Health services and pregnancy care in the UK

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The Saving Babies Lives Care Bundle (SBLCB) assessment, which supports the goal of better births, has a 20% reduction in the stillbirth rate in maternities where the packages have been implemented.

It is advisable to consult a midwife or a general practitioner as soon as a pregnancy is detected.

After that, prenatal follow-up is organized. It is important to have regular prenatal appointments, to keep a check on various parameters which are essential for a smooth pregnancy.

Some of the tests and measurements need to be done at specific times, which are monitored and guided by the affected midwives as the pregnancy progresses.

A midwife facilitates care during pregnancy and has expertise in normal childbirth. Midwives are specially trained to care for mothers and babies throughout pregnancy, labor and postpartum.

Health services by the NHS:

  • 10 pregnancy appointments (7 if you have already had a child)
  • Screening tests are offered at different stages of pregnancy.
    The sickle cell and thalassemia test is offered from the start around 10 weeks of pregnancy. In addition, blood tests for HIV, hepatitis B, and syphilis are recommended early in pregnancy. These blood tests should be done before the first test appointment.
    Screening for trisomy 21, Edwards syndrome and Patau syndrome is done around 11 to 14 weeks of pregnancy. Other tests to check the baby’s development are done around 18 to 21 weeks of pregnancy.

In some hospitals an obstetrician is there to check for any complications, but in other hospitals the midwife or GP will refer an obstetrician if they have concerns or if there has been a history of previous complications.

An epidural is given by an anesthetist to relieve pain during labor.

In the event of a cesarean section, an anesthesiologist provides the appropriate anesthesia.

The anesthesiologist is present if an epidural is needed for an instrumental delivery using forceps or a vacuum delivery.

Suction is performed by a device called a sucker, which is a cup-shaped suction device that is attached to the baby’s head to help the baby to be born.

A pediatrician would then check the baby to make sure the baby is okay, especially in cases where labor was difficult for the mother.

Neonatal nurses take care of premature or sick babies when they are born.

An obstetric physiotherapist helps cope with physical changes during and after pregnancy and childbirth.

The NHS annually reviews and analyzes pregnancy and care data for statistical analysis.

Stillbirths, early neonatal deaths, cases of severe brain damage in infants, as well as maternal deaths are reviewed by the Health Care Safety Investigations Directorate.

Most maternity service providers use the Perinatal Mortality Review Tool. This ensures a high-quality review of the circumstances and care leading up to and surrounding each stillbirth and newborn death.

Article for Emergency Live by Irawati Elkunchwar

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Source:
1. https://www.birthrights.org.uk/
2. https://bmcpregnancychildbirth.biomedcentral.com/
3. Office for National Statistics (2018) Summary tables of death registrations – England and Wales. Available at https://www.ons.gov.uk
4. Office for National Statistics (2018) Infant mortality in England and Wales. https://www.ons.gov.uk/
5. MBRRACE-UK (2018) Saving lives, improving care for mothers.
6. https://www.npeu.ox.ac.uk/mbrrace-uk/reports
7. https://www.longtermplan.nhs.uk/


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