More flexible antenatal care needed to support vulnerable mums-to-be
Pregnant women living in difficult social circumstances, including those who misuse drugs or experience domestic abuse, need specialised, flexible antenatal care to prevent serious complications before and after giving birth, says new guidance published today by NICE.
The new guideline, which was welcomed today by organisations including the Royal College of Obstetricians and Gynaecologists and baby charity Tommy's, includes practical recommendations on how services can reach out to women who may not always attend regular antenatal appointments, including young mums under the age of 20, and recent migrants or asylum seekers who have difficulty speaking or reading English.
Increasing the uptake of antenatal care amongst these women is important because without it there is an increased risk of death from complications during pregnancy or after birth. Women living in areas of high deprivation in England are five times more likely to die during pregnancy or after childbirth than women in more affluent areas.
The guideline highlights the importance of making antenatal services more accessible to these women. On a practical level this includes holding antenatal clinics in different locations and at more flexible times, or providing an interpreter who can communicate in the woman's preferred language.
It is also important to make sure all women are treated sensitively and with respect, so that they do not feel intimidated or overwhelmed when accessing antenatal care - for example the guideline recommends that healthcare professionals and clinic receptionists should receive training on how to communicate sensitively with women who misuse substances.
“I work with women who misuse substances and recent migrants who do not speak or read much English,” said Rhona Hughes, Lead Obstetrician at NHS Lothian who worked on the guidance. “Both groups attend antenatal services intermittently and in some cases this is because they have found staff to be very judgemental. Training is crucial to make our antenatal services welcoming to all women.”
The guideline recommends that an important first step is recording information about the number of women with complex social factors currently using antenatal services, and finding out their specific needs, so that local NHS organisations can adapt their services to best serve their local populations.
The new guideline also stresses the importance of local NHS organisations working closely with colleagues in social care and voluntary organisations to provide vulnerable women with adequate, timely and flexible care.
Amanda Edwards, Deputy Chief Executive of the Social Care Institute for Excellence, welcomed the recommendations:
“A multi-agency approach is an absolute necessity to make sure their needs are fully met...midwives and other healthcare professionals should be offering women information about support offered by other agencies, or in other words, acting as a ‘bridge' to other services.”
This is the latest in a series of guidance and supporting information on reducing complications in pregnancy for healthcare professionals and pregnant women and their partners.
22 September 2010
This page was last updated: 22 September 2010