Since 2015, the Royal College of Physicians and Surgeons of Glasgow has been working with key stakeholders to address the issue of indirect maternal deaths.
In December 2014, MBRRACE-UK published the results of a confidential enquiry into maternal deaths and morbidity (2009-2012), titled Saving Lives, Improving Mothers' Care, with the aim of informing future maternity care in the UK and Ireland. The findings of the report showed that two thirds of maternal deaths were from causes not directly related to pregnancy or childbirth.
The Royal College of Physicians and Surgeons of Glasgow and the Royal College of Physicians of Edinburgh then met with Dr Catherine Calderwood, now Chief Medical Officer for Scotland, in March 2015 to discuss the findings of the MBRRACE report. Following the meeting, recommendations were put forward as strategies to reduce the incidence of maternal death.
From June 2015 Dr Rebecca Northridge, a senior trainee in obstetrics and gynaecology, was funded by the Cruden Foundation to complete a year as a Scottish Clinical Leadership Fellow with the Royal College of Physicians and Surgeons of Glasgow with a focus on maternal health. During her Fellowship, Dr Northridge led two collaborative projects to address the recommendations from March 2015:
the first, working with Scottish Intercollegiate Guidelines Network (SIGN) to raise awareness about risks and support for pregnant women (or those planning pregnancy) with epilepsy; the second, working with both the Royal College of Physicians and Surgeons of Glasgow and the Royal College of Obstetricians and Gynaecologists to produce a poster and an animated video to help doctors to assess unwell pregnant or post-partum women and reduce maternal mortality from indirect causes
In September 2016 the College brought together representatives from each of the Scottish Health Boards and senior clinicians to discuss the improvement of obstetric care of women with heart disease. These discussions formed the basis of a new set of standards of care.
Preventing maternal deaths
It's better to ask: working together to prevent maternal mortality
A collaborative project between Royal College of Physicians and Surgeons of Glasgow and the Royal College of Obstetricians and Gynaecologists, led by Dr Rebecca Northridge, aimed at reducing the rate of maternal mortality from indirect causes. The animated video titled, It's better to ask: working together to prevent maternal mortality, highlights the main indirect causes of maternal mortality (cardiac conditions, neurological conditions such as epilepsy, influenza and pneumonia, and mental health problems resulting in suicide) and gives guidance on the assessment of unwell pregnant and post-partum women who display associated symptoms. Watch and share the video below.
Three Ps in a Pod
A poster was also produced as part of the Preventing maternal deaths project, titled Three Ps in a Pod. The poster highlights the main causes of maternal death and provides advice for assessing pregnant and post-partum women who are feeling unwell. The posters were distributed to all A&E departments and medical assessment units in the UK on 20 June. Download and share the poster below.
Pregnancy and epilepsy
Working with the Scottish Intercollegiate Guidelines Network (SIGN), Dr Rebecca Northridge and the Royal College of Physicians and Surgeons of Glasgow have produced a set of resources to raise awareness of the risks to and support available for pregnant women (or those planning pregnancy) with epilepsy. The resources included information postcards produced for distribution with epilepsy medication prescriptions, and posters and leaflets to be displayed in hospitals and GP surgeries.
The key messages to women with epilepsy who are pregnancy or trying to become pregnant are:
- Do not to stop epilepsy medication without consultation with a specialist nurse or doctor
- Begin a high dose of folic acid if trying for a baby and for the first 12 weeks of pregnancy
- Make an appointment with your doctor or epilepsy specialist to discuss your pregnancy and ensure you are in the best health possible
Download and share the resources below:
Addressing the Heart of the Issue
On 7 September 2016 the College hosted a meeting to discuss how to tackle inequalities of obstetric care for women with cardiac disease and improve outcomes for patients. The meeting was attended by representatives from each of the Scottish Health Boards, Health Improvement Scotland, midwives, nurses and senior clinicians from obstetrics, cardiology and anaesthesia.
The outcome of this meeting was the development of a new set of College standards for good clinical practice in the shared obstetric and cardiology care of women of childbearing age. The standards, Addressing the Heart of the Issue, have been produced as a collaborative effort with support from the CMO for Scotland, Dr Catherine Calderwood. The College believes that by adopting these standards, Health Boards in Scotland can reduce unnecessary morbidity and mortality from cardiac disease in women of child-bearing age.