Maternity

 This section considers health and wellbeing during and immediately after pregnancy. While the core elements of antenatal care are considered in the section Antenatal pathway, specific issues of smoking during pregnancy and mental health during and after pregnancy are considered separately (see chapters smoking in pregnancy and maternity mental health).

What do we know?

A healthy lifestyle during pregnancy is key to good outcomes for both mother and baby. This includes ensuring a healthy weight and good nutrition of the mother, in addition to supporting smoking cessation and adhering to safety advice with regards food and alcohol. Screening for disease and immunisations are also vital for healthy mothers and babies.

Facts, Figures, Trends

The population of Slough is young and growing. The fertility rate in Slough (the number of live births per 1,000 women of reproductive age) is significantly higher than the England average though the general trend is downward (Figure 1).

Figure 1. Fertility rate in Slough

Figure 1

 The fertility rate in Sough can be broken down further according to ward of residence (Figure 2) showing that compared to the average rate for the borough, Central and Chalvey wards have significantly higher rates of births whereas Langley and Foxborough have significantly lower rates of births.

Figure 2. Fertility rate according to electoral ward in Slough

 
Figure 2

National & Local Strategies (current best practices)

National

 NICE Quality Standards for Antenatal Care

These outline the best practice in terms of routine antenatal care for expectant mothers. It covers a range of issues from schedule of appointments to recommended advice, screening tests and interventions.

This is just one set of standards focused on routine care among a whole suite of NICE Guidance and Quality Standards covering a range of topics during and after pregnancy covering both routine low-risk pregnancies and complex high risk cases. Specific guidelines inlcude; pregnancy and complex social factors, diabetes in pregnancy and postnatal care.

Local

National Guidelines acknowledge that women who are most vulnerable i.e new entrants to the UK, suffering from domestic abuse, misusing substances, or who have had a history of mental health problems or sexual abuse should receive specialist outreach. A specialist service is available at Wexham Park Hospital called the Crystal midwifery team for women who are identified at risk during pregnancy.

What is this telling us?

Though birth rate in Slough is slowly coming down it remains significantly higher than the national average. This means that local services have a significant workload. Making sure that babies born in Slough get the very best start in life is vital to improving the health of the population.

What are the key inequalities?

There are well established inequalities in maternal health and infant outcomes according to socioeconomic status, ethnic group and age of mother (Knight et al). This is associated with ethnic and social inequalities in women’s access to and experience of maternity services (Raleigh et al).

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