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New specialist centres for pregnant women with medical problems

Seventeen new centres will be built across England to ensure that pregnant women who have serious medical problems can access the treatment they need, NHS England has announced.

Seventeen new centres will be built across England to ensure that pregnant women who have serious medical problems can access the treatment they need, NHS England has announced.

There will be at least on centre in every region of England, including at Guy’s and St Thomas’ and St Georges in London, Oxford University Hospitals, and across Liverpool, Manchester and Newcastle.

The centres are designed to help women with pre-existing medical conditions, or conditions that arise during pregnancy to quickly get the extra care they might need.

Professor Jacqueline Dunkley-Bent, England’s Chief Midwifery Officer, said: “We know that pre-existing medical problems are a significant factor in the variation in rates of mortality for Black and Asian women.

“The establishment of these maternal medical networks will improve every woman’s access to specialist care for medical problems in pregnancy and will play an important part in our wider efforts to improve care for women and babies right across our maternity services.”

Reducing maternal mortality rates

Figures show one in five women will have a medical issue during pregnancy, and most of these issues can be safely managed locally.

Some women may be sent for an initial assessment at one of the centres, where they will be set up with a personalised management plan that they can continue at home, with support from their local maternity team.

Serious cases will be treated at the centres themselves, where women can be closely monitored and provided with specialist treatment throughout their pregnancy.

Dr Matthew Jolly, National Clinical Director for Maternity and Women’s Health, said: “Maternal Medical Networks and their specialist centres are a vital step in improving the identification and management of potentially fatal medical conditions in pregnancy, wherever a woman receives care, and to ensure England continues to improve in its position as one of the safest countries in the world to give birth.”

“While maternity providers already offer services ranging from midwife-led diabetes clinics, to joint clinics with physicians from particular specialties – the new Maternal Medicine Networks will work with local GPs, emergency departments, and community midwifery services to ensure all pregnant woman can access these services when needed.”

Reducing maternal mortality rates

The new centres are part of the NHS’ commitment to halve the maternal mortality rate by 2025. While maternal mortality in England is very rare, the majority of maternal deaths are caused by medical conditions that pre-date or develop during pregnancy – such as cardiac disease (23%), blood clots (15%) and epilepsy and stroke (13%) – that can be missed or misattributed to pregnancy.

To ensure that these conditions are caught early, the hubs will be led by a dedicated multidisciplinary team, including at least one obstetric physician.

All maternity services and emergency departments will also be made aware of key ‘red flag’ symptoms in pregnancy and have measures in place so that pregnant women can be appropriately assessed by a specialist.

How will the centres be staffed?

There are currently only 10 obstetric physicians in the country, but the NHS has funded the training of a further six consultants, with three more due to start by the end of next year.

This is part of the NHS’ commitment to have obstetric physicians in place in every maternal medicine centre and establish a sustainable training pathway for them with the Royal College of Physicians and Health Education England.

It is not clear who the remaining hubs will be led by while there is still a deficit of obstetric physicians, but Lucy MacKillop, Consultant Obstetric Physician at Oxford University Hospitals and Regional Obstetric Medicine Lead and Chair for the Thames Valley Maternal Medicine Network, says the OSM “welcomes the recognition of the vital role Obstetric Physicians can play in these networks, and the recent investment in training these specialists to care for pregnant people with the highest risks of complications during or soon after pregnancy.”

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