Maternity Care for Vulnerable Women
Who are we trying to help? “Relationship or personal continuity over time has been
found to have a positive effect on user experience and
• Women with social vulnerability outcome…Pre-term births have also been found to be
• Women with mental health needs reduced through continuity of the care.”
• Teenage pregnancies
Better Births report 2016
What are we trying to do?
What we would like to
• Understand the current maternity models of ask you
care on offer in North West London and
where these vary • What should be in/out of the
definition of vulnerability?
• Agree a shared definition of ‘vulnerability’
• Expand existing and implementing case • Should we have the same model
across North West London?
loading models across North West London
to reach more vulnerable women • Who should the key partners be
• Interventions to improve health outcomes to work alongside maternity
teams?
Top things we need to consider
• The definition of ‘vulnerability’ – what should be
included?
• The definition of ‘continuity’ – what should be
included?
• Ways of working, training and education needs
of the maternity workforce
• Availability of resources
What are we trying to achieve?
• Higher levels of continuity of care for
vulnerable women
• Improved health outcomes for women
• Reduced duplication
• Increased staff awareness
• A toolkit to share with other sites who
wish to implement continuity models for
vulnerable women
Midwifery-led Care What we would like to ask you
Who are we trying to help? Users:
• Describe your ideal pathway
• Healthy pregnant women without obstetric or medical • Do you want the same midwife every time?
complications
Midwives:
• Pregnant women local to our geographical location • What would your working day look like?
• New midwives: would you like to work on caseload after
What are we trying to do?
qualification?
• Understand current models of how midwifery-led care is
provided across North West London Management:
• How would you make this model of care work operationally?
• Develop personalised models of care adaptable to all
maternity pathways and needs
Top things we need to consider
• Logistics for service redesign, opportunities and constraints
• Embedding new changes to workforce model and
engagement
• Financial impact, cost of redesign and benefits realisation
• How new care model integrates into holistic maternity
system
What are we trying to achieve?
• Continuity of carer
• Reduction in adverse outcomes
• Improve maternity care experience throughout the care
journey
• Better workforce design and experience
“Relationship or personal continuity over time has been found to
have a positive effect on user experience and outcome…Pre-term
births have also been found to be reduced through continuity of the
care.”
Better Births report 2016
Shared Obstetric Care What we would like
to ask you
Who are we trying to help?
• What are the barriers
• Pregnant women with medical conditions to continuity?
• Pregnant women with previous obstetric
• Which women would
complications benefit the most?
What are we trying to do? • How do we change the
current models?
• Define what ‘continuity’ means and how to
increase continuity in a shared obstetric care “Relationship or personal continuity over time has been found to have a positive
pathway effect on user experience and outcome…Pre-term births have also been found to
be reduced through continuity of the care.”
• Provide continuity of care to specific identified
groups of women Better Births report 2016
Top things we need to consider
• What does continuity mean / look like?
• What is shared care?
• Continuity with the midwife as a the ‘navigator’
What are we trying to achieve?
• Provide a minimum of antenatal continuity
• Move to providing postnatal continuity
• Offer intrapartum continuity to particular groups of
women
• A toolkit to share with other sites who wish to
implement continuity models for women on
shared obstetric pathway
Postnatal Care
Who are we trying to help? What we would like to ask you
• Pregnant women • How would you like to be involved?
• Women seeking postnatal information / advice • Testing continuity of care or carer
• What are likely barriers / blockers to the postnatal care model?
What are we trying to do?
“Relationship or personal continuity over time has been found to have a positive
• Improve postnatal maternity experience and effect on user experience and outcomes…Pre-term births have also been found
outcomes for women. to be reduced through continuity of the care.”
• Empower women to make informed decisions on Better Births report 2016
their pathway
• Develop personalised models of care adaptable to
all maternity pathways and needs
• Integrate services with antenatal pathways
Top things we need to consider…
• Financial impact: Lack of funding for postnatal care
• Team work: Staff work / life balance, working hours
• Consistency of information and advice
• Holistic approach to model of care design
What are we trying to achieve?
• Consistent information and advice
• Model of care suitable for mothers and workforce
• Realistic and effective model within current financial
environment