iHV welcomes the call from the One Voice Partnership to a county council to rethink its plan to cut £2.09 million per year from its public health budget.

In a letter to Hampshire County Council (HCC), the One Voice Partnership (which includes the Royal College of Midwives (RCM), the Royal College of Obstetricians and Gynaecologists (RCOG), Sands, and the National Childbirth Trust (NCT)) has called on HCC to re-examine as a matter of urgency the impact that the proposed budget cuts will have on women before, during and after pregnancy, and on their babies. Not only would the proposal widen inequalities yet further, but it could open the door to preventable harm to women and their babies.

The One Voice Partnership has called the HCC proposal a canary in the mine, with local government budgets across the country under significant pressure.

One Voice is also reminding all local councils of their statutory safeguarding responsibilities and the impact of any budget cuts on the wider health and social care system, including maternity services.

Furthermore, One Voice say that the introduction of non-face-to-face methods for delivering the Healthy Child Programme are currently untested and there is not enough evidence on their effectiveness as an alternative method of providing support and identifying risk and vulnerability.

The Royal College of Obstetricians and Gynaecologists (RCOG) and The Royal College of Midwives (RCM) are hosting a webinar tomorrow (Wednesday 14 April)  for maternity staff on COVID vaccines – however, all are welcome to attend by registering via the link below.

This RCOG and RCM event is a fantastic opportunity to hear and ask questions about the latest advice, research and guidance on how to counsel pregnant women offered a COVID-19 vaccine. Vaccine hesitancy among healthcare professionals and in those with concerns about fertility or breastfeeding will also be covered.

This webinar is essential viewing anyone working in primary care and maternity services, as COVID-19 vaccines are offered to more pregnant women at higher risk of serious illness, including those with gestational diabetes.  

Wednesday 14 April 2021 19:30  21:00

Register here for – COVID vaccines, pregnancy, fertility and breastfeeding webinar

The Maternal Mental Health Alliance (MMHA), the Institute of Health Visiting (iHV),  the Royal College of Obstetricians and Gynaecologists (RCOG), and the Royal College of Midwives (RCM) are delighted the NHS Benchmarking report on Universal Perinatal Mental Health Findings was published on Friday 14 September.

Prior to this study, information on service provision and staffing of universal perinatal mental health (PMH) services was not available at a national level. The study sought to gain an understanding of the extent of PMH provision in universal services across England, supplementing an annual audit of Specialist PMH services undertaken by the NHS Benchmarking Network for NHS England.

The data collected from providers suggested that:

  • Capacity in universal services is very limited and does not provide the necessary broad base from which the Specialist PMH services can operate effectively and efficiently as a secondary care tier.
  • The provision of specialist perinatal mental health care within universal services is highly variable across England, with some areas having no, or limited, provision (obstetric & midwifery providers 61%; health visiting providers 30%).

Specialist provision within universal services is necessary to coordinate, inform and support evidence based PMH care across the whole service, and therefore offers a clear reflection of the care women are able to access. The large gap in health visiting PMH capacity was particularly evident, with 70% of providers having no specialist provision within the service.

If we are to deliver on the ambition of the Five Year Forward View for Mental Health, attention must be paid to the full spectrum of need. This report is critical because it focuses on the universal element, where the vast majority of women need to receive their care. Most recognition of mental health problems and risks, most prevention and early intervention, can only be coordinated and provided within universal services. Universal services are therefore a crucial element of the PMH care pathway at every local level and have the potential to create great savings in relation to both human and economic costs in the short and long term.

Dr Cheryll Adams, Executive Director at the iHV, said:

 “The Institute of Health Visiting warns that the real state of today’s health visiting support for mothers suffering with perinatal mental illness (PMI) may be significantly worse than that found by the NHS Benchmarking report based on data from 2016, as there have been further cuts to the workforce and the development of a significant postcode lottery of services up and down the country. Health visitors across the country nevertheless continue to strive to deliver an excellent service to children and families, and will do everything in their power to promote good family mental health.”

 Alain Gregoire, Chair of the MMHA, said:

“There has been excellent progress in funding specialist perinatal service provision across England, but we know that specialist services alone are not enough. All women in pregnancy and postnatally should have equitable access to the support, prevention and treatment they need for their mental health as much as for their physical health. This report shows that investment is essential to ensure that there are sufficient, well-trained staff across universal services so that women get the care they should expect from the NHS, and our children can get the best start in life.”

Janet Fyle, Professional Policy Advisor at the Royal College of Midwives, said:

“Whilst there is progress in some areas, there is still a lot more to do.  Our survey showed that we remain seriously short of specialist maternal mental health midwives and services to support women with mental health problems and needs in the community and in their homes. There is also a need to ensure that all midwives involved in the care of pregnant women receive adequate training, so that they can identify women with mental health problems and refer them appropriately for care and support as required.”

Dr Alison Wright, Consultant Obstetrician and Vice President of the Royal College of Obstetricians and Gynaecologists said:

“Despite maternal mental health being a key priority of the Government, this report shows the extreme pressure faced by obstetricians and psychiatrists, midwives and health visitors who provide perinatal mental healthcare. Healthcare professionals are usually the first point of contact that a woman reaches out to and we must ensure that all staff involved in the care of women during pregnancy and beyond, have the relevant education and training in perinatal mental health. Every maternity unit across the country should have in place a clearly defined care pathway for referring women to local specialised perinatal mental health services which all women can access when needed.”

Collectively, we will continue to push for equitable access to evidence based PMH care for women with mental health problems and their families through robust universal services alongside the development of specialist PMH services – women and their families need both. We support the call for all maternity and health visiting services (and GP services) to be sufficiently resourced, so that all professionals across universal services have sufficient capacity, competence and confidence to deliver top quality proactive mental health care to all families. Furthermore, we advocate that these healthcare professionals should be supported by having lead specialist professionals/Champions from within their respective professions in every organisation.

Background Information to the report

In January 2017, the NHS Benchmarking Network was commissioned by Health Education England, funded by NHS England, and partnered with the iHV, RCOG and RCM to complete a stocktake of perinatal mental health (PMH) care within maternity and health visiting services. Data collection took place from February to May 2017 and referenced the year January to December 2016. Universal PMH services in this report included obstetrics, midwifery and health visiting.

There was a high response rate from organisations across England, with numbers of responses by service type as follows:

  • Obstetric services 141
  • Midwifery services 123
  • Health visiting services 88

 In total, the following specialist practitioners were identified in the study:

  • Obstetric services = 40.8 WTE (1.3% of total obstetric capacity)
  • Midwifery services = 228 WTE (1.4% of total midwifery capacity)
  • Health Visiting services = 60.6 WTE (0.78% of total health visiting capacity)

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.

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

A new patient leaflet to help in the battle against group B Strep (GBS) has been launched and which is recommended to be provided to all pregnant women for the first time.

GBS is the UK’s most common cause of life threatening infection in newborn babies but recent surveys have shown that many pregnant women feel inadequately informed about the illness. On average:

  • two babies a day develop the infection
  • one baby a week dies from GBS infection, and
  • one baby a week survives with life-changing disability.

This clear and concise patient information leaflet is to be provided to all pregnant women as part of their routine antenatal care.

The leaflet was jointly written by experts at the Royal College of Obstetricians and Gynaecologists (RCOG) and the campaigning charity Group B Strep Support, and is based on the RCOG’s recently updated Green-top Guideline, Group B Streptococcal Disease, Early-onset.

The joint leaflet is now available online from the RCOG and from GBSS, and will be available as a hard copy in 2018 from Group B Strep Support.

The iHV along with the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) have been involved in shaping a project, funded by Health Education England and led by NHS England Benchmarking, to collect data from maternity and health visiting services, focused on perinatal mental health provision in universal health services. This very important data will complement previous data collections within specialist mental health services, thus contributing to an overall picture of perinatal mental health provision in England.

A short data specification has been prepared and sent to all CEOs and Heads of Children and Maternity Services. This work has great potential to act as a lever for really enabling women and their families to receive the right care, at the right time, in the right place. There are organisational benefits to participating as all participants will receive a toolkit to enable local analysis and all organisation will have access to their own bespoke report detailing local positions against the national range. Data collection runs until the 24th March and reporting of the findings is due in late May.

If you require further details, please contact Jessica Walsh at [email protected].


Women with mental health problems during and after pregnancy reveal the impact of low rates of specialist referral, long waits, as well as lack of consensus over medication and little support for their partners, in a survey published today (22 February) by the Royal College of Obstetricians and Gynaecologists (RCOG) and supported by the Maternal Mental Health Alliance (MMHA).

The survey of over 2,300 women who had given birth in the last five years in the UK, explores their experiences of perinatal mental health problems, engagement with healthcare professionals and the quality of care they received.

Dr Cheryll Adams CBE, executive director, iHV, said:

“The Institute of Health Visiting, a member of the Maternal Mental Health Alliance, welcomes the results of the ‘Women’s Voices’ survey run by the Royal College of Obstetricians and Gynaecologists and launched today.

“This survey gives real life evidence on the level of support that women receive when suffering from perinatal mental illness (PMI) – and the variation there is in the level of services across the country.  Health visitors are key healthcare professionals who are well-placed to identify and offer support to women suffering with PMI.  However, our own surveys have shown that, although parents will turn to their health visitor for support,  there is often insufficient time for the health visitor to offer the level of support required.

“We, at the iHV, deliver perinatal mental health (PMH) and infant mental health training to ensure standardised practice for health visitor professionals and the families they work with.  Our PMH training has now been delivered to well over 10,000 health visitors and others across England. However, for this training to have the impact it should, more health visitors need the time to use what they have learnt to improve services, especially at the recommended contacts.

“Perinatal mental health is an incredibly important area of healthcare which can have a negative effect on the health and wellbeing of babies and families and ultimately on our society when we don’t recognise it early. Health visitors have always made a huge contribution to supporting pre-school children and their families and are the best-placed professional to help give all children the best start in life during the early years of life.”