have been harmed by medical products have written to the health secretary warning that government inaction is "causing pain and destroying lives" by ignoring review recommendations. Some 18 months ago, an independent review recommended financial help for people damaged by some products and drugs that had been prescribed by UK doctors. The government - which set up the Independent Medicines and Medical Devices Safety Review in the first place - has chosen to ignore several of its recommendations. Alleged victims of vaginal mesh, and the drugs valproate and Primodos, have written to Health Secretary Sajid Javid and Maria Caulfield to say they feel ignored. The letter states: "Our members gave evidence to the two-year-long review, sometimes travelling long distances, often with disabilities." "Families shared intimate details of their medical problems, their daily struggles, their difficulties parenting, sometimes even their sex lives. The panel, led by Baroness Cumberlege, was set up by the government to listen, assess and direct policy towards the best course of action. "What was the point of this exercise and the hard work of the panel, if their key recommendations are then ignored by the government?" In the letter, campaigners say: "The decision not to offer an agency for redress (Cumberlege recommendation 3) means that the review has lost its teeth." "Still, no one is facing consequences of medical failures other than the patients. At a time when the public is being asked to put its faith in vaccines, this is a bad look for the government." Kath Sansom, of the campaign group Sling the Mesh, said: "Women must dutifully accept their health has been irreversibly shattered by a medical product they were told was safe, some now needing a disabled blue badge, and they must put up and shut up." Read full story Source: Sky News, 17 February 2022 MeshPrimodosSodiumValproate_LettertoMariaCaulfield_170222.pdf
  24. Content Article
    The purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) was to help improve patient safety in relation to the instructions 999 call handlers give to women and pregnant people who are waiting for an ambulance because of an emergency during their pregnancy. The HSIB investigation reviewed the case of Amy, who was 39 weeks and 4 days pregnant with her first child. She contacted 999 after experiencing abdominal cramps and bleeding. While waiting for an ambulance to arrive, Amy received pre-arrival instructions which were generated through a clinical decision support system (CDSS) from a non-clinical call handler. Amy was then taken by ambulance to hospital where her baby, Benjamin, was delivered by emergency caesarean section. Amy had excessive blood loss due to a placental abruption and was admitted to the high dependency unit for 12 hours following the birth. Benjamin required resuscitation to help him breathe on his own, he was intubated, and he received 72 hours of therapeutic cooling. He spent 13 days in hospital.
  25. Content Article
    In this blog, Stuart Bonar, Public Affairs Advisor at the Royal College of Midwives, looks at the growing midwifery workforce crisis in the UK. For the first time since records began, the number of midwives is falling year-on-year. The impact on those midwives who remain in the NHS is bigger workloads and decreasing wellbeing. The author calls on the government to pay attention to the situation, and suggests that an adequate pay rise for midwives and midwifery assistants should be part of the solution to falling staff numbers.
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