Today marks the release of the second organisational report of the National Maternity and Perinatal Audit (NMPA). The report maps service provision as of January 2019 across England, Scotland, and Wales, including an overview of maternity and neonatal care settings, the availability of services, staffing levels, and how these have changed since the last audit in 2017.

The audit has found that there has been an increase in the provision of services for women experiencing perinatal mental health problems, both in the community and in specialist psychiatric clinics. More trusts and health boards are working to implement continuity of care, although these services are predominantly for specific, small groups of women. The number of obstetric units that are co-located with midwifery-led units has increased, however many free-standing midwifery units are facing long or permanent closure. The results of the audit also show that there has been no increase in smoking cessation and weight management support services since 2017. You can read the full report here.

We know from the latest MBRRACE-UK report that poor mental health contributes to the leading cause of direct maternal deaths occurring within one year after the end of pregnancy. We also know from our own survey that managing mental health is one of the biggest concerns for women during their pregnancy journey, and is an area in which they would like more support. As such, an increase in the provision of services can only be welcomed.

What the NMPA doesn’t tell us

However, the NMPA cannot tell us about the experiences of women accessing maternity and perinatal services in England, Scotland and Wales, and how they engage with the services that are available to them. The NMPA report specifically recommends that women themselves be involved in future audits and guideline development.

Through our in-depth interviews, The WRISK Project aims to shed light on women’s experiences, particularly women whose voices are often not listened to. This includes women from a BAME background who disproportionately experience poorer maternal health outcomes. We are particularly interested in learning more about the discrepancy between the volume and intensity of messages about particular ‘risks’ that women may receive, and what support and services are actually available to enable her to effectively act upon these messages, should she wish to do so. This is particularly pertinent in light of the fact that weight management support is only available at 45% of trusts and health boards.

Our findings from both the WRISK survey and in-depth interviews with women will contribute to the development of co-produced recommendations for the improved communication of risks in pregnancy, which will be developed by a network of expert lay and professional stakeholders, including women themselves.

Clare Murphy, the WRISK Project’s Principal Investigator, comments:

“One of the issues clearly emerging from our interviews with women is the disconnect between the messages women receive around how to achieve a healthy pregnancy and the support and services they need to act on them. It’s interesting to highlight that less than half of the trusts surveyed had weight management support available, when women increasingly feel under pressure to make lifestyle and dietary changes in order to minimise risk to their pregnancy.”

Dr Heather Trickey, Research Lead for The WRISK Project, said:

“We hope our project to better understand women’s experiences of evaluating and managing risk in pregnancy – and the areas they themselves prioritise – will lead to the development of more effective woman-centred messages, with the ultimate goal of improving women’s pregnancy journey and the outcomes for herself and her baby.”

If you have any questions about The WRISK Project, please get in touch.