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Content Article
In this interview, Dr Alice Ladur talks about her experience of using the Whose Shoes? approach to increase male partners’ involvement in maternity care in Uganda. Whose Shoes? is a co-production tool that uses a board game to help participants share experiences and reflect on their experiences of services. Alice describes the importance and impact of involving partners and families in antenatal care and highlights the value of adapting interventions to specific cultures and locations. -
Content Article
Being fat & pregnant is not a crime (29 January 2022)
Patient-Safety-Learning posted an article in Maternity
In this blog for Refinery29, Sadhbh O'Sullivan looks at the issues faced during antenatal care by pregnant women who are overweight. She recounts the perspectives of several pregnant women who felt dehumanised and blamed for their weight during pregnancy. She also highlights issues with the way in which risks are communicated to pregnant women, with overcommunication and overestimation of risk causing anxiety and sometimes making women reluctant to engage with maternity services. She also discusses failures of informed consent, the role of comorbidities and the impact of wider health inequalities. -
Content ArticleThis is the transcript of a Westminster Hall debate in the House of Commons on fulfilling the recommendations of the Cumberlege Report.
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Content ArticleThis index of medications provides evidence-based patient leaflets about the use of different medicines in pregnancy. The leaflets are produced by the UK Teratology Information Service (UKTIS). Women can look up medications to understand their impact on pregnancy and how they may affect the chances of miscarriage and birth defects, and provide information on their own pregnancy to add to the knowledge base around medicines in pregnancy.
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News ArticleGeneticists have warned the public against buying polygenic risk score analyses, which some private fertility clinics claim can help parents using in vitro fertilisation in selecting embryos that carry the least risk of future disease. It appears that at least one child has been born after such a procedure, but the use of polygenic risk score analysis in this respect is severely limited. No evidence shows that these tests can predict the likelihood of an unborn child being liable to a specific disease in the future, representatives from the European Society of Human Genetics wrote in the European Journal of Human Genetics. Polygenic risk score analysis is mainly offered by fertility clinics in the US, although the practice is also being promoted in the UK. Patients need to be properly informed on the limitations of its use and a societal debate, focused on what should be considered acceptable with regard to the selection of individual traits, should take place before any further implementation of the technique in this population. Read full story (paywalled) Source: BMJ, 26 January 2022
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News Article
NHSE calls on systems and maternity leads to vaccinate more pregnant women
Patient Safety Learning posted a news article in News
An NHS England letter has warned of “significant variation” in the uptake of the COVID-19 vaccine amongst pregnant women, and called on systems to enable more “spontaneous” antenatal vaccination. In the letter, sent to integrated care system vaccination programme leads, ICS maternity leads and other NHS clinical directors, NHS England said that while the rates of women who had received at least two doses of the vaccine before giving birth was on the rise, there was “significant variation in uptake between regions and systems and in every system, between women of different ethnicities, decile of deprivation in their local area, and age groups”. The letter asks that covid vaccines are made available within antenatal clinics “to maximise uptake” and that partially vaccinated women “are offered vaccine confidence conversations and advised antenatally on the nearest available walk-in vaccinations”. Vaccination programme and maternity service leads have also been told to make use of resources and funding available to drive uptake in at-risk groups. It said: “Vaccination and maternity leads should discuss how this resource could be used to provide in-reach clinics within every maternity service, without creating additional burden on midwifery staff.” Read full story (paywalled) Source: HSJ, 26 January 2022 -
News Article
Mum tells of heartbreak at baby loss in Covid coma
Patient Safety Learning posted a news article in News
A woman has spoken of her "devastation" after losing a baby delivered while she was in an induced coma with Covid. Rachel, from Wolverhampton was admitted to hospital over the summer in the 19th week of pregnancy. She said uncertainty about whether pregnant women should have the Covid vaccine had put her off getting it. Her condition deteriorated and she said she was so ill she did not realise at first son Jaxon was stillborn. "I was heavily sedated a lot of the time and from what I'm told by my family, my chances weren't looking very good," the 38-year-old said. "They were trying to get the baby to survive to 28 weeks but unfortunately, at 24 weeks, my son was born stillborn." Rachel, who said she had planned to have the vaccine after giving birth, is now urging others to get the jab, particularly women from minority backgrounds, for whom uptake is lower. Read full story Source: BBC News, 15 January 2022 -
News Article
Covid in pregnancy linked to birth-related complications
Patient Safety Learning posted a news article in News
A new study has linked COVID-19 to complications during pregnancy. Scottish researchers found that women who catch the virus near the end of pregnancy were more vulnerable to birth-related complications. They are more likely to suffer them than women who catch Covid in early pregnancy or not at all. The researchers say getting vaccinated is crucial to protect pregnant women and their babies from life-threatening complications. The latest findings come from the Covid in Pregnancy Study (Cops), which carried out research across Scotland to learn about the incidence and outcomes of Covid-19 infection and vaccination in pregnancy. It is one of the first national studies of pregnancy and Covid. They found that preterm births, stillbirths and newborn deaths were more common among women who had the virus 28 days, or less, before their delivery date. The majority of complications occurred in unvaccinated women. The results, which have been published in Nature Medicine, come after recent data showed 98% of pregnant women admitted to UK intensive care units with coronavirus symptoms were unvaccinated. Researchers are now calling for measures to increase vaccine uptake in pregnant women. Read full story Source: BBC News, 13 January 2022 -
Content ArticlePopulation-level data on COVID-19 vaccine uptake in pregnancy and SARS-CoV-2 infection outcomes are lacking. Stock et al. describe COVID-19 vaccine uptake and SARS-CoV-2 infection in pregnant women in Scotland, using whole-population data from a national, prospective cohort. They found that vaccine coverage was substantially lower in pregnant women than in the general female population of 18−44 years. Overall, 77.4% of SARS-CoV-2 infections, 90.9% of SARS-CoV-2 associated with hospital admission and 98% SARS-CoV-2 associated with critical care admission, as well as all baby deaths, occurred in pregnant women who were unvaccinated at the time of COVID-19 diagnosis. Addressing low vaccine uptake rates in pregnant women is imperative to protect the health of women and babies in the ongoing pandemic.
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News Article
Pregnant women urged not to delay getting jab
Patient Safety Learning posted a news article in News
Pregnant women are being urged not to delay getting their Covid jab or booster in a government campaign. More than 96% of pregnant women admitted to hospital with Covid symptoms between May and October last year were unvaccinated, according to the UK Obstetric Surveillance System. The campaign will share testimonies of pregnant women who have had the jab on radio and social media. The government said the vaccine was safe and had no impact on fertility. In December, the Joint Committee on Vaccination and Immunisation added pregnant women to the priority list for the vaccine, saying they were at heightened risk from Covid. Around one in five pregnant women admitted to hospital with the virus needed to be delivered pre-term to help them recover, and one in five of their babies needed care in the neonatal unit, the Department of Health and Social Care (DHSC) said. Prof Lucy Chappell, chief scientific adviser to the DHSC, told BBC Radio 4's Today programme that a third of unvaccinated pregnant women with COVID-19 needed help with breathing and one in six were admitted to intensive care. "We've also seen stillbirths and neonatal deaths in the latest wave," she said. Prof Chappell said the vaccine causes pregnant women to produce antibodies against the virus, which cross over to their babies and give them protection too. Dr Jen Jardine, from the Royal College of Obstetricians and Gynaecologists, who is seven months pregnant and has had her booster jab, said: "Both as a doctor and pregnant mother myself, we can now be very confident that the Covid-19 vaccinations provide the best possible protection for you and your unborn child against this virus." Read full story Source: BBC News, 10 January 2022 -
Content ArticleA midwife in England shares their experiences of working in the NHS in 2021. They describe the mental and physical impact of having to work beyond capacity on a daily basis, a situation caused by a staffing crisis in the midwifery workforce. The impact of this is that more midwives are leaving the NHS as they are unable to cope with these pressures, which makes the workload for remaining staff even heavier.
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Content ArticleThis guidance will help Local Maternity Systems align their Equality and Equality Action Plans with Integrated Care Systems health inequalities work. The guidance includes an analysis of the evidence, interventions to improve equity and equality, resources, indicators and metrics.
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News Article
Fat-shamed by banter at my pregnancy scan
Patient Safety Learning posted a news article in News
A mum-of-four said she felt "fat-shamed" at a pregnancy scan and during follow-up appointments. Alexandra Dodds said her weight was raised at every appointment, and circled with a pen so vigorously in her notes that she wanted to lose them. "It was just kind of jokes, like 'hope you've stopped the Christmas snacks', or 'make sure you've thrown the box of chocolates away'," said Ms Dodds. "I didn't feel like it was said in a spiteful way to try to upset me, it was like banter, but I don't feel like you can banter about that," she added. Baby Brianna was born healthy at home before a midwife could arrive in July, last year. Alexandra said she only felt able to speak out about what she wanted during her pregnancy and labour because of three previous pregnancies. "If I feel any level of shame, that's just a clear indication that I have to talk about it, because it means I'm not the only person and other people will understand," she added. Joint research by Cardiff University and the British Pregnancy Advisory Service (BPAS) found women with higher BMIs felt stigmatised by risk messaging in maternity care. The Wrisk Project, which surveyed more than 7,000 women, looked at how risk is communicated in pregnancy following concerns it didn't always "reflect the evidence base". Clare Murphy, director of BPAS, said the work showed they hadn't got it right. "Pregnant women are often infantilized, and it feels like sometimes decisions are made about them, for them," she said. The Royal College of Midwives (RCM) said care should be based on respect and understanding of women's needs. Read full story Source: BBC News, 3 January 2021 Related resources My ob-gyn kept shaming me for my weight gain during pregnancy - patient video -
Content ArticleLindsey's doctor was so focused on the 52 pounds she'd gained during her third trimester, she missed a pregnancy disorder that could have killed Lindsey and her unborn child. Watch Lindsey's video where she talks about her experience and why it is important to find a doctor who respects you and who you can trust.
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Content ArticleIn a recent survey, the Patient Information Forum asked women how to make information on induction better. Here presented in poster form are the top 5 suggestions from an analysis of 1,200 comments. Read full survey results here.
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Content ArticleRhian Rose underwent feticide on 22 November 2019 and was admitted to a maternity ward on 24 November 2019 for medical termination of pregnancy. By the evening of her admission, Rhian had clear symptoms of infection, however the sepsis pathway and antibiotics were not commenced until the following morning. In the late afternoon on 25 November 2019, Rhian became acutely unwell resulting in unconsciousness, emergency caesarean section, subsequent cardiac arrest and eventually her death. In this report the Coroner raises concerns about a lack of informed consent and discussion of maternal wishes and the mode of delivery highlighted by this case. He highlights a lack of guidance relating to the infection risk when a mother is attending for delivery following feticide.
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News Article
Pregnant women angry at long waits for boosters
Patient Safety Learning posted a news article in News
Pregnant women say they are queuing for hours at busy vaccination centres for a booster jab, despite being at greater risk from Covid-19 if seriously ill. All adults in England, Scotland and Wales have been offered a booster by the end of 2021. Pregnant women have not been prioritised, but doctors say they should be first in line to protect them and their babies against Omicron. The NHS is urging people to book a jab appointment to avoid waiting in queues. And the UK's vaccine advisory committee, the JCVI, said women who were pregnant and already had two vaccine doses were included in the accelerated booster programme. However, the charity Pregnant Then Screwed said thousands of pregnant women had "encountered unnecessary barriers" which had "left many without the protection they need". Read full story Source: BBC News, 16 December 2021 -
EventuntilThis Patient Information Forum webinar will share the key findings of our survey on maternity decisions. Our expert panel will share recommendations to help empower women to make informed decisions about the induction of labour. Open to members and non-members. Register
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News Article"You hear his heartbeat and the next thing you know, you've got nothing." A woman whose son was stillborn has said she wants to change the law to enable an inquest to investigate the circumstances surrounding his death. Katie Wood's son Oscar was stillborn on 29 March 2015, but under law in England and Wales, inquests for stillborn babies cannot take place. A consultation was put out by the UK government in March 2019, but the findings have yet to be published. The UK government said it would set out its response in due course, but this delay was criticised by the House of Commons justice committee in September. Katie and her family said they have never received satisfactory answers about why Oscar died. Her pregnancy, while challenging, had not given any serious cause for concern. An investigation by the Aneurin Bevan health board found a number of failings in Katie's care. A post-mortem examination suggested a condition known as shoulder dystocia, where the baby's shoulder becomes stuck during birth, may have contributed, but this is rarely fatal. The health board said it conducted a serious incident investigation into Oscar's death and added: "Whilst we seek to find answers during any investigation, in some cases, a full understanding around the cause of death may not always be achieved and we accept the unavoidable distress this may pose for families." Clinical negligence and medical law specialist, Mari Rosser, says allowing coroners to look into the reasons for a baby's death is long overdue. "Currently parents who suffer a still birth can have the circumstances investigated, but the circumstances are investigated by the health board and of course that's less independent," she said. Read full story Source: BBC News, 9 December 2021
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Content ArticleIn this podcast episode, host Aaron Harmon speaks to Dr Neil Vargesson, chair in developmental biology at the University of Aberdeen, about the importance of Good Laboratory Practice (GLP) and why pre-clinical studies are key to keeping people safe. They discuss the history of Primodos, a hormone-based pregnancy test that was given to women between 1959 and 1978. It was developed before GLP and before standardised testing for teratogenesis (causing birth defects). There are data that suggests Primodos caused birth defects, but more questions remain.
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Content ArticleThis report looks at several incidences of pregnant women with Covid-19 symptoms being sent to a maternity unit, when it would have been more appropriate for them to attend A&E. It highlights some confusion amongst health professionals and states that the Coronavirus (Covid-19) Infection in Pregnancy Guidance was updated to make care pathways clearer.
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News Article
Jailed women in UK five times more likely to suffer stillbirths, data shows
Patient Safety Learning posted a news article in News
Women in prison are five times more likely to have a stillbirth and twice as likely to give birth to a premature baby that needs special care, new data collected by the Observer shows. Following two baby deaths in prisons since 2019 there have been increasing concerns about safety for pregnant women and their babies. Figures obtained through freedom of information requests made to 11 NHS trusts serving women’s prisons in England show 28% of the babies born to women serving a custodial sentence between 2015 and 2019 were admitted to a neonatal unit afterwards – double the national figure, according to data from the National Neonatal Research Database. The findings come as the House of Lords prepares to vote this week on proposed changes to bail and sentencing laws that would improve the rights of pregnant women and mothers facing criminal charges. A report published in September examined the circumstances of a baby’s death at Bronzefield prison in Surrey where an 18-year-old was left to give birth alone in her cell. When Anita rang her cell bell at 5.30am when she went into labour the guards said they would send somebody. It was only during the morning rounds at 7.30am that a nurse was called. She was transferred to hospital at 10.30am. Anita said: “Despite being in active labour the guards would not remove my handcuffs and ignored me when I asked them to call the baby’s father and my mum – who were eventually contacted by a doctor.” Read full story Source: The Guardian, 5 December 2021 -
Content ArticleWhere a new or under-recognised risk identified through the NHS England's review of patient safety events doesn’t meet the criteria for a National Patient Safety Alert, NHS England look to work with partner organisations, who may be better placed to take action to address the issue. To highlight this work and show the importance of recording patient safety events, they publish regular case studies. These case studies show the direct action taken in response to patient safety events recorded by organisations, staff and the public, and how their actions support the NHS to protect patients from harm.
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News Article
Did bad vaccine advice cost Samantha Willis her life?
Patient Safety Learning posted a news article in News
When the UK’s jab programme began, expectant mothers were told to steer clear – so Samantha decided to wait until she had had her baby. Two weeks after giving birth, she died in hospital from Covid. Samantha was unvaccinated – she had received advice against getting jabbed at an antenatal appointment. When the Covid vaccine programme began in the UK on 8 December 2020, pregnant women were told not to get vaccinated. But in October 2020, the Royal College of Obstetricians and Gynaecologists (RCOG) published guidance warning that “intensive care admission may be more common in pregnant women with Covid-19 than in non-pregnant women of the same age” and that pregnant women with Covid were three times more likely to have a preterm birth. Further evidence emerged in 2021 indicating that pregnant women were particularly vulnerable to Covid, especially in their final trimester. Research from the University of Washington, published in January, found that pregnant women were 13 times more likely to die from Covid than people of a similar age who were not pregnant. But throughout February and March, the JCVI’s scientists did not appear especially concerned about examining the case for vaccinating pregnant women. Priority in the early stages of the vaccine programme was being given to older people, so many pregnant women remained towards the back of the queue. The maternity campaign group Pregnant Then Screwed said: “If you look at who was on the Covid war cabinet and leading the daily briefing, it was nearly all men,” says Joeli Brearley, its founder. “Pregnant women were treated as if they were very similar to the general population, rather than being seen as a special cohort that needs special consideration. They were just not a priority.” Read full story Source: The Guardian, 23 November 2021 -
News Article
Covid vaccines safe in pregnancy, data shows
Patient Safety Learning posted a news article in News
The UK's Health Security Agency says its analysis of English data shows Covid vaccines are safe in pregnancy, reinforcing international evidence. The agency found similar rates of stillbirths and preterm births for vaccinated and unvaccinated mothers. Researchers say women should feel confident the jabs will help protect them and urge more to take them. Their report shows just 22% of women who gave birth in August had had at least one jab. Since mid-April, mothers-to-be have been offered the Pfizer-BioNTech or Moderna jab, with the second dose recommended eight weeks after the first. But women first eligible for vaccination were more likely to be older or have an underlying medical condition - putting them at higher risk of premature births, researchers say. Meanwhile, studies suggest about one in five women admitted to hospital with the virus have their babies delivered early and some of these babies need special intensive care. And evidence suggests the risks of stillbirths are higher if a woman has Covid in pregnancy. UKHSA immunisation head said the new information on safety was reassuring. "Every pregnant woman who has not yet been vaccinated should feel confident to go and get the jab and that this will help to prevent the serious consequences of catching Covid in pregnancy," she said. Read full story Source: BBC News, 26 November 2021
