Maternity Matters

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 GPs
• 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, Childrens 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 Childrens 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 GPs, 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