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Content ArticleThis resource from Best Beginnings provides information about many national and local charities offering remote support for pregnant families and new paretns during COVID-19. The list includes organisations offering support and advice around: Pregnancy and birth Health conditions in pregnancy Parents of twins, triplets and more Premature Unwell babies Babies with disabilities or health conditions Breastfeeding and infant nutrition Mental health Bereavement Birth trauma.
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Content Article
Home births, fears and patient safety amid COVID-19
PatientSafetyLearning Team posted an article in Blogs
The COVID-19 outbreak has had an impact on all areas of health and social care. While understandably the focus of the healthcare system currently rests on the pandemic, it is important that we also consider the impact on non COVID-19 treatment and care. This has been recently highlighted by the UK Chief Medical Officer Professor Chris Whitty, who has warned about the impact that the pandemic will have on other areas as the health system is “reorientated towards COVID”.[1] Patient Safety Learning believe that in this context the need to pay attention to patient safety is now more important than ever. Pregnant women represent a unique patient group, facing very specific challenges. Although early evidence indicates that babies and children are less severely affected by the virus, many are concerned for the safety of their baby within the unfamiliar backdrop of COVID-19. It is understandable that fears persist when there are reports of pregnant women, children and midwives who have tragically lost their lives. This is the first blog where we will look at the impact of the pandemic on maternity services. Here we will focus on the safety implications of both low and high-risk women choosing to birth at home due to fears of contracting the virus in hospital. We also raise questions as to whether a blanket suspension of home birth services is putting some women and babies at greater risk. -
Content Article
Birthrights: COVID-19
PatientSafetyLearning Team posted an article in Good practice and useful resources
Birthrights are working hard to support maternity healthcare professionals to make thoughtful decisions even in these challenging times and to support pregnant individuals and their families. This webpage includes further information about pregnant women's rights, Birthrights position statement in light of the pandemic and a list of FAQs. -
Content ArticleThis briefing, from the Royal College of Midwives, sets out the potential impact of the COVID-19 pandemic on the number of women choosing to birth unassisted (freebirth). It highlights that anecdotal evidence suggests the number of women choosing to have their babies in this way is on the rise, due to a reduction in birth options. This briefing looks at the safety and legal implications, key guidance around freebirthing and lists some important considerations for midwives when caring for women who make this decision.
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Content ArticleThis letter template was created by Maternity Action. It can be used by pregnant women to request a risk assessment in relation to their job and the risk of infection from COVID-19.
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Content ArticleThis guidance was published on 9 April 2020 by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwifery. It highlights that childbearing women and newborn infants continue to require safe person-centred care during the current COVID-19 pandemic and they represent a unique population. The majority are healthy, experiencing a life event that may bring clinical, emotional, psychological, and social needs. Women and newborn infants therefore require access to quality midwifery care, multidisciplinary services and additional care for complications including emergencies, if needed. When staff and services are under extreme stress there is a real risk of increasing avoidable harm, including an increased risk of infection, morbidity and mortality, and reductions in the overall quality of care. Safety, quality and preventing avoidable harm must be key priorities in decision making. Continuation of as near normal care for women should be supported, as it is recognised to prevent poor outcomes.
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Content Article
Primary Care Women's Health Forum: Resources
PatientSafetyLearning Team posted an article in Women's health
This webpage from the Primary Care Women's Health Forum (PCWHF), contains the latest guidelines, patient materials and articles from the board alongside recommended external resources. Resources include: Intrauterine methods for all indications. How to manage contraceptive provision without face to face consultations. Having a pessary fitted for a vaginal prolapse. Advice following insertion or removal of your contraceptive implant. -
Content ArticleReducing inequalities in maternal healthcare in England is an important policy aim. One part of achieving that is to ensure that women from Black, Asian and minority ethnic communities, as well as women from the most deprived areas, see the same midwife or midwifery team throughout their pregnancy and postnatal period. Emma Dodsworth takes a closer look at the data to reveal what progress is being made on this.
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News Article
Soaring congenital syphilis rates in US risk lives of thousands of babies
Patient Safety Learning posted a news article in News
Health advocates in the USA are calling on the Biden administration to declare a public health emergency over a steep rise in congenital syphilis cases. The easily treated infection has quintupled in 10 years and can have harrowing impacts on children. Congenital syphilis happens when a baby contracts syphilis from its mother. Up to 40% of babies born to untreated mothers will be stillborn or die. Others can be left with severe birth defects such as bone damage, anaemia, blindness or deafness, and “neurological devastation”. “There is not a single baby that should be born in the US with syphilis,” David Harvey, the executive director of the National Coalition of STD Directors, told the Guardian. “We will be judged very severely as a country and a society for allowing this to happen to babies, when it is so easy to diagnose, treat and prevent this disease.” Rates of the disease have reached a nearly 30-year high just as supplies of the preferred medication, called Bicillin L-A, are in short supply. Syphilis can be cured with between one and three shots of the medication. Pfizer is the only manufacturer of the medication, a form of the first antibiotic ever synthesized, penicillin. The company said it does not expect shortages to be resolved before 2024, and blamed low supply partly on the increase in syphilis cases. Read full story Source: The Guardian, 17 October 2023 -
News ArticleValproate-containing medicines will be dispensed in the manufacturer’s original full pack, following changes in regulations coming into effect on Wednesday 11 October 2023. The Medicines and Healthcare products Regulatory Agency (MHRA) has published new guidance for dispensers to support this change. Following a government consultation, this change to legislation has been made to ensure that patients always receive specific safety warnings and pictograms, including a patient card and the Patient Information Leaflet, which are contained in the manufacturer’s original full pack. These materials form a key part of the safety messaging and alert patients to the risks to the unborn baby if valproate-containing medicines are used in pregnancy. The changes follow a consultation on original pack dispensing and supply of medicines containing sodium valproate led by the Department of Health and Social Care (DHSC), in which there was overwhelming support for the introduction of the new measures, to further support safety of valproate-containing medicines. Minister for Public Health, Maria Caulfield, said: “This safety information will help patients stay informed about risks of valproate, and I encourage all dispensers of valproate to consult the new guidance carefully. “This continues our commitment to listening and learning from the experiences of people impacted by valproate and their families and using what we hear to improve patient safety.” Read full story Source: MHRA, 11 October 2023
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Content ArticleThe Children and Young People’s Mental Health Coalition (CYPMHC) and the Maternal Mental Health Alliance have launched ‘The Maternal Mental Health Experiences of Young Mums’ report, which includes both a literature review and first-hand insights from young mums impacted by maternal mental health problems.
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Content ArticleReducing inequalities in maternal health care in England is an important policy aim. One part of achieving that is to ensure that women from Black, Asian and minority ethnic communities, as well as women from the most deprived areas, see the same midwife or midwifery team throughout their pregnancy and postnatal period. Emma Dodsworth takes a closer look at the data to reveal what progress is being made on this.
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Content ArticleTrust boards’ regular oversight of the quality and safety of maternity and neonatal services has been the subject of successive inquiries and reviews. In this report, the Sands and Tommy’s Joint Policy Unit review publicly available board papers and minutes for seven NHS Trusts in England. They analyse whether the information presented to boards, the process for review, and actions taken enabled boards to deliver effective oversight over the safety and quality of maternity and neonatal services.
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News Article
Black babies in England three times more likely to die than white babies
Patient Safety Learning posted a news article in News
Black babies in England are almost three times more likely to die than white babies after death rates surged in the last year, according to figures that have led to warnings that racism, poverty and pressure on the NHS must be tackled to prevent future fatalities. The death rate for white infants has stayed steady at about three per 1,000 live births since 2020, but for black and black British babies it has risen from just under six to almost nine per 1,000, according to figures from the National Child Mortality Database, which gathers standardised data on the circumstances of children’s deaths. Infant death rates in the poorest neighbourhood rose to double those in the richest areas, where death rates fell. The mortality for Asian and Asian British babies also rose, by 17%. The annual data shows overall child mortality increased again between 2022 and 2023, with widening inequalities between rich and poor areas and white and black communities. Most deaths of infants under one year of age were due to premature births. Karen Luyt, the programme lead for the database and a professor of neonatal medicine at Bristol University, said many black and minority ethnic women were not registering their pregnancies early enough and the “system needs to reach them in a better way”. “There’s an element of racism and there’s a language barrier,” Luyt said. “Minority women often do not feel welcome. There’s cultural incompetence and our clinical teams do not have the skills to understand different cultures.” Read full story Source: The Guardian, 9 November 2023 -
Content ArticleThe latest Care Quality Commission (CQC) report on the state of care in England is far from an encouraging read.1 Although the healthcare system is under serious strain, maternity services are among the areas identified as especially challenged. The problems identified in maternity care, while shocking, come as no surprise. The sector is seeing repeated high profile organisational failures and soaring clinical negligence claims, together with grim evidence of ongoing variation in outcomes, culture, and workforce challenges and inequities linked to socioeconomic status and ethnicity. In this BMJ Editorial, Mary Dixon-Woods and colleagues discuss why it's time for a fresh approach to regulation and improvement.
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Content ArticleThe 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.
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Content ArticlePrompt referral to early pregnancy services can make the difference between life and death in the diagnosis of ectopic pregnancies. This Healthcare Safety Investigation Branch (HSIB) report into the diagnosis of ectopic pregnancy found that differing levels of provision and a mismatch between capacity and demand in early pregnancy units (EPUs) heightens the risk that the diagnosis of this time-critical condition is delayed or missed.
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Content ArticleChildren born to women who take valproate during pregnancy are at significant risk of birth defects and persistent developmental disorders. As such, it is vital that women and girls are dispensed valproate safely. The General Pharmaceutical Council is reminding all pharmacy professionals of what they must do to ensure women and girls receive the right information about valproate and the risk of birth defects. The update includes
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Content Article
A bitter pill: Primodos (Sky News, 3 January 2023)
Patient-Safety-Learning posted an article in Medication
This Sky News investigation looks at one of the pharmaceutical industry's biggest scandals—the hormone pregnancy test Primodos which was prescribed to pregnant mothers in the UK between 1958 and 1978. Primodos was found to lead to birth defects, miscarriages and stillbirth, and regulatory failings led to avoidable harm to thousands of babies. -
Content ArticleThis is guidance for dispensing of valproate-containing medicines in the manufacturer’s original full pack, following amendments to the Human Medicines Regulations (HMRs). These amendments currently apply in England, Scotland and Wales. This guidance should be regarded as good practice by pharmacists in Northern Ireland. The change comes into force in England, Scotland and Wales from 11 October 2023.
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Content ArticleIn this article for The Guardian, journalist Sirin Kale speaks to Janet Williams about the impact the epilepsy drug sodium valproate has had on her family. Janet took the medication to treat her epilepsy throughout her two pregnancies in 1989 and 1991, but had never been warned about the potential risks to her babies. Foetal valproate syndrome can cause spina bifida, congenital heart defects and developmental delays and is believed to have affected around 20,000 children in the UK. Both of Janet's sons were affected by the medication and require full time care as a result. Janet describes how being told about the risks would have enabled her to make an informed decision about whether to have children, and how her experience led her to help set up In-FACT (the Independent Fetal Anti Convulsant Trust) in 2012.
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Content Article
Considering Valproate video (February 2022)
Patient-Safety-Learning posted an article in Medication
Sodium valproate is a medication used to treat epilepsy, bipolar disorder and migraines, but it can cause birth defects, learning disabilities and developmental problems in babies if taken during pregmamcy. This video by Central and North West London NHS Foundation Trust discusses the various effects of using valproate, including the potential harmful effects the medication can have on unborn foetuses. It features a conversation between a pharmacist and patient discussing the need for a valproate pregnancy prevention programme if the patient is to be prescribed valproate.
