Cambridge Maternity Services Liaison Committee
We care about your care!
Cambridge Maternity Services Liaison Committee
We care about your care!
In Attendance:
Sue Allen-Mills (Chair); Rachel Avevo (for Celia Nicol); Nicola Clapperton; Callie Copeman-Bryant; Angela D’Amore; Julie Gardiner; Maddie McMahon; Karen Miles (research nurse); Boo Newns; Sue Prytherch; Sharon Shipp; Heather Sturman; Jo Watt
Apologies were received from: Joanne Brown; Kim Clark; Cheryl France; Nisrin Marcus; Celia Nicol; Charlotte Patient; Jo Sharman; Anna Shasha; Kate Wilson
Agreed as a true record.
Shahida Trayling has now left the Trust and would like to say goodbye and good luck to the committee. User rep, Helen Fairchild, has also left the committee, as she has moved away from Cambridge.
3.5 - The publicity leaflets and posters have now been reprinted. Copies of the leaflet will be going into the postnatal discharge packs. SA-M asked the committee to take any posters and leaflets that they could distribute within the community.
3.6 - With reference to action points from the January 19 meeting, CP has spoken to JG about the need for community midwives to be given consistent advice to women about ECV and about birth options for babies who remain breech. She has not had a formal meeting with junior doctors about ensuring that vaginal birth is presented as a real option for women with breech babies, but she has spoken to individuals about this.
SA-M has had an e-mail from Amy Mokady of the Breech Babies Support Group who had received feedback about women being supported in their choice to birth their breech babies vaginally.
4(i) - SA-M has been in touch with JG concerning what guidance community midwives should give to parents about providing information to the ambulance service if they need to call an ambulance when there is no emergency, but a midwife is not expected to arrive in time for the birth. JG and SA-M are meeting Ben Myer from the Ambulance Service next month to discuss this.
5 - SA-M has contacted Sheila Reed in the antenatal screening clinic about the possibility of using Paling Palettes as a tool for discussing risk with parents. She is meeting Sheila later in the month to pursue this.
Next meeting Anna Shasha was unable to attend this meeting to talk about her plans, but will do so at the meeting on May 25.
The meeting was attended by Karen Miles, a research nurse in vascular research at Addenbrooke's, who is applying for a grant to do research on the cardiovascular risk for children of normotensive, hypertensive and pre-eclamptic mothers, and was seeking the committee’s opinion of the proposed research.
Karen presented an outline of the research proposal. The intention is to investigate whether the children of women who develop hypertension in pregnancy have higher blood pressure, a worse cardiovascular risk profile and stiffer arteries than the children of women whose blood pressure was normal. The intention is to recruit 600 women (50 in each of 12 sub-groups) who gave birth at the Rosie and their children between the ages of 7 and 15. The study will involve a 90-120 minute appointment at Addenbrooke’s, during which various non-invasive tests (e.g. blood pressure, heart rate, cardiac output, aortic stiffness) will be carried out, alongside optional blood and urine tests.
The committee expressed an interest in the research. Concerns were raised about children being worried about the results of the tests, or mothers being anxious because they had been unaware of the possible effects of their pregnancy experience on their child’s health. Karen said that these issues would be addressed by appropriate referrals (e.g. cardiological or psychological) being made. She pointed out the value of the research in uncovering problems that might otherwise have gone unrecognised till much later.
Karen left questionnaires enlisting opinions about the research for committee members to complete and return to her. (If any members who were unable to attend the meeting would like to complete a questionnaire, or find out more about the research, please contact Karen at
(i) AGM – it was agreed to hold this on October 6, and to ask if we can use the Fields Children’s Centre as a venue. SA-M to contact Gill October
ACTION: SA-M
There was some discussion about whom to invite as speaker(s). Suggestions included Anna Shasha and the new consultant midwife; Françoise Freedman and/or Sally Lomas from Birthlight; Birte Harlev-Lam to speak about the work of the SHA; local MP(s) to talk about the future of maternity services. There was general support for the MP idea, although it won’t be possible for this to be pursued until after the election. Issue to be discussed further at the next meeting.
(ii) Addenbrooke’s Open Day, Sept 25. The MSLC will have a stand at this. There is material available which was prepared for displays last year, so little should need to be put together for the Open Day, but SA-M asked members to note the date and if they would be willing to spend an hour or two on the stand, so that staffing it can be shared.
Induction is the topic for the meeting on May 25, which CP will be attending. SA-M felt that it would be useful to draw up a list of issues that the committee would like to address, which can be given to CP in advance, so that she can bring the necessary information/figures to the meeting. The following were suggested (in relation to induction for post-dates):
• the timing of post-dates induction – is there a consistent policy/practice on this
• women being left with the impression that they ‘have’ to be induced at a particular time post-dates – i.e. how are choices presented to women
• women seeming to be unaware of the expectant management option
• what about offering expectant management with induction as an alternative option (rather than the other way round)
• what options are offered to women if there are signs of placental failure post-dates
• GPs lacking the necessary knowledge to counsel women who go past their dates
• should the whole issue of giving women an EDD be reconsidered
• educating women antenatally about going past their EDD, and informing them about their choices (particularly primips, who are likely to go past their EDD)
• has there been any audit of outcomes among women who are induced
• the current patient leaflet on induction could be more user-friendly
SP has been looking into this. She is currently seeking funding from the Friends of the Rosie to train 20 health professionals to use aromatherapy. The training package she is interested in purchasing is provided by Denise Tiran.
Community midwives are to be involved in developing a form asking women if they would be interested in using aromatherapy.
CC-B asked if there were any plans to offer hypnotherapy. At present there are not.
As an additional item, SA-M asked SP if there had been any progress on the collection of data on the rate of normal birth, as defined by the Maternity Care Working Party, but so far there has not. SA-M raised the question whether the information could be extracted by tweaking available data. It was suggested that Emma Te Braake be asked about this, which SA-M agreed to do.
ACTION: SA-M
Romsey Mill: SA-M had been asked by Rachel Bennett at Romsey Mill to go and talk to the young mums there, as she (RB) had become aware of some concerns about the girls’ experiences of their care at the Rosie. SA-M was only able to speak (one-to-one) to half a dozen girls, but almost all of them felt that they had not been listened to, and that their wishes weren’t followed. It was unclear what the reasons for their wishes not being adhered to were (e.g. clinical necessity), but nonetheless they were left feeling that they had not been listened to, and a couple of them were clearly distressed about their experience (SA-M referred them to Birth Afterthoughts). SA-M contacted Trisha Nolan, who was not aware of the issues. It was suggested that Jo Goddard was also informed.
ACTION: SA-M to contact JoG.
SA-M asked whether the Every Child Matters guidelines on providing a young person-friendly service were followed by midwives, and it was said that they were.
SA-M is going back to Romsey Mill in June to talk to other young mums.
SA-M also reported that at a meeting of the Better Support for Young Parents Group (City & S Cambs) that she had attended, a Family Nurse who was present reported young mums having told her that they had felt disapproved of when they went for scans. This should be reported to Trish Chudleigh.
ACTION: SA-M to contact TC.
W. Essex: SA-M had attended the W.Essex MSLC AGM, at which a summary of outreach work co-ordinated by the W.Essex PCT had been presented. MSLC reps had spoken to parents attending baby clinics about their maternity care experiences. As 23% of the respondents had birthed at the Rosie, SA-M asked W Essex PCT to extract the feedback that related to the Rosie. Two main concerns emerged. The one most frequently mentioned was cross-border communication. This is being addressed by Cambs PCT via the Healthy Child Programme group. The second concern was poor aftercare on Lady Mary.
MSLC website: Two users had raised issues via the MSLC website. One was concern about inconsistent breastfeeding advice on Lady Mary. Attempts are being made to address this. The other issue concerned a baby who had jaundice in the first 24 hours being discharged from hospital, inappropriate feeding advice being given, and the baby being admitted to hospital with severe jaundice at three days. The case occurred 21 months ago. This having happened was contrary to procedure, then and now, and it was hard to say why it happened. It was suggested that the mother be referred to Birth Afterthoughts.
There was some discussion about educating parents about jaundice antenatally, though it was acknowledged that often parents don’t take information about breastfeeding in before the baby is born.
SA-M presented an overview from the last update she had received.
No meeting had taken place, so there was nothing to report.
Jo Watt provided an update on progress towards Baby Friendly accreditation. The process is being overseen by Julie Smee, Senior Professional Officer UNICEF UK Baby Friendly Initiative (BFI). Training sessions are being held for midwives, and an action plan has been formulated and submitted. Feedback on this from BFI has been positive. JW is planning to have a meeting with AS to discuss plans. The unit AS has come from was also working towards accreditation and was further through the process, so her experience and knowledge will be valuable. JW is also working with Bridget Halnan and Alison Ryder in their CCS/BFI coordinating roles
Breastfeeding drop-in sessions have just started on Lady Mary Ward, on weekday mornings. These are open sessions that women on the ward can go along to to get help and support with breastfeeding. MMcM offered to try and get volunteers to help with this if needed.
SA-M asked if there was any link-up with the NCT on training breastfeeding peer supporters. JW was not aware of one. SA-M will investigate.
ACTION: SA-M
SS reported that a dual headset has been ordered for the DU to provide Language Line translation services for non-English speaking women.
Although no HoM report was presented at this meeting, because AS was unable attend, SA-M read an e-mail from Emma Te Braake, which had accompanied the circulation of the end of year statistics. There were 5610 deliveries, 390 fewer than predicted and three fewer than 2008/9. March saw the highest number of homebirths (23) and 71 Birth Centre births. SP said that she would like to see this number a lot higher, and that all low-risk women coming into hospital should be birthing on the Birth Centre. There was some discussion of the routing of calls from women in labour, with SP suggesting that it would be advantageous to have a triage system. Postnatal discharges directly from the DU in March were 39, the highest number this year. The caesarean rate for March was 23.7%, the lowest this financial year. VBAC rates were 81.8%, with 37.5% birthing vaginally.
SA-M asked that whether there was anything in particular that could be identified as contributing to the lower caesarean rate. It was suggested that as individual consultants take different approaches, this could have been a factor. It was agreed that it would be interesting to find out what the caesarean rate is for each consultant. SA-M to ask Emma Te Braake if this information can be provided.
ACTION: SA-M
25 May, 12.00 pm – 2.00 pm
Seminar Room 4, Rosie Maternity Hospital
