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Maternity Matters

Maternity Matters. To continue to improve patient safety and the patient experience (SaTH, 2007). What is Maternity Matters?.

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Maternity Matters

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  1. Maternity Matters To continue to improve patient safety and the patient experience (SaTH, 2007)

  2. What is Maternity Matters? • The new DOH Maternity Strategy has been developed in close consultation with key professionals from the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists, other Royal Colleges and the voluntary sector • Published in April 2007 • To be achieved by end of 2009

  3. Maternity Matters There are 4 National Choice Guarantees described: • Choice of how to access maternity care • Choice of type of antenatal care • Choice of place of birth • Homebirth • Birth in a local facility including a hospital under the care of a Midwife • Birth in a hospital supported by a local maternity care team which includes Midwives, Anaesthetists and Consultant Obstetricians 4. Choice of place of postnatal care

  4. Maternity Matters In addition to these choices: • A woman may choose to access maternity services outside her area with a provider that has capacity • Every woman will be supported by a midwife she knows and trusts throughout her pregnancy and after birth

  5. Main themes of Maternity Matters Choice of how to access maternity care • When women discover they are pregnant they should be able to go straight to a Midwife if they wish • In Shropshire, most mothers access maternity care via their GP’s • Bridgnorth, Ludlow and Oswestry offer pregnancy tests and direct access to a Midwife

  6. Main themes of Maternity Matters Choice of type of antenatal care • Women and their partners will be able to choose between midwifery care or care provided by a team of maternity health professionals • In Shropshire, most mothers have a choice of shared antenatal care or Midwife led care • Antenatal care is offered by Midwives in the following settings: All Midwife Led Units, GP Surgeries, RSH and PRH, Children’s Centres and at home

  7. Main themes of Maternity Matters Choice of place of birth In Shropshire, the following options for place of birth are offered to women: • Home • The Midwife Led Units in Bridgnorth, Ludlow, Oswestry, Shrewsbury and Wrekin • The Consultant Unit at Shrewsbury • Waterbirth is also available in the Low Risk Units and can be provided in individual homes

  8. Main themes of Maternity Matters Choice of place of postnatal care • After going home women will have a choice of how and where to access postnatal care • In Shropshire postnatal care occurs in a variety of settings, including: RSH Consultant care, midwifery care at the 5 Low Risk Midwifery Units, home and Children’s Centres

  9. Main themes of Maternity Matters Continuity of care • Maternity matters supports patterns of care where mothers have a known Midwife caring for her during her pregnancy and postnatal period and individual support throughout labour • Although the above type of care is not currently commissioned in Shropshire, we do strive for continuity of carer antenatally and postnatally, and one to one care in labour

  10. Maternity Matters: Commissioner Led The Self Assessment • A tool has been designed to assist Commissioners to complete a self assessment Scoring • Part of DOH Annual Health Check Maternity Joint Commissioning Group developing a Maternity Strategy • Chaired by Cathy Smith – Head of Midwifery • 20 members includes Public Health, PCT Commissioners, Children Centre Leads, Domestic Violence Leads, Breastfeeding Leads, Mental Wellbeing Leads, SaTH Contract Officer To improve partnership working and delivering a coherent vision for the future of health and social care in Shropshire (SaTH, 2007)

  11. Actions towards achieving Maternity Matters A number of actions have already been decided and include: • Promoting direct access to Midwife for antenatal care • Review the system for allocating appointment times • Access demand and feasibility for holding evening obstetric clinics • Agree actions required to support mothers with mental health problems • Develop join care pathways with adult mental health services • Develop a drug awareness manual for GP’s, Health Visitors and Midwives

  12. Actions towards achieving Maternity Matters • Agree actions required to support mums suffering domestic violence (care pathways, guidelines and training) • Establish system for translation of written information into foreign languages as required • Use the new midwifery IT system to monitor first antenatal appointments, identify immigrants, travellers and asylum seekers and track outcomes, review how other areas support this group of patients

  13. Maternity Matters: Statement or Question Why? • West Midlands Region has the highest perinatal mortality rate in England, and the gap is widening • 1.0% above the England rate in 1993, 1.9% above in 2005

  14. Maternity Matters: Statement or Question Why? • Higher than average death rates occur amongst babies born in black and ethnic minority populations; babies of teenage mothers; babies registered at birth by one parent rather than both • Some areas have very high levels of deprivation • Babies born in the most deprived areas of the country are 6 times more likely to die in infancy.

  15. Maternity Matters: Why? • The Confidential Enquiry into Maternal Deaths showed women living in families where both partners are unemployed, many with features of social exclusion are 20 times more likely to die as a result of childbirth than women in advantaged groups • Single mothers are 3 time more likely to die than those in stable relationships

  16. Maternity Matters: Why? • Women living in the most deprived areas have a 45% higher death rate compared to those living in other areas • 30% of domestic violence starts or escalates during pregnancy • High rates of miscarriage, low birth weight, premature birth, fetal injury and fetal death • 16% of all women (many under 18 years of age) delay seeking maternity care until they are five or more months pregnant

  17. Maternity Matters • Maternity care provides a unique opportunity for health care professionals to meet and support women, partners and their families who might otherwise never or rarely access health services • Healthy mothers tend to have healthy babies • A mother who has received high quality maternity care throughout her pregnancy is well placed to provide the best possible start for her baby

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