Birth - 8 weeks
At Birth or soon after
To meet statutory requirement to notify birth/ death of a baby
Midwifery
Complete notification to registrar:-
- Still Birth - register non-live birth
- Live birth - but baby dies later both birth and death registration
- Termination for abnormality
At Birth or soon after
To facilitate information sharing and co-ordination of support.
Midwifery
Notification of death to other agencies To ensure other agencies are informed.
Notification to CC to facilitate ongoing support.
At Birth or soon after
To meet legal requirement to obtain consent for post- mortem with the exception of Coroner's case
Midwifery
Consent for Post Mortem obtained by most appropriate registered professional
Ongoing
Provision of support to the family and appropriate referral to other agencies.
Health Visiting
Provision of ongoing support for existing family.
Midwifery
Appropriate management and support provision:
- Midwife
- Obstetrician
- Paediatrician
- GP
- HV
- SANDS
- Hospital Chaplin /liaison team
- Children’s Centre’s
Childrens Centres & EYFS
Provision of ongoing support for existing family.
Primary Care & GP
Provision of appropriate ongoing care and support.
Ongoing
Provision of support for future pregnancy.
Midwifery
Debrief and follow up discussion for future pregnancy planning/management delivered by:
- Midwife
- Obstetrician
- Paediatrician
- Specialist Consultant, etc.
At Birth or soon after
Care of unwell mother, provision of appropriate specialist care pathway & co-ordination of care.
Midwifery
Transfer to ward, ITU, HDU as appropriate , where possible with baby.
Mental Health Admission to Mother & Baby unit supported by community midwifery postnatal care provision.
Maternal Mental Health
Provision of appropriate care pathway Liaison with multidisciplinary team.
Primary Care & GP
Ongoing support and care provision.
At Birth or soon after
Provision of care for baby if not resident with mother and ongoing support to family.
Midwifery
If necessary undertake assessment of who will look after baby in partnership with social worker.HV etc eg:
- NICU
- Postnatal Ward
- Home with relative
- Paediatric Ward
At Birth or soon after
Co-ordination of care.
Midwifery
Discharge home notification to GP and HV and other relevant professionals.
At Birth or soon after
Co-ordination of care
Midwifery
Discharge home prior to 28 days P/N midwife to visit, post 28 days referral to relevant community professionals.
New Birth Visit (NBV)
Universal Plus all services and corresponding rationale as for Universal with additional as detailed in this section for Universal Plus.
To identify health needs and assess maternal emotional wellbeing and referral to specialist mental health services.
Health Visiting
Comprehensive assessment of the physical and emotional health of mother and baby ,to include a review of the mothers’ mental health; to include 3 WHO questions and clinical judgement to assess maternal mood.
A supplementary mental health assessment may also be used e.g. HADS, EPDS.
Prompt referral to Perinatal Psychiatry Services (puerperal psychosis).
Adult services to work with children’s services in the event of child safeguarding concerns.
Reference local referral pathway to specialist services – inform GP.
Promote support within social networks and family, promote breastfeeding.
Midwifery
Update HV on the health and emotional and social status of both mother and baby - notify GP.
Ask NICE recommended predication questions (only asked again if answers ‘no’ at midwife booking appoint).
Prompt referral to Perinatal Psychiatry Services (puerperal psychosis).
Adult services to work with children’s services in the event of child safeguarding.
Maternal Mental Health
In-depth liaison with Midwifery /HV services to determine level of parental mental health problems.
Assessment of parental isolation.
Prepare Mother for Health Visiting led Post Natal Depression support group if previous depressive history.
Refer to counselling as appropriate and liaise with GP.
A detailed discussion regarding attachment and attribution, transition to parenthood, family involvement and support required.
Observe for parents interaction with baby and signs of attachment and attribution.
Arrange follow up visits in agreement with parents.
One week – 6 - 8 weeks
Additional Assessment Visit
Needs to be carried out for each parent when the Mental Health issue is identified.
Listening Visits
Health Visiting
Maternal Mental Health
PHQ9 assessment reviewed and additional support contacts with parents identified.
Inform and refer to GP as needed. Refer to counselling with consent.
Facilitate access to Infant massage courses, postnatal education groups.
Negotiate Listening Visits.
More detailed discussion regarding attachment and attribution, transition to parenthood, family involvement and support.
Attachment Therapeutic Groups.