Show…
Filter by…

Antenatal

The following pathway should not be read as stand-alone and MUST be read in conjunction with Section 3: Pathways.

During the antenatal period the Midwifery Service is the accountable professional and lead for the care of the mother and the unborn / newly born child(ren) and works as part of the Health Child Programme (HCP) team. Partner services will work collaboratively with the Midwife to provide continuity of care between the Antenatal and postnatal period. The Health Child Programme focuses greater emphasis on the antenatal period and for preparation to parenthood.

There are no rationales that match your filters.

Please amend your choices to see more rationales.

Preconception

Provision of information, advice and education

Support pregnancy planning for mothers/partners with pre-exisiting conditions.

Primary Care & GP

Management of pregnancy planning in relation to pre exisiting conditions including past history of mental health issues.

Antenatal

Any point during pregnancy

Continuity of care and wellbeing of pregnant mother.

Midwifery

  • Additional follow-ups - intermediate or intensive pathways as required.
  • These will be delivered if a need is identified such as pre-exisiting or pregnancy related medical condition e.g. diabetes, cardiac, connective tissue disorder, epilepsy etc
  • Multiple births, previous obstetric history, Complications associated with pregnancy & the baby and will include joint working with other professional groups and referral to specialist pathways as required to ensure appropriate specialist care e.g:
    • Obstetrician
    • Fetal Medicine Specialist
    • Specialist Consultant Dietician
    • Anaesthetist
    • etc

Primary Care & GP

  • Antenatal care for women/ families and management of pre-existing illnesses
  • Recognition and referral of acute/emergency conditions directly to hospital.
  • Continuity of care
  • Forward planning for: Follow-up care for medical conditions such as diabetes and hypertension

Any point in pregnancy that an issue is identified

Care of vulnerable mothers/unborn.

Health Visiting

Ongoing liaison with MW, GP and mental health services team.

Midwifery

Midwifery team to notify health visiting team of pregnancy, includes assessment of maternal mental health using three WHO questions and clinical
judgement, including needs of father and referrals to other agencies and action plan; this should be a particular consideration for women and fathers with complex social factors (NICE 110).

Previous mental health issues (see MH categories tab/sheet).

Following assessment categorised as low:

  • Refer to Gp
  • Refer to Mental Health Services if required
  • Referral to specialist pathways as required to ensure
  • appropriate specialist care

Maternal Mental Health

  • Low
  • Mothers who may have accessed services in GP surgeries or mild to moderate depression
  • Previously CLA
  • Self-help
  • CBT
  • IAPT
  • Exercise programme
  • Delivery of more intensive parenting programmes e.g. Mellow Bumps
  • Midwife
  • HV
  • FNP
  • Mental health services
  • Children’s Centre’s
  • Voluntary sector
  • To support greater bonding with the unborn baby

Primary Care & GP

GPs to be involved in all cases where there is a past history of mental health issues.

GP should be consulted to provide necessary background if the mother has an identified issue Children’s social care (CSC) should also be involved.

Any point during pregnancy

Care of vulnerable mothers/unborn baby.

Midwifery

Clinical need for diagnostic tests for abnormality and subsequent provision of appropriate care pathway with partner professionals.

Any point during pregnancy

Appropriate care of vulnerable mothers/unborn baby.

Midwifery

Referral to specialist pathways as required to ensure appropriate specialist care ensure HV are notified of referral.

Any point during pregnancy - On discharge home if hospital admission has been required

Appropriate care and support of vulnerable mothers/ unborn baby.

Midwifery

Co-ordination of service.

Support for the family to make informed decisions and aid parental mental health.

Early Support Programme (piloted in Essex - need details of the service) - for children with identified complex needs.

  • TAC or TAF
  • CIN
  • TAF

By 20 weeks

Facilitate information sharing & support joint working.

Health Visiting

Receipt of notification of pregnancy from midwife.

Midwifery

Following initial Midwifery assessment, provide notification of pregnancy to the Health Visitor detailing information relating to issues such as:

  • Actual or potential vulnerability of the family
  • Previous sudden infant deaths
  • History of physical and mental health problem
  • Safeguarding issues and any child protection concerns
  • Domestic abuse

28 weeks +

Core Purpose 1, 2, 3

Delivery of (targetted) additional support.

Childrens Centres & EYFS

Delivery of evidence based early intervention attachment programmes e.g. Mellow Bumps to Babies. To improve parenting competencies, boost self esteem and enhance children’s wellbeing.

Vulnerable families who need multi-agency support. TAF/C.

Targeted services initiated via a CAF with a lead professional/agency.

Support for vulnerable /targeted families as part of a multi-disciplinary/agency team.

Reduce risk of/actual child abuse/neglect

28 weeks +

Core Purpose 1, 2, 3

Targeted support for Hard to reach families.

Childrens Centres & EYFS

Outreach home visiting family support.

Access for hard to reach families.

28 weeks +

Core Purpose 1, 2, 3

Targeted early intervention and consultation to reduce the need for more complex service intervention and risk of/actual child abuse/neglect.

Childrens Centres & EYFS

Social Work early support for individual vulnerable/targeted families.

28 weeks + (32-36 weeks)

Facilitate Joint working and support integrated care planning.

Health Visiting

Face to face appointment with HV & MW as required.

DoH recommends the visit from HV service to deliver the promotional guide visit be undertaken from 28 weeks. In higher risk pregnancies this visit can be before this

Any point during pregnancy (32-40 weeks)

Facilitate Joint working and support integrated care planning.

Health Visiting

Joint antenatal appointments for vulnerable women this may include various combinations depending on identified needs of the individual by MW & HV.

For women with identified vulnerability e.g. maternal mental health, learning disability, fetal developmental issue, obstetric issue, domestic violence, an individualised postnatal care plan should be developed with the MW and HV.

From 28 - 40 weeks

Follow-up Antenatal Visit to provide additional support, advice and information and signpost/refer to other appropriate services as required.

Health Visiting

  • Provide further advice & support relating to parental health issues or parenting issues
  • Promote parental understanding of baby brain development and an awareness of attachment theory using Solihull approach

Partnership Collaboration

  • Work in partnership with Children’s Centre to promote attendance at Centre and groups.
  • Work with midwifery team through local networks. (Example of good practice
  • Antenatal Healthy Child Collaborative developed in Suffolk).

Referrals and Signposting

  • Make referrals with consent to appropriate services (dependent on parent’s wishes)
  • Liaison with other services as required.
  • Negotiate additional Health Visitor contacts with parents as appropriate.