Child and Maternal Health

Using technology to support maternity care – during Covid-19 and beyond

June 18, 2020 by Ann Holmes No Comments | Category Best Start, Maternity, Midwifery, Neonatal, NHSScotland, Uncategorized

Globally, we are in uncharted territory with the emergence of COVID-19 and it’s impact on our way of life.  Scotland’s health and care services are at the forefront of our collective response to support the people of Scotland – thinking differently to redesign provision and maintain essential care.  And with that comes positive innovation and change.

Throughout the pandemic period women will continue to become pregnant and babies will continue to be born.  Maternity and neonatal services have no option to stand down – so we need to consider the potential for technology to support us maintaining the care that is critical to the outcomes for women and families.  In addition, current COVID-19 guidelines recommend that people with certain pre-existing health conditions be shielded and self-isolate wherever possible and pregnant women make up a small number of this group.  Often the nature of their pre-existing condition will mean they require more regular clinical care.

NHS Near Me

Technology can have a place in helping deliver aspects of care provision where this is appropriate – reducing the need for some women to attend clinics in person and enabling those who are shielding to stay at home as much as possible.  Technology can also have an equally important role in supporting the relationship building that is so important to women, midwives and obstetricians.

NHS Near Me has already been used successfully in some maternity settings, mostly linked to remote and rural healthcare and we must learn from that experience.  For example, while the need for face to face care for antenatal or postnatal care will continue for many women, the use of Near Me can help minimise unnecessary physical attendance, supporting pregnant women who are shielded or self-isolating to stay at home.

Through Near Me women and staff can see each other’s faces without a mask – and we have heard from women and clinicians that this makes a real difference.  Not only to the relational aspects of care, but in making care more inclusive – for example enabling bringing translation services into the consultation. So Near Me technology has been made available to all of our maternity services and we are seeing an increasing number of consultations making use of this innovation.

Remote monitoring

Similarly, a large quantity of blood pressure (BP) monitors and home urinalysis kits (approved for use in pregnancy) have been purchased and distributed to NHS Boards.  This is because we know that raised BP affects approximately 10% of pregnancies worldwide – that almost half of these women develop pre-eclampsia and that globally around 15% of maternal mortality is due to pre-eclampsia.  Prevention and early detection are paramount.  So we are recommending self-monitoring of blood pressure and urinalysis for pregnant women with hypertensive disorders, who would ordinarily require to attend hospital up to three times per week, and also for women in the shielded group.

To support maternity staff implement these innovations in practice, a package of guidance is available on the Perinatal Network’s website: https://www.perinatalnetwork.scot/maternity/maternitynearme/

Colleagues in Healthcare Improvement Scotland have also been supporting a number of Boards to implement Near Me and remote monitoring in their area.

Significant progress has been made in implementing these technologies locally already, but there is more that we can do.  Some Boards have shared early learning on enablers and barriers to change and their tips for implementation are outlined below.

A short video showing the benefits of using technology within maternity services can be viewed below. Please note that this video was filmed before the Covid-19 pandemic and shows NHS Near Me being used to support care in a remote and rural area which includes face to face care with a midwife.

https://www.youtube.com/watch?v=_knTDiyBVs0&t=122s

I ask you to use the support and resources available to help implement the use of technology, where appropriate, within maternity services in your Board area.  The benefits and learning from its use during the COVID-19 pandemic will have real potential for innovation in maternity care going forward.

Professor Ann Holmes
Chief Midwifery Officer and  & Deputy Chief Nursing Officer (Children)

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