Mental health is especially important as women transition into parenthood. The COVID-19 pandemic has necessitated the rapid reconfiguration of maternity services, including perinatal mental healthcare, as offered by Specialist Perinatal Mental Health Midwives, in NHS Trusts in the United Kingdom. This article represents work undertaken in rapid response to the COVID-19 pandemic and aims to document the findings from March 2020 up until May 2021 in literature published on perinatal mental health through the pandemic, as well as to engage in a knowledge mapping exercise across five NHS Trusts in London. In this research, we utilised a critical review methodology which purposefully selects and synthesises materials after extensive literature searching to provide a broad and informed narrative around an issue. For our knowledge mapping exercise, we utilised an inclusive stance to gather, pool, and synthesise data from five NHS Trusts regarding the provisions and reconfigurations of their perinatal mental health services, creating a comparable and translatable snapshot in time. Our rapid, critical review highlighted two themes: ‘Increased Perinatal Distress’ and ‘Inaccessible Services and Support’. Our knowledge mapping exercise produced four themes: ‘Retention of Existing Service Provision’; ‘Additional Services Provided’; ‘Reconfiguration of Service Provision’; ‘Additional Provision to Support Staff Wellbeing’. We conclude by offering best practice guidance in order to provide shared learning to aid the transition through para-pandemic circumstances to service delivery in a post-pandemic ‘new normal’.
Purpose Women with little-to-no English continue to have poor birth outcomes and low service user satisfaction. When language support services are used it enhances the relationship between the midwife and the woman, improves outcomes and ensures safer practice. However, this study has shown a reluctance to use professional interpreter services by midwives. This study aims to understand the experiences of midwives using language support services. Design/methodology/approach A maximum variation purposive sampling strategy was used to recruit midwives (N = 12) to a qualitative, semi-structured interview study. Data were analysed using thematic analysis. Findings Four themes were generated from the data analysis with a central organising concept of “Navigating Care Without Language”. These themes were: “Continuity as Key”, “Facilitating Tools”, “Networks of Support” and “Innovative Planning”. Each of these themes had between three and four sub-themes. It was found midwives are keen to support women with language barriers. However, support can be difficult due to the unavailability of equipment and resources; lack of continuity (of interpreter and midwife); inability to plan for the acute care of women who require interpreter services; and the system not being accessible enough to women who require language support services, thus causing them to fall through the net. Originality/value Continuity of carer appears to be a protective factor due to the flexibility, relationship and continuum of support. This study will aid the development of education for undergraduate, post-graduate and practising midwives. It will also inform policymakers working to improve the service offered to women who speak little-to-no English.
As healthcare professionals, effective communication is so important to every contact we have with patients. Our relationships can impact on their mental health and, when communication is empathetic and trusting, it can have life-changing effects. As midwives, we can improve physiological and physical outcomes by creating a supportive and listened-to environment. Postpartum psychosis is an obstetric emergency and can be the first time a woman experiences mental health services. Ellie Ware discusses her experience of postpartum psychosis and how important communication was to her treatment and recovery.
Background The human and financial costs of diabetes related illness and treatment are significant and increasing. This is also true of women who develop gestational diabetes in pregnancy, the majority of which are subsequently likely to develop type 2 diabetes. The National Institute for Health & Care Excellence (NICE) guidance sets out clear expectations of the care pregnant women should receive. However, evidence suggests reality is a long way from this guidance. Methods Data was collected from the population health management system covering the London borough of Lewisham. This was used to compare actual care with NICE guidance. The results were used to target cultural appropriate interventions to improve care. ResultsThe care pregnant women were receiving fell a long way short of NICE guidance, with 84% of women not being screened at the initial 3 months postpartum and 99% of women not being screened annually. This is significantly worse than the UK average. ConclusionUsing population health management is beneficial in identifying the gap between actual care and best practice. The process of examining the data through population health management also enable targeted culturally appropriate interventions.
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