Tags: pregnancy

Celebrating continued collaboration between iHV and APF

The Active Pregnancy Foundation (APF) and the Institute of Health Visiting (iHV) have been working together for more than five years to deliver the This Mum Moves (TMM) educational programme. The Institute is the APF’s official training partner, supporting the development of place-based leaders – known as This Mum Moves Ambassadors – who promote physical activity within their local communities and settings. 

On 8 October, the APF and iHV hosted the This Mum Moves Annual Networking Event, themed ‘Maternal Health Equity in Motion‘. The event brought together TMM Ambassadors from across the UK to share research, resources, and practical strategies to advance health equity in the perinatal period. 

Speakers and topics included: 

  • Professor Hora Soltani, Sheffield Hallam University – Maternal Health Equity and Movement: Priorities, Barriers and Bridges in the Perinatal Period 
  • Dr Danielle Schoenaker, University of Southampton – The Preconception Care Toolkit: Guidance to Support Pregnancy Planning and Preparation 
  • Dr Lamia Zafrani, OBGYN – Active Pregnancy: My Journey and the Call for Maternal Equity 
  • Beth Marriott, Sport in Mind – Sport in Mind’s Pregnancy and Postnatal Programme 
  • Scott Radcliffe, Sport England – We Like the Way You Move 

As part of its work to address inequalities, the APF has been awarded over £250,000 of National Lottery funding through Sport England to tackle key systemic challenges in maternal physical activity. Current guidelines tend to focus on women with uncomplicated pregnancies and good baseline health. However, a significant gap remains in meeting the needs of women with disabilities, mental health challenges, or those at risk of long-term health conditions. These challenges are often compounded by socio-economic status, ethnicity, and geography, leaving many women underserved and facing barriers to staying active during pregnancy and the postnatal period. 

This investment aligns with Sport England’s This Girl Can campaign, which recently launched “We Like the Way You Move”. The campaign takes an intersectional approach to promoting activity among diverse groups, including pregnant women, new mothers, Black communities, and South Asian Muslim women. Read more here. 

Updated Good Practice Point – Promoting physical activity during pregnancy and the period following childbirth

The APF and iHV are committed to highlighting the vital role of health visitors in supporting physical activity as part of maternal and family health. To complement this work, the Good Practice Point resource (available to iHV members and TMM Ambassadors)  – Promoting physical activity during pregnancy and the period following childbirth – has been updated to reflect the latest evidence, guidance, and examples of best practice. 

Physical activity during and after pregnancy is not only safe for most women but also offers significant benefits: improved mental wellbeing, enhanced cardiovascular fitness, and reduced risk of complications such as gestational diabetes and excessive weight gain. As trusted professionals, health visitors are uniquely placed to support and encourage women to remain active during this important stage of life. 

Go to GPP - Promoting physical activity during pregnancy and the period following childbirth

  • iHV members can access this updated GPP via the above link when logged into the iHV website.
  • TMM Ambassadors who are not iHV members will need to log in to access via the TMM training resources on iHV LEARN.

This Mum Moves Ambassadors Training

Through this collaboration, iHV delivers the This Mum Moves training in partnership with subject matter experts at the APF to health visitors, allied health professionals, fitness and other professionals. Those completing the training become This Mum Moves Ambassadors, equipped with the knowledge, confidence, and tools to: 

  1. Understand the evidence base for physical activity during and beyond pregnancy, including national guidelines; 
  2. Promote physical activity effectively using the Chief Medical Officers’ (CMO) guidance; 
  3. Offer appropriate and timely advice, guidance, and signposting to trusted resources; 
  4. Access and use tools to support conversations and engagement around physical activity; and 
  5. Act as advocates for active, healthy lifestyles within their local areas. 

For more information about This Mum Moves Ambassador training, please click here or contact [email protected] to register your interest.

Updated NICE guideline on maternal and child nutrition

On 15 January 2025, NICE published the much anticipated updated guidance “Nutrition and weight management in pregnancy, and nutrition in children up to 5 years” (NICE guidance 247).

NICE guidance 247 replaces guidance on “Maternal and child nutrition” (PH11), partially replaces “Weight management before, during and after pregnancy” (PH27), and has been developed to be read in conjunction with guidance on “Overweight and obesity management” (NG246).

Through a review of the evidence in PH11, this new guidance is intended to provide clear recommendations from pregnancy, through the postnatal period and into early childhood, using the current evidence base and recommendations from research and subject experts. The guidance covers the following key areas:

  • Vitamin supplementation, including the Healthy Start scheme and clarification on folic acid now that bread and flour are fortified.
  • Healthy eating, physical activity and weight management during pregnancy.
  • Breastfeeding and formula feeding beyond 8 weeks after birth, returning to work and the value of continuing until around 2 years or beyond.
  • Weighing babies and young children.
  • Healthy eating behaviours in babies and children from 6 months and up to 5 years.

The guidance has been written for all healthcare professionals working with those who are pregnant, babies and children under 5 years old; in particular, midwives, dietitians and health visitors. One of the overarching messages that is embedded throughout the guideline is the importance of personalised healthcare, through tailored, non-judgemental, culturally sensitive conversations, using evidence-based information to improve maternal and child nutrition.

Key points of interest for health visitors include:

  • The importance of appropriate support for breastfeeding before birth and during the first weeks after birth to enable continued breastfeeding for longer – alongside messaging on the importance of focus on face-to-face contacts, both individually and in groups, to achieve this (recommendations 1.3.1 to 1.3.10).
  • The importance of discussing vitamin supplements, including vitamin D at health visitor appointments (1.1.10).
  • Guidance on the introduction of solid foods (complementary feeding) for babies between 6 months and 1-year-old – including a comprehensive “topics to discuss” section (1.5.1- 1.5.7). The guidance makes specific reference that:
    • Commissioners and providers of services should support healthcare professionals who have knowledge and expertise in introducing solid foods to babies (for example, health visitors) to act as ‘champions’ to pass on information to other staff (1.5.2).
    • When the baby is between 4 and 5-months-old, health visiting teams or other community health services should arrange an opportunity for parents to find out more about introducing their baby to solid food from the age of 6 months. This could be a face-to-face or online appointment, phone consultation or group session (1.5.5).

To read the guidance in full, follow this link https://www.nice.org.uk/guidance/ng247

 

Pertussis (Whooping cough) case numbers in England continue to rise

Worrying new 2024 data published by the UK Health Security Agency (UKHSA) show an increase in cases of pertussis across all regions in England this year.

UKHSA are calling for frontline clinicians to promote uptake of the pertussis vaccine. Pregnant women can have a pertussis-containing vaccination between 16 and 32 weeks’ gestation – they should also be vaccinated with every pregnancy.

Pertussis is a serious disease that can lead to pneumonia and permanent brain damage. Infants who are too young to be fully protected through vaccination are at greatest risk of serious complications or, rarely, death. A large majority of infants who develop symptoms of pertussis will require hospitalisation.

The UKHSA has published an updated briefing note which summarises current epidemiology, trends in vaccine coverage and an update to national public health guidance during periods of heightened transmission.

UKHSA warn that incidence of pertussis is highest in infants under the age of 3 months, with 181 laboratory-confirmed cases identified between January and April 2024, and state that “this is of particular concern since these infants are at greatest risk of severe disease and are too young to benefit from complete vaccination”.

The most recent data show that there were 8 deaths reported in infants who developed pertussis in England between January to April 2024. Since the introduction of pertussis vaccination in pregnancy, from 2013 to the end of April 2024, there have been 29 deaths in total among infants with confirmed pertussis who were all too young to be fully protected by infant vaccination. Of the 29 infants that died, 23 had mothers who were not vaccinated at any point in pregnancy.

In the context of the current increase in pertussis case numbers, UKHSA’s briefing note contains useful updates on:

  • National guidance on the public health management of pertussis during periods of heightened transmission.
  • NICE Clinical Knowledge Summary and the NHS website which clarify approaches to, and requirements for testing for case confirmation and surveillance.
  • Guidance on the management of outbreaks in nurseries and other childcare settings for Local Authority Health Protection Teams.

General Practices remain the core providers for this vaccination programme. However, health visitors have a vital role to play in discussing vaccinations with parents and caregivers and promoting vaccine uptake. As a universal service, they visit every family, building trust through regular visits, often in the family’s home. Resources are available for health visitors and their team members to support communication around vaccines with pregnant women.

UKHSA are also calling for help to bolster uptake through the routine childhood vaccination programme. Vaccination against pertussis through the routine programme is offered at 8,12 and 16 weeks of age, with a preschool booster offered in primary care settings. This offers direct protection to infants and children against severe outcomes from pertussis.

Health visitors can promote vaccine uptake by checking vaccine status, as well as providing guidance on where and when to obtain them, and addressing any queries parents or caregivers may have. It’s important that parents and care givers are given the opportunity to ask questions about their child’s vaccinations with a trusted practitioner. This is a crucial part of the health visitor’s role. Trusted healthcare professionals provide the best support for parents and pregnant women regarding vaccinations. Health visitors, by building trusting relationships with families, are essential in boosting vaccine confidence and ensuring the success of the childhood vaccination programme.

Read the updated UKHSA briefing note here

Read our recent Voices blog from Dr Helen Campbell, Lead Scientist, Immunisation Division, UKHSA

“Active Mums Start With You”: This Girl Can launches first campaign for healthcare professionals

  • Research by Sport England has found that 64% of pregnant women and women with children under 1 have experienced nervousness or anxiety related to being physically active, either during pregnancy or in early motherhood.
  • A survey among healthcare professionals indicated that 33% rarely or never give advice on physical activity to pregnant women.
  • ‘Active Mums Start With You’ is a new campaign from This Girl Can, to support and encourage healthcare professionals such as GPs, Midwives and Health Visitors to have more conversations with pregnant women and new mothers about the benefits of being active.
  • The campaign is supported by the Royal College of GPs, the Institute of Health Visiting and The Active Pregnancy Foundation.

A new survey from Sport England has revealed that 64% of pregnant women or women with children under 1 have experienced nervousness or anxiety related to physical activity[1] . For example: worrying that they might harm the baby or themselves, worrying about which forms of activity are safe, or concerns related to their pelvic floor and leakage.

Anxiety about what is and isn’t safe to do when pregnant and after childbirth is one of many factors, alongside fatigue and childcare responsibilities, that can prevent these women from being physically active. However, being active during pregnancy and postnatally can be hugely beneficial in supporting both the physical and mental health of mothers. Regular activity improves emotional wellbeing, reduces depression and hypertensive disorders, and reduces the risk of developing gestational diabetes[1].

In response, the award-winning This Girl Can is launching a new campaign, ‘Active Mums Start With You’. The campaign is designed to support GPs, Midwives and Health Visitors to proactively talk to and advise pregnant women and new mothers about activity in order to build their confidence and provide advice if they’re unsure what is safe to do. Healthcare professionals can have a positive influence on people’s activity levels, with 74% of women surveyed saying that they felt, or would have felt, more reassured to become or stay active as a result of receiving safety advice or encouragement from a healthcare professional.

A survey conducted with 393 midwives and health visitors indicated that 33% rarely or never talked about or gave advice on getting active to pregnant women –  and 27% rarely or never gave advice to new mums[2].

Previous research with healthcare professionals, focusing on GPs, has found that omitting to discuss physical activity in appointments is often down to lack of time, knowledge & skills, confidence in raising physical activity and a lack of training[[3]][[4]] . There are also many other important topics to raise with pregnant women and new mothers, with appointment times often being brief and time pressures exacerbated by the pandemic.

The campaign features imagery showing pregnant women and new mothers getting active in a variety of dynamic but safe ways – and reminds professionals of the positive influence they can have, stating that “active mums start with you.” The campaign links to a wide range of resources and training materials which support GPs, Midwives and Health Visitors to have these conversations. These include training that has been developed as part of the This Mum Moves project[5] as well as a brand-new series of resources developed by the Active Pregnancy Foundation in collaboration with experts, which provide guidance on popular activities such as resistance training, dance and yoga for pregnant women and new mothers.

Webinar for healthcare professionals

To support the launch of the Sport England and This Girl Can healthcare professional-focused campaign, Active Mums Start With You, the Active Pregnancy Foundation and Institute of Health Visiting (iHV) are delighted to bring you a live webinar on the importance of healthcare professionals’ role in supporting and promoting active lifestyles during and beyond pregnancy.

You will be given an overview of:

  • Current guidance
  • Resources
  • Opportunities to support your practice

We will also be sharing the next steps in the This Mum Moves programme, including new training events for March 2022.

DATE: 9 December 2021

TIME: 15:00 – 16:00

LOCATION: Zoom

Book your place here

Limited places available!

 

[1] Methodology: Savanta ComRes interviewed 1,097 Women in the UK between 19th and 21st November 2021. This included: 122 Pregnant and/or new mothers with children under 1. Data was weighted to be demographically representative of the UK population by gender, age, region, and social grade. Savanta ComRes is a member of the British Polling Council and abides by its rules.

[2] spear (2018-2021), This Mum Moves Final Report, survey with 393 midwives and health visitors

[3] AuYoung M, Linke SE, Pagoto S, Buman MP, Craft LL, Richardson CR, Hutber A, Marcus BH, Estabrooks P, Sheinfeld Gorin S. Integrating physical activity in primary care practice. Am J Med. 2016;129(10):1022–9.

[4] Chatterjee R, Chapman T, Brannan MG, Varney J. GPs’ knowledge, use, and confidence in national physical activity and health guidelines and tools: a questionnaire-based survey of general practice in England. Br J Gen Pract. 2017;67(663):e668-e675. doi:10.3399/bjgp17X692513

[5] The This Mum Moves project was developed by ukactive, Canterbury Christ Church University and the Institute of Health Visiting

New resources for women with a mental health condition who are planning a pregnancy

Close to 551,000 people in the UK are managing a mental health condition.  A large proportion of these are women who may be contemplating pregnancy or are at risk of unplanned pregnancy.

A partnership, comprising Tommy’s, Public Health England, NHS England and King’s College London, has developed a set of supportive resources for women with mental health conditions who are planning a pregnancy or may wish to become pregnant in the future.

Mental health conditions can refer to a wide range of conditions. The new resources have been developed to specifically offer support to those who have been diagnosed with a mental health condition, including bipolar disorder, schizophrenia, severe depression and psychosis. They aim to help women with SMI make informed decisions around when to get pregnant, what to watch out for and how their condition could be treated before, during and after pregnancy.

The resources include new online information and support hub for anyone with severe mental illness (SMI) planning a pregnancy, as well as practical guidance for the frontline healthcare professionals who support them. Tommy’s has also updated their Planning for Pregnancy tool so that users with severe mental illness get specific tailored advice.

Go to Tommy's Pregnancy Hub: Planning a pregnancy when you have a severe mental health illness online information and support hub

Guide for healthcare professionals delivering preconception care to women with a serious mental illness

Tommy's updated Planning for Pregnancy tool

#PregnancyInformation #SupportWithMentalHealth #TryingToConceive #ttc #Preconception #TryingForABaby #FreeResources #MentalHealthMatters

 

Here are Top 5 tips for anyone planning a pregnancy with a diagnosed mental health condition, click on the video below:

PHE Guidance – Health matters: reproductive health and pregnancy planning

A resource focusing on reproductive choice and ensuring that pregnancy, if desired, occurs at the right time and when health is optimised.

This resource for professionals working with women and men that may have children in the future focuses on reproductive choice and ensuring that pregnancy, if desired, occurs at the right time and when health is optimised. Effective contraception and planning for pregnancy mean that women and men stay healthy throughout life and take steps to improve the health of the baby.

Go to PHE Guidance

PHE Guidance – Vaccine in pregnancy: advice for pregnant women

Guidance for health professionals to share with pregnant women immunised with MMR (measles, mumps, rubella), chickenpox or shingles vaccines.

This advice provides information on the safety of each vaccine when given in pregnancy for health professionals to share with pregnant women who have been inadvertently vaccinated.

Go to PHE Guidance - Vaccine in pregnancy

New Planning for Pregnancy tool launched

Tommy’s, in partnership with the Royal College of Obstetricians and Gynaecologists (RCOG), Public Health England (PHE) and the UCL Institute for Women’s Health, has launched a digital tool today to give women all the information they need to know before pregnancy.

There are several key steps that can be taken before conception to improve fertility, pregnancy health and the baby’s future health. However, before women become pregnant, they are often not talking to health professionals and many are not aware of about how they can reduce their risks.

The tool is being launched this week with a national #AreYouReady campaign to raise awareness of the importance of planning for pregnancy as a factor in having a safe and healthy pregnancy.

In a survey of more than 750 women, pregnancy health charity Tommy’s found that the majority of women put a lot of thought and planning into an annual holiday. When it comes to trying for a baby, however, most of us aren’t aware there is anything to do other than stopping contraception.

The survey found that 67% of women plan for three or more months for a holiday, compared to 20% planning for three or more months for a pregnancy. Just under 40% of respondents said they stopped using contraception the same week they made the decision to have a baby, leaving little time to make any change that might affect the health of pregnancy and baby, such as taking folic acid, improving diet and achieving a healthy weight.

The survey also found a big difference between the perception of how long it takes to get pregnant compared to the reality. More than a quarter of women surveyed (25.3%) became pregnant within one month compared to fewer than 5% expecting this to happen.

Go to Planning for Pregnancy Tool

Go to Planning for Pregnancy Hub

The hub includes comprehensive information about all the topics women planning a pregnancy need to know about, from healthy diet and exercise, to taking folic acid.

The #AreYouReady campaign

The campaign to launch Tommy’s new Planning for Pregnancy digital tool (#AreYouReady) plays on the idea that women are currently not aware that there is anything to be done before getting pregnant, and thus they do not plan for it as they do for other events in their lives, such as holidays or moving home.

The campaign aims to educate and inform women aged 18-40 of the importance of looking after yourself and making behaviour changes before pregnancy.

This includes

  • taking folic acid at least two months before pregnancy
  • quitting smoking
  • maintaining or coming closer to a healthy weight (BMI)
  • adopting healthy eating behaviours
  • staying active or becoming more physically active before pregnancy
  • speaking to a GP if taking medication for a mental or physical condition.

#AreYouReady campaign film

Do you have a case study on smokefree pregnancy to share?

Teenage pregnancy and young parents publication

Published by Public Health England (PHE) and the Local Government Association, Good progress but more to do: teenage pregnancy and young parents provides case studies and practical information.

It is over 15 years since the then government launched its Teenage Pregnancy Strategy in response to England having one of the highest teenage pregnancy rates in Western Europe. Since then, thanks to the hard work of councils and their partners, the under-18 conception rate has dropped by 60 per cent and the proportion of teenage mothers in education and training has doubled.

As time has gone by it has become clear what works. Evidence shows that high quality relationships and sex education (RSE), welcoming health services (in the right place, open at the right time) and friendly non-judgmental staff, help young people to delay sex until they are ready and to use contraception effectively.

Go to LGA Good progress but more to do: teenage pregnancy and young parents