Maternity DMA Report Digital Maturity Assessment of Maternity Services in England 2018

NHS England | November 2018 |Maternity DMA Report Digital Maturity Assessment of Maternity Services in England 2018

The Maternity DMA allows us for the first time to measure how well maternity services in England are making use of digital technology. The outputs of the Self-Assessment will help individual organisations to identify key strengths and gaps in their provision of digital services. The analysis contained in this report provides an overview across the country of the progress maternity services are making in obtaining the benefits associated with adopting digital technology.

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The Digital Maturity Assessment (DMA) has been completed by 100% of maternity services, with the majority of returns being completed by clinicians. For the first time, NHS England has a complete picture of the digital maternity landscape across England – a baseline for improvement at both a national and local level. It shows us how developed the foundations are for maternity care to be at the forefront of a digital NHS. This has been a necessary first step to achieve our ambition.
Alongside this national report every Local Maternity System (LMS) has also been issued with a local report to help guide planning. This will facilitate joined up working on digital solutions which provides clinicians the information that they need to deliver high quality care, reduces the reporting burden and delivers rich data for insight and improvement (Source: NHS England).

Read the full report here 

Each Baby Counts: 2018 progress report

New report reveals improvement of local investigations into baby deaths and brain injuries which happened during childbirth

Every year in the UK over 1,000 babies die or are left with a brain injury during term labour. These are investigated at a local level by a hospital or maternity unit. The Each Baby Counts team is bringing together the results of these local investigations to make recommendations to improve future care on a national level.

This report presents key findings and recommendations based on the analysis of data from 2016 relating to the care given to mothers and babies, to ensure each baby receives the safest possible care during labour.  Each Baby Counts is a clinical quality improvement programme that aims to halve the number of stillbirths and babies who die or are left severely disabled due to incidents during term labour by 2020.

Full report:  Each Baby Counts: 2018 progress report   The Royal College of Obstetricians & Gynaecologists

Additional link: RCOG press release

Caesarean section use has almost doubled globally since 2000

University of Central Lancashire | October 2018 | The Lancet: Caesarean section use has almost doubled globally since 2000

New research published in The Lancet as a global Series shows that the Caesarean section rate increased globally, nearly doubling in period between 2000-2015 from 12% to 21%. 

The study found that while some countries did not use C-sections enough, with the authors estimating that in 2015 more than a quarter did not use this method of delivery. 28% (47/169 countries). At least 15 countries C-section rates’ exceeded 40 per cent by 2015- a population rate above 10-15 per cent is considered excessive.

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Series lead Dr Marleen Temmerman, of Aga Khan University, Kenya said: “Pregnancy and labour are normal processes, which occur safely in most cases. The large increases in C-section use – mostly in richer countries for non-medical purposes – are concerning because of the associated risks for women and children. C-sections can create complications and side effects for mothers and babies, and we call on healthcare professionals, hospitals, funders and families to only intervene in this way when it is medically required.”

Read the full press release from UCLAN 
Executive Summary (Optimising caesarean section use)

Caesarean section—the most common surgery in many countries around the world—is a procedure that can save women’s and babies’ lives when complications occur during pregnancy or birth. However, caesarean section use for non-medically indicated reasons is a cause for concern because the procedure is associated with considerable short-term and long-term effects and health-care costs. Caesarean section use has increased over the past 30 years in excess of the 10–15% of births considered optimal, and without significant maternal or perinatal benefits. A three-part Lancet Series on Optimising Caesarean Section Use reviews the global epidemiology and disparities in caesarean section use, as well as the health effects for women and children, and lays out evidence-based interventions and actions to reduce unnecessary caesarean sections (Source: The Lancet).

Read the full series on C-Section from The Lancet 

See also:

The Lancet  FIGO: How to stop the Caesarean section Epidemic [position paper]

Two academics from UCLAN’s School of Community Health & Midwifery,  alongside WHO researchers  contributed to the third paper in the global Series which focused on reducing unnecessary c-sections. They recommend further research is required to study relaxation training, childbirth training workshops, educational lectures and brochures, and meeting with health professionals to promote supportive relationships, collaboration and respect.

 

Health of babies and expectant mothers

Understanding the health of babies and expectant mothers | Nuffield Trust

The Nuffield Trust has published an ‘explainer’ Understanding the health of babies and expectant mothers. This article looks at the possible reasons why progress on stillbirths and neonatal and infant mortality has slowed down in the UK in recent years and what can be done about it.

Additional link: Are the government’s targets for reducing stillbirths and neonatal deaths achievable? | Nuffield Trust blog

Saving Lives, Improving Mothers’ Care

Saving Lives, Improving Mothers’ Care | Healthcare Quality Improvement Partnership

This is the fifth edition of the Maternal, Newborn and Infant Clinical Outcome Review Programme’s report concerning maternal deaths and morbidity. The report includes surveillance data on women who died during or up to one year after pregnancy between 2014 and 2016 in the UK.

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Image source: http://www.hqip.org.uk

There was a statistically non-significant increase in the overall maternal death rate in the UK between 2011–13 and 2014-16, which suggests that implementation of the recommendations of these reports is needed to achieve a reduction in maternal deaths. Assessors judged that 28% of women who died and 12% of women surviving with major obstetric haemorrhage had good care. However, improvements in care may have made a difference to the outcome for 38% of women who died and 74% of women with major obstetric haemorrhage who survived.

Full document: Saving Lives, Improving Mothers’ Care

Proportion of babies breastfed at six to eight weeks lowest in England for four years

Data published by Public Health England reveals the proportion of babies who are still being breastfed six to eight weeks after birth in England has fallen to its lowest level in the past four years | via OnMedica

The data covers the period 1 April 2017 to 31 March 2018, and were submitted by local authorities on a voluntary basis through an interim reporting system set up to collect health visiting activity data at a local authority resident level. baby-21167_1920

Some 140 out of 150 local authorities provided sufficient data, and their returns show an aggregate prevalence of 42.7% for 2017-18. This compares with 44.1% in 2016-17; 43.1% in 2015-16; and 43.8% in 2014-15.

Dr Max Davie, Royal College of Paediatrics and Child Health officer for health promotion said: “Breast milk gives babies the best possible start in life. These figures are therefore disappointing, but sadly not surprising.”

He said the significant drop-off at the six to eight-week mark was due to a range of factors, which included lack of local support services, social stigma around breastfeeding in public as well as “inconsistent messaging from health professionals.”

Full story at OnMedica

Full detail:

Breastfeeding at 6 to 8 weeks after birth: annual data | Public Health England:

 

Why do babies cry?

Scott-Jupp R | Why do babies cry? | Archives of Disease in Childhood | 2018; 103 p1077-1079.

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Persistent, inconsolable crying in young infants is common, distressing but usually benign. This selective review examines perceptions and perceived origins of this phenomenon in babies where serious pathology has been excluded.

Adult brains have evolved to become hypersensitive to infant cries. Babies respond to parental stress by crying more, thus setting up a vicious cycle. Most treatments appear to work largely through a placebo effect.

The imperative for healthcare professionals is to reduce parental anxiety by offering reassurance and support.

Full detail at BMJ journals