Leading Royal Colleges say multi-disciplinary maternity care is key to improving maternal outcomes
Today two leading Royal Colleges have said its vital that all pregnant women admitted to hospital with COVID-19 have multi-disciplinary maternity care from the start and that the information given to pregnant women must be accessible to all.
Responding to a new report from the MBRRACE-UK Confidential Enquiry into Maternal Deaths, the Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) said that clarity is key when providing specific advice to women with COVID-19 during pregnancy and after birth. They also stated the need for special attention to be paid to those at higher risk, including black, Asian and minority ethnic women, including providing access to an interpreter where needed.
The report reviewed the care of 16 pregnant and postnatal women who died with COVID-19, from mental health-related causes or due to domestic violence between 1 March and 31 May 2020. During this period, ten women died with COVID-19 infection, eight directly related to COVID-19 and two from other causes. Four women died by suicide and two due to domestic violence. During the three months covered by this report over 160,000 women gave birth in the UK.
Commenting, RCM CEO Gill Walton said:
“While this is small study, it sadly indicates that many of the women who died from COVID-19 were from black, Asian or ethnic minority backgrounds. This further emphasises the need for clear information to be given to these women so that they are better able to manage their health appropriately. Ensuring that those at higher risk are supported by a multi-disciplinary team – and that they see the same professionals over time - is key to tackling and improving outcomes for women with high risk pregnancies.
“Isolation during the pandemic has been very difficult for some women during their pregnancy and after birth. That is why we must ensure that they are able to access appropriate community-based care from midwives, health visitors and perinatal mental health teams. While we welcome the greater use of technology to support pregnant women, it is not a wholesale substitute for face-to-face support. This is particularly true for picking up on safeguarding issues, including women at risk of domestic abuse. We fully support those maternity teams offering a blended approach, giving the reassurance of ongoing virtual contact alongside the ‘in person’ appointments that allow women to get timely help and support.”
Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, said:
“Every one of these deaths is a tragedy and our thoughts are with the families of the 16 women who died. It is crucial that we learn from the findings of this rapid report to help prevent future deaths.
“Through our collaborative working with the MBRRACE team throughout the pandemic, the clinical recommendations have already been incorporated into our guidance for women and healthcare practitioners.
“The guidance makes clear that pregnant women admitted to hospital with COVID-19 must have multi-disciplinary maternity care and states there should be a low threshold for review of pregnant Black, Asian, and minority ethnic women with COVID-19.
“Addressing health inequalities is a key priority for the College, and we established a Race Equality Taskforce earlier this month to focus on reducing adverse outcomes in BAME women. This report highlights that we must also ensure that services are fit to support vulnerable women who are victims of domestic violence or abuse.
“Future pandemic planning should ensure that the care of pregnant women is not compromised by redeployment of maternity staff and that access to face-to-face antenatal and postnatal care for women who need support with their mental health is prioritised.”
To contact the RCM media office call 020 7312 3456 or email [email protected]
To contact the RCOG press office call 020 7772 6300 or email [email protected]
Notes to Editors
- MBRRACE rapid report: Learning from SARS-CoV-2-related and associated maternal deaths in the UK: https://www.hqip.org.uk/resource/maternal-newborn-and-infant-programme-learning-from-sars-cov-2-related-and-associated-maternal-deaths-in-the-uk/#.Xz44f0BFzD5
- RCM and RCOG joint guidance for pregnant women during COVID-19 https://www.rcm.org.uk/advice-for-pregnant-women/
- Clinical advice for midwives during the crisis https://www.rcm.org.uk/clinical-advice-during-the-crisis/
- RCM offers advice to pregnant women as new study shows heightened risk to some communities https://www.rcm.org.uk/media-releases/2020/may/rcm-offers-advice-to-pregnant-women-as-new-study-shows-heightened-risk-to-some-communities/
- RCM’s Race Matters Campaign https://www.rcm.org.uk/supporting/race-matters/
- The Inequality of COVID-19 https://www.rcm.org.uk/news-views/rcm-opinion/2020/the-inequality-of-covid-19/
- Advice NHS staff who may be more at risk from COVID-19 because of the race can be read at https://www.rcm.org.uk/media/3939/risk-assessment-wraparound-guidance-a3-may-2020.pdf.
- System failing BAME women’ says RCM https://www.rcm.org.uk/media-releases/2020/june/system-failing-bame-women-says-rcm-on-new-study/
- The RCOG’s Race Equality Taskforce was established on 15 July 2020 to better understand and tackle racial disparities in women’s healthcare and racism within the obstetric and gynecology workforce: https://www.rcog.org.uk/en/news/rcog-launches-race-equality-taskforce/
The RCM is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team. We provide workplace advice and support, professional and clinical guidance and information, and learning opportunities with our broad range of events, conferences and online resources. For more information visit the RCM website at https://www.rcm.org.uk/.
The RCOG is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision. Find out more at www.rcog.org.uk