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Better Beginnings: Improving Health for Pregnancy

NIHR review into health before, during and after pregnancy involves City research


Three City research studies feature in a new NIHR review which aims tosupport health professionals involved in maternity care to fully understand the evidence that underlies our public health messages to women who are pregnant or planning a pregnancy.

The Better Beginnings report focuses on improving health and wellbeing before, during, and after pregnancy and brings together information from recent and forthcoming studies funded by the National Institute for Health Research (NIHR). These include three from the Centre for Maternal and Child Health Research Health in the School of Health Sciences.

The first City study mentioned - led by Professor Alison Macfarlane and involving Lucia Rocca-Ihenacho and others - assessed the impact of a new birth centre on choice and outcome of maternity care in Tower Hamlets.

To do this, the researchers worked with bilingual interviewers to ask women who started their care at the birth centre with those of women who satisfied the criteria for using the birth centre but chose hospital care about their experiences of care. It found that women with low-risk pregnancies who planned to give birth in a freestanding midwifery unit rather than in the local hospital obstetric unit were more likely to report good experiences and being able to make choices about their care. They worked with health economists from the National Perinatal Epidemiology Unit who assessed the costs of care and found them lower on average for women who chose midwifery unit care.

The second study, which is led by Professor Susan Ayers, is looking to improve the psychological and physical health of new mothers using expressive writing for 15 minutes per day for three consecutive days. The researchers hope that this could be a cost-effective intervention that can be easily accessed via the internet.

The third study, which involves Professor Christine McCourt, relates to the current REACH Pregnancy Programme. The project aims to improve access, value and experience of antenatal care (ANC) for socially disadvantaged and ethnically diverse communities who experience some of the worst birth and infant outcomes in the UK.

The REACH programme is led by Professor Angela Harden at University of East London and other project partners include Queen Mary, University of London; University College London (UCL); and Barts Health NHS Trust. REACH has also recently been shortlisted for the prestigious Royal College of Midwives Innovation Award.

By drawing together a wide range of studies, the review provides research evidence for healthcare professionals working with women around the time of pregnancy, particularly midwives, general practitioners, obstetricians, and health visitors. It is also relevant to colleagues with a wider interest in women’s and children’s health including public health, children’s services and social care.

It is also hoped that the evidence can help commissioners to plan and shape future services, and that it will also be useful to women interested in research findings about health for pregnancy.

Professor Macfarlane said:

“It is good to see that NIHR has brought together the findings of the research it has funded on aspects of health before, during and after pregnancy and it is great to see City research mentioned. We hope this initiative will help health professionals and women who are pregnant or planning a pregnancy to use the latest NIHR research to improve public health.”

Professor McCourt said:

It’s really encouraging to see the increasing contribution of NIHR research in this field to understanding the social determinants of health as well as the impact that different models of care can have. Maternal health is a key public health issue, with long-term consequences that are often overlooked.

Professor Ayers said:

“This report showcases some of the excellent research being conducted in the Centre for Maternal and Child Health Research and illustrates how our research informs healthcare practice in pregnancy and after birth.”

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