There were more than 626,000 births in the NHS in 2017/18, with around 100,000 neonatal admissions to hospital each year.
This report focuses on how NICE’s evidence-based guidance contributes to improvements in maternity and neonatal care.
Published September 2019
Updates from our last maternity report
In May 2018 we published the NICEimpact report on maternity. We review the impact of NICE guidance from the previous report where new data has become available.
Maternity and mental health
Up to 20% of women experience perinatal mental health problems, which if left untreated can have long-lasting effects on mother, baby and family. We review how NICE guidance is contributing to improvements in this area.
Specialist care of newborns
Newborn babies who are born prematurely or need treatment in hospital require specialist neonatal care. We consider the impact of NICE’s recommendations across the care pathway, including how NICE guidance is helping to support mothers to initiate and continue to breastfeed while their babies are receiving specialist neonatal care.
Spotlight on valproate prescribing
Babies exposed to valproate in the womb are at a high risk of serious complications. We look at how updated NICE guidance is aligning with regulatory safety advice to reduce risk in this area.
Commentary
Dr Kathryn Gutteridge, President of The Royal College of Midwives, reviews recent achievements and considers NICE’s role in improving maternity and neonatal care.
Why focus on maternity and neonatal care?
NICEimpact reports review how NICE recommendations for evidence-based and cost-effective care are being used in priority areas of the health and care system, helping to improve outcomes where this is needed most.
NICE provides evidence-based guidance and advice to help improve health and social care services. The uptake of NICE guidance is influenced by close relationships with partners in the system, such as NHS England, NHS Improvement and Public Health England (PHE).
NICE published its first maternity guideline, on antenatal care, in 2003. Since then we have produced a suite of maternity and neonatal related guidance. Since the last NICEimpact report on maternity in May 2018 we have published or updated guidance on:
- Intrapartum care for women with existing medical conditions or obstetric complications and their babies
- Specialist neonatal respiratory care for babies born preterm (quality standard to follow in 2020)
- Developmental follow-up of children and young people born preterm
- Antenatal and postnatal mental health: clinical management and service guidance (updated)
- Antenatal care for uncomplicated pregnancies (updated)
- Hypertension in pregnancy: diagnosis and management (updated)
- Preterm labour and birth (updated)
- Twin and triplet pregnancy (updated)
The Department of Health and Social Care (DHSC) set out a vision in 2015 to halve the number of stillbirths, neonatal and maternal deaths and brain injuries by 2030. As a result, NHS England established the Maternity Transformation Programme. This was the focus of the last NICEimpact report on maternity. Since then the DHSC announced a renewed commitment to achieve this aim by 2025, which was highlighted in the NHS Long Term Plan.
NICE routinely collects data which provide information about the uptake of its guidance. To produce this report, we have worked with national partners to select those data which tell us about how NICE guidance might be making a difference in priority areas of maternity and neonatal care. They also highlight areas where there is still room for improvement.
Antenatal care is the care people receive from healthcare professionals during their pregnancy.
The perinatal period is the period immediately before birth to just after birth.
Postnatal care covers the period after birth.
The neonatal period covers the care of newborn babies from birth to 28 days.
This report highlights progress made by the health and care system in implementing NICE guidance. We recognise that change can sometimes be challenging and may require pathway reconfiguration. It may also require additional resources such as training and new equipment.
We work with partners including NHS England, Public Health England and NHS Improvement to support changes. We also look for opportunities to make savings by reducing ineffective practice.
We would like to thank Dr Matthew Jolly, National Clinical Director for the Maternity Review and Women’s Health and Dr Kathryn Gutteridge, President of The Royal College of Midwives. We would also like to thank Mumsnet, Bliss and NHS Blood and Transplant for their contributions to this report.