Pandemic changes affected maternity care for women who had stillbirths

Changes due to Covid may have lead to increased numbers of stillbirths (POOL/AFP via Getty Images)

Changes to maternity services during pandemic, including the mandatory redeployment of midwives and doctors to care for infected patients, may have affected the care given to women who had stillborn babies, an investigation has found.

According to the Healthcare Safety Investigation Branch changes to the way women were looked after during their pregnancy meant some women may not have had the same level of checks while others did not have face to face appointments.

The safety watchdog launched an investigation after the number of stillbirths after the onset of labour increased between April and June 2020. During the three months there were 45 stillbirths compared to 24 in the same period in 2019.

The HSIB launched a probe examining the care of 37 cases.

Among its findings the watchdog said staffing levels were affected because of the NHS response to the pandemic.

In its report it said this “influenced normal work patterns and the consistency and availability of clinicians.”

As an example, in one maternity unit the staffing numbers were short by three midwives due to sickness and redeployment. In another consultant presence was reduced overnight.

During the pandemic both the Royal College of Midwives and the Royal College of Obstetricians criticised NHS trusts for redeploying maternity staff when mothers continued to need services regardless of the pandemic.

HSIB said none of the women in its report were recorded as having the virus, but it found the pressures and changes as a result of the pandemic may have affected the care they received.

The study stressed that the proportion of consultations undertaken remotely was not known and “the impact of remote consultations is not clear from this review”.

However, it said there was evidence that remote consultations resulted in fewer opportunities for physical examinations, meaning trends in how the baby was growing could be missed.

After 28 weeks’ gestation, not all consultations included measuring from the mother’s pubic bone to the top of the womb (a standard measure to inform baby growth), while there was a “lack of recording and plotting” of this information, HSIB said.

Some face-to-face appointments were postponed until later in the pregnancy, while in some remote consultations clinicians did not have access to clinical notes or ultrasound scan reports.

On three occasions this resulted in ultrasound scans being cancelled or not being made available, and in one case there was a significant change to the intended birth plan.

In one of the cases, the mother “chose not to attend the appointment after considering the risks of Covid-19 against the risk of not attending the appointment and on balance chose the latter”.

The HSIB said many of the safety risks identified in the review were already known to maternity services and exacerbated by the pandemic, for example, the level of staffing in maternity units.

Other issues noted were challenges in interpreting and implementing rapidly changing national guidance on Covid, difficulties in communication by phone, and workforce demands in the NHS, which led to absence and sickness.

A lack of oxygen to the baby during labour was identified as a cause of death for 10 babies.

When it came to contact with the NHS during labour, 19 babies had no signs of life on the first visit to hospital.

But 11 of these women and pregnant people had made telephone contact for healthcare advice and were advised to remain at home.

For five babies, the heart rate was identified during a visit to hospital, then no signs of life were found at the next hospital visit several hours later or the following day.

Kathryn Whitehill, principal national investigator at the HSIB, said: “We recognise that the current maternity system has had success through national initiatives in reducing the number of stillbirths and that throughout the pandemic thousands of babies were delivered without any problems.

“However, our review did highlight the extreme pressure maternity services were under – they had to balance the risks associated with uncertainty and emerging evidence on Covid-19 transmission with the clinical assessments that are needed to monitor the safety of patients.

“Our recommendations are aimed at identifying where there might be gaps in safety management and supporting the system to take a proactive approach in ensuring the wellbeing and effective care of women and pregnant people and their babies across the country.”

For 10 babies in the review, the cause of death was related to the function and structure of the placenta. Two babies died following placental abruption, which is the separation of the placenta from the uterine wall before birth.

One died following uterine rupture, while three died following complications with the umbilical cord.

Among the recommendations made by the HSIB is one for NHS England and NHS Improvement to lead work to “collate and act on the evidence on the risks and benefits associated with the use of remote consultations at critical points in the maternity care pathway”.

Another recommends that the Department of Health and Social Care commissions a review “to improve the reliability of existing assessment tools for foetal growth and foetal heart rate to minimise the risk for babies”.

Read More

Internet Explorer Channel Network
News Related

OTHER NEWS

Ben Simmons takes ‘first step' to rebuilding 76ers relationships

Ben Simmons’ teammates with the 76ers publicly supported the All-Star point guard after he told them in a team meeting before Friday’s game against the Nets that he’s “not mentally ... Read more »

Devils nip Sabres in OT to give Nico Daws win in NHL debut

Pavel Zacha scored at 3:09 of overtime to give the New Jersey Devils a 2-1 victory over the Buffalo Sabres on Saturday night at Prudential Center in Newark. Nico Daws ... Read more »

Coronation Street fans in tears as Johnny Connor drowns after hearing the voice of dead son Aidan

CORONATION Street fans are in tears after Johnny Connor drowned after confessing his love for ex-wife Jenny. The businessman – who is played by actor Richard Hawley in the ITV ... Read more »

Secretary of Evil: True she is 96 and her alleged complicity in the horrors of Hitler's death camps was 76 years ago. But IAN BIRRELL says justice must be served - however belatedly

Eighty years ago this weekend, a young SS recruit started working as a guard at Sachsenhausen, the concentration camp close to Berlin conceived by Nazi leaders as a potent symbol ... Read more »

Chiefs-Titans battle a key early AFC showdown

When the Chiefs and Titans play each other Sunday in Nashville, it will be an opportunity for one team to begin to run away with its division and the other ... Read more »

Hairdresser reveals why it's ‘completely normal' for your hair to come out in the shower and when you should be worried

EVER been left surprised by the amount of hair that seems to fall out when washing your locks in the shower? A professional hairdresser has taken it upon themselves to ... Read more »

Delayed! NASA is now targeting February 2022 for its Artemis I mission to the moon as cost setbacks, lawsuits and the pandemic pushed back the timeline

NASA is now targeting February 2022 for its uncrewed Artemis 1 mission, a delay caused by several reasonsLawsuits, COVID-19, cost overruns and manufacturing issues pushed it back The U.S. space agency wanted to send the test flight into orbit by the end of 2021The next windows are in March and April, but are dependent on orbital mechanics and the relative position of the Earth to the moonNASA stacked the Orion crew capsule on the SLS rocket on October 20Artemis 1 is the first step in the US's plan to return humans to the moon by 2024  Read more »

NYS Police replaces head of gov's detail in wake of sex harass report

New York Attorney General Letita James’ sexual harassment report concluded a NYS Trooper was one of the eleven women sexually assaulted by former governor Andrew Cuomo. AP ALBANY — The ... Read more »

Unvaccinated Americans are more likely to die of non-Covid causes than those who received their shots, CDC report finds

A new CDC report compared non-Covid-related deaths among vaccinated and unvaccinated AmericansThere were 1.11 deaths per 100 people per year among unvaccinated Americans compared to 0.35 and 0.34 for Pfizer and Moderna recipients, respectivelyFatalities were also higher among the unvaccinated compared to J&J recipients at 1.47 per 100 people per year versus 0.84 per yearResearchers say the findings show vaccines don't increase the risk of death and suggest that vaccinated people are overall healthier than unvaccinated people Read more »

Simon Cowell lines up Mabel to be a judge on his new game show Walk The Line

SHE may warn people not to call her up, but we can reveal that Mabel has been letting Simon Cowell's calls through the net. The Mad Love singer is in ... Read more »

Emmerdale star Paige Sandhu reveals men pester her to send X-rated snaps

EMMERDALE’S Paige Sandhu has told how men send her saucy proposals — and pester her for X-rated pics. The actress, who plays killer nurse Meena Jutla, is on an app ... Read more »

Alec Baldwin tweets article that he ‘was told prop gun was safe before fatal shooting' as he attends memorial for cinematographer he shot

Alec Baldwin tweeted a Variety article on Friday that he 'was told prop gun was safe before fatal shooting' of female cinematographer on the set of Western filmThat same night he attended a private memorial in Halyna Hutchins' honor with her husband, Matthew, and 9-year-old sonEarlier in the day Baldwin tweeted: 'There are no words to convey my shock and sadness regarding the tragic accident' The actor accidentally shot and killed Hutchins on the set of Rust when he was handed a prop gun loaded with live ammunition  Read more »

McAuliffe shrugged off Virginia gov's racism scandal after pushing resignation

Gubernatorial candidate Terry McAuliffe dismissed Virginia Gov. Ralph Northam‘s racial scandal, where Northam was accused of being in a photo with a person dressed in blackface. Getty Images Months after ... Read more »

Dyson Airwrap 10% cheaper at Outlet refurbished store

DYSON products are famous for their quality – but you certainly have to pay for the quality. That's why we're flagging that refurbished products at the Dyson Outlet store can ... Read more »

What's the deal for Dublin and can I visit France if I'm unvaccinated? The Holiday Guru answers readers' Covid-related travel questions

The Holiday Guru is always on hand to answer your questions. This week, he helps one reader who is planning a trip to the Emerald Isle and advises another who ... Read more »

Video: Britney Spears says it's 'bittersweet' seeing sons Sean, 16, and Jayden, 15, grow up as she shares photos of them as children: 'Why can't they just stay babies forever?'

Read more »

Keep your pets fed for less with these paw-some tips and tricks

KEEP your furry friends fed well for less with these paw-some tips and tricks. As any owner will know, food is one of the biggest expenses for a pet. Keep ... Read more »

Orange FBI marker paint on leaves marks the swampy, desolate spot where Brian Laundrie's remains were found after six-week search for Gabby Petito's fiance

Dailymail.com ventured into the desolate swampland scene where Brian Laundrie's bones were discovered and photographed orange and lime green flags and FBI paint markers where the fugitive presumably diedThe Carlton Reserve opened up to the public following a near six-week FBI-led search for Laundrie and the death scene is just 700 yards from the entrance to the Myakkahatchee Creek Environmental ParkBefore Laundrie's remains were found the spot had been under flood water for weeks in a spot just four miles from the Laundrie home in North Port, FloridaIt is not known how long Laundrie was in the reserve before he died. He fled there on September 13, two days after police arrived at the home he shared with his parents to speak with him over Gabby’s disappearanceOn Thursday the FBI confirmed the skeletal remains they found the day before belonged to Brian LaundrieOn Friday the Laundrie family lawyer Steve Berolino said that the autopsy was inconclusive and further tests by a forensic anthropologist are needed to determine how he died  Read more »

Rebecca Judd flaunts her abs in a glamorous outfit as she celebrates Melbourne's Freedom Day with a night out on the town

Rebecca Judd is ready for a night out on the town to celebrate Melbourne’s Freedom Day after 262 days in lockdown. On Friday, she flaunted her glamorous outfit in a ... Read more »

Premier League star and terrified girlfriend tied up at home by machete wielding thugs

A PREMIER League star was attacked by masked thugs with machetes in his own home, then tied up along with his terrified partner. The player — who we are not ... Read more »

Colombia captures its most wanted drug lord 'Otoniel'

© Provided by dw.com According to police, Otoniel was hiding in the jungle in the Uraba region, where he is from Colombian authorities said on Saturday they captured Dairo Antonio ... Read more »

Hospitalized COVID-19 patients are up to three times as likely to suffer a cognitive issue after their bout with the virus as those who have a mild case

Covid patients who required hospitalization were three times as likely to suffer cognitive issues after recovery than those with mild cases, a new study finds  Many with mild cases also worryingly reported some cognitive issues after recovery from the virusCognitive issues include memory recall issues, limited attention and memory encoding problemsResearchers note that the participants of the study were young, with an average age of 49, and are not of an age to typically have these types of issuesCognitive issues are a well known symptom of 'long Covid', an expert tells DailyMail.com  Read more »

Conor McGregor's amazing body transformation, from his UFC debut in 2011 as a featherweight to tipping scales at 170lb

CONOR McGREGOR is bigger than ever – and we're not talking about his popularity. Notorious, 33, is continuing his rehab from a horror leg break that forced him to concede ... Read more »

Why WAS a gun on Alec Baldwin movie set loaded with live ammo? Mystery over events that led to actor killing cinematographer - after his stunt double ALSO fired off bullets on production overseen by daughter, 24, of legendary sharpshooter

Cinematographer Halyna Hutchins was accidentally killed on Thursday when she was shot on set of film RustAlec Baldwin, 63, fired a live round towards the camera, killing the cinematographer and injuring the directorThe actor was wrongly handed a gun loaded with live ammunition, rather than blank, by the assistant directorComes after his stunt double also fired off live bullets while on set, there were two other shooting accidents Production's armorer was identified as Hannah Gutierrez-Reed, 24, the daughter of the legendary Thell Reed Read more »

Disturbing video shows pedestrian fatally struck by speeding SUV in NYC

A 63-year-old man was struck and killed by a speeding hit-and-run driver while trying to cross the street in Brooklyn, police said. The SUV did not remain on scene after ... Read more »

We must resist the drum beat of more Covid restrictions – for the sake of our young who have sacrificed so much for the rest of us, argues author and commentator MARY HARRINGTON

The drum beat has started for another round of Covid restrictions. The NHS Confederation, the body representing NHS staff, wants the Government to impose ‘Plan B’ to manage rising cases ... Read more »

Arizona attorney general asks for temporary restraining order to stop Biden's COVID-19 vaccine mandate calling it an ATTACK on 'individual liberty and federalism'

Arizona AG on Friday applied for immediate halt to COVID-19 vaccine mandate Mark Brnovich said it was vital to protect millions of workers'Once a vaccine has been administered, it can never be undone,' he saidArizona is one of a number of Republican-led states fighting the measuresConservatives say they are federal overreach and infringe individuals' rights  Read more »

Video: Joe Cole believes Norwich's flops are 'not playing for manager' Daniel Farke and 'need a fresh voice in the dressing room' after suffering humiliating thrashing against Chelsea

Read more »

Two more members of right-to-die organisation arrested

Photo: Depositphotos Two more members of an organisation that advocates for the right to die have been arrested as part of a police investigation into illegal assisted suicide. The Dutch ... Read more »

Facebook services were used to spread religious hatred in India and may have inflamed 2020 riots in Delhi that left 53 dead, internal documents leaked by whistleblower Frances Haugen claim

Reports from Facebook researchers warned that the social media company was fueling divisions between India's Hindu majority and Muslim minorities Interviews with users revealed that they were worried about the amount of anti-Muslim posts on the site and feared that violence may eruptWhile researchers recommended Facebook take down several Hindu nationalists groups, the company allegedly ignored the requestsThey said Facebook's inaction could be linked the 2020 religious riots in Delhi Researchers were told it was over 'political sensitivity' as the groups were linked to Indian Prime Minister Narendra ModiThey were told going after one of the groups could infuriate Modi and put Facebook's business prospects and staff in danger Read more »

Great British boltholes: The lavish hotel in Hereford that feels like it's been plucked from 1930s New York

Sarah Hartley checks into Hereford's refurbed Green Dragon Hotel   The decor is a confident mix of modern glamour and vintage It's a great hotel for 'entertaining and being entertained', she declares   Read more »

Dutch taxpayers may have missed out on €27bn in dividend taxes: FTM

Photo: DutchNews.nl Banks, investors and intermediaries cheated the Dutch treasury out of potentially €27bn in the period 2000 to 2020, according to an international investigation by research collective The CumEx ... Read more »

Elon Musk says SpaceX's 'Starship will be ready for its first orbital launch attempt next month' just hours after SN20 fired off its engines for the first time - even though the firm still needs FAA approval

SpaceX successfully fired up its SN20 Starship prototype for the first timeElon Musk tweeted an orbital launch could happen next month - just hours after the static fire testHowever, SpaceX is still needs FAA approval before launching the rocketThe FAA is only on the fourth step of its eight-part review  Starship is a reusable rocket and spacecraft combination built for a trip to Mars SN20 Starship craft is being prepped for an orbital flight in the coming months Read more »

Victim of ‘Butcher Baker' serial killer identified after nearly 40 years

“Horseshoe Harriet” was actually homeless teenager, Robin Pelkey (left), who was killed by Robert Hansen. Anchorage Daily News via AP A woman known for decades as “Horseshoe Harriet” after she ... Read more »

Unvaccinated Tennessee woman, 36, who caught COVID-19 during her pregnancy and had to give birth prematurely dies of the virus

Amanda Perry, 36, of Dickson County, Tennessee, died of COVID-19 on Monday after a month-long bout with the virusPerry was 32 weeks pregnant when she contracted the virus, and required an emergency C-sectionShe was unvaccinated because she had a history of miscarriages and feared the vaccine could hurt her pregnancy Perry was transferred from Tennessee to Richmond, Virginia, for treatment and her husband Billy temporarily lived in the city to stay near herPregnant women are among the least vaccinated demographics in America, at only 35% despite suffering an increased risk of complications from the virus  Read more »

Legal experts weigh in on Alec Baldwin's possible liability in tragic on-set shooting of Halyna Hutchins

Alec Baldwin fired the prop gun that killed a crew member on the set of “Rust.” Instagram The tragedy on the Santa Fe, New Mexico, set of Alec Baldwin’s “Rust” ... Read more »

'Trans criminals are not women': Home Secretary Priti Patel orders 'woke' police forces to stop recording offences as female crime statistics

Home Office officials are working with police to make records more accurateThe ban follows cases where violent and sexual offences by men who call themselves female were recorded as being committed by womenThe change was revealed in an official response to feminist campaigners  Read more »

Why you should ALWAYS say sorry to your kids after a quarrel: Radio 2's Dr Rangan Chatterjee reveals parenting tricks to stop tinderbox family rows - including writing a daily journal and not instantly blaming your partner

TV and radio doctor Dr Rangan Chatterjee says there are steps you can take to stop flying off the handle at your kids - and partner - after a stressful daySays it's important to recognise 'micro doses' of stress - little anxieties or stresses that build up before combining to tip you over the edge Writing a journal and saying sorry to your kids after a row can all help Learning how to speak to your partner to avoid antagonising a stressful situtation can ensure you're on the same team when it comes to parenting   Read more »

Turkey to toss out US envoy, 9 others for urging release of prisoner Osman Kavala

Turkey‘s President Recep Tayyip Erdogan announced the expulsion of ambassadors on Saturday. AP Turkey will expel 10 foreign ambassadors, including the United States envoy, for calling for the urgent release ... Read more »

A THIRD juror is dismissed from Elizabeth Holmes' trial after admitting to playing Soduku during testimony: Fellow panelist tipped off judge in Theranos fraud case

The female juror got the boot after it was discovered she kept Sudoku in a court-issued notebook and played the game for up to ten days of court testimonyU.S. District Court Judge Edward Davila questioned juror No. 5 in his chambers on Friday after being tipped off by a fellow juror via email According to court transcripts, the juror said she played the game to help her focusThis comes after a Buddhist juror was dismissed because if Holmes were found guilty and sent to prison for a 'long, long time' she would 'feel like it's my fault' Read more »
On free-english-test.com you will find lots of free English exam practice materials to help you improve your English skills: grammar, listening, reading, writing, ielts, toeic