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Better Beginnings – For the Healthiest Pregnancies and the Future Health of our Children

Sarah Fox, Professional Policy Advisor
10 April, 2017

Better Beginnings – For the Healthiest Pregnancies and the Future Health of our Children

On the 28th February, the Royal College of Midwives had the privilege of co-launching the National Institute for Health Research’s (NIHR) “Better Beginnings”.  The RCM believes that this review is a fantastic resource for midwives.  Better Beginnings summarises the NIHR research that examines the behaviours that can be modified before, during and after pregnancy to improve health outcomes for mother and baby, the review covers:

  • Smoking
  • Healthy diet and weight
  • Alcohol and drugs
  • Mental health
  • Violence against women
  • Supporting families using multifaceted approaches


    The NIHR was set up in 2006 as the research arm of the NHS, to provide research that is based on the needs of the service users.  NIHR has a Dissemination Centre who are tasked with ensuring clinicians throughout the NHS are aware of relevant research findings and are applying them to their own clinical care.  It is the Dissemination Centre who oversaw the developing and writing of Better Beginnings

    The Review

    NIHR Better Beginnings
    The review focus’s on building health for women to enable the healthiest possible pregnancy and future health for their children.  The review is particularly relevant for midwives and we would recommend its reading.  As we know putting research into practice can help deliver better health for women and their children.

    Many of the evidence highlights will come as no surprise to midwives, most are probably aware that smoking is the greatest modifiable risk for poor pregnancy outcomes.  By referring smokers to Stop Smoking Services (SSS), this action alone, can help women to remain smoke free in pregnancy.  The evidence also suggests that the effectiveness of Nicotine Replacement Therapy in pregnancy is mixed, which may be less well known.  The review challenges us to use a clear pathway that identifies women who are smoking, provide them with support and refer to SSS.

    Take home messages

    Advice is summarised into 8 areas that all women should be aware of to improve their health before, during and after pregnancy:

    1. Improve health before pregnancy
    2. Stop smoking and remain smokefree
    3. Eating a healthy diet including folic acid supplementation
    4. Being a healthy weight and physically active
    5. Breastfeeding
    6. Avoiding alcohol and illicit drug use
    7. Addressing mental health problems and psychosocial stress
    8. Support families with multifaceted approaches

    Of course some of these areas including preconceptual care is a challenge within most of our current models of maternity services, however, there is much still that midwives today can take from the report to ensure their care is based on relevant findings from well conducted studies.

    If you wish to read Better Beginnings for yourself, you will find it through this link:


    If you wish to discuss any aspects of the report further, please do not hesitate to contact sarah.fox@rcm.org.uk

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