Pregnant women with serious medical problems will now have access to specialist treatment centres across the country.
The 17 new centres of excellence will help women with pre-existing medical conditions, or conditions that arise during pregnancy to quickly get the extra care they might need.
As part of the NHS commitment to halve the maternal mortality rate by 2025, a wide ranging team will be on hand to provide specialist medical advice before during and after pregnancy, bringing together expert physicians, obstetricians, midwives, nurses and other clinicians in one place.
There is at least one centre in every region of the country, including at Guy’s and St Thomas’ and St Georges in London, Oxford University Hospitals, and across Liverpool, Manchester and Newcastle.
Networks linked to these centres ensure that access to expert maternal medicine care is available to all women. They also ensure that all maternity services and emergency departments are aware of key ‘red flag’ symptoms in pregnancy and have measures in place so that pregnant women can be appropriately assessed by a specialist physician or obstetrician.
Though 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.
The NHS is ensuring that each specialist hub is led by a dedicated multidisciplinary team, including at least one obstetric physician – doctors who are specialists in medical problems and treatments during pregnancy.
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.”
Figures show one in five women will have a medical issue during pregnancy, and every network will ensure women who need specialist care receive medications and procedures that are safe in pregnancy, from an expert team who can advise on how to optimise those treatments.
Most conditions, like well-managed diabetes, 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.
The most serious cases will be treated at these 17 centres, where they will be closely monitored and provided with specialist treatment throughout their pregnancy.
Dr Matthew Jolly, National Clinical Director for Maternity and Women’s Health, said: “For a number of years too often we have seen symptoms of serious medical problems being missed or misattributed to pregnancy.
“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.
Previously, there were fewer than 10 obstetric physicians in the country, but the NHS has already funded the training of a further six consultants, with three more due to start by the end of next year, as part of the commitment to have obstetric physicians in place in every maternal medicine centre and, in line with Donna Ockenden’s Final Review, establish a sustainable training pathway for them with the Royal College of Physicians and Health Education England.
