Community Midwifery Service Nottingham University Hospitals NHS Trust

Community Midwifery Service Nottingham University Hospitals NHS Trust

Structure of Teams Deputy Head of Midwifery Janine Kettle Matron for Antenatal and Community Midwifery Services Community Midwifery Team Managers Cathy Palmer Danielle Smith Jane Appleton Jackie Skeavington Arnold Bestwood Sherwood Carlton Mary Potter Hucknall Eastwood Strelley Bulwell Radford Wollaton Beeston Stapleford St Anns Clifton West Bridgford Rushcliffe Administration – Sandra Stanley & Debra Postle: Sherwood Rise Health Centre, 0115 8838926 Zoe Scott

Specialist Teams Deputy Head of Midwifery Janine Kettle Matron for Antenatal and Community Midwifery Services Community Midwifery Team Manager and Substance Misuse Midwife Domestic Abuse and homelessness Louise Harrison Deb Hampson Substance Misuse Midwife Mental Health Midwife Teenage team

Teenage Team The team provide care for all girls who are under 19 years of age. They see them in clinics where they live and at home and offer enhanced NICE guidelines to meet their individual needs. They also attending hospital clinics each week at both sites to provide continuity with the Consultant in teenage pregnancy. They also provide Teenage Active Birth classes at both hospitals each month. Each pregnant girl has a designated midwife who follows her throughout her pregnancy and attends all social care or CAF meetings that she may need. School girls can be seen at their school and the team also lead multi agency meetings to support them through their pregnancy.

Substance and alcohol misuse Provides out-reach maternity care to clients with a history of complex substance misuse including dependence on prescription opiates, those currently in drug treatment services, on a replacement prescription (methadone) or disclosing substance misuse at booking. Support/shared care can be provided by the team for those clients also using cannabis and / or New Psychoactive substances.

Mental health Delivers education and training to maternity colleagues. Works closely with the perinatal psychiatric service and provides antenatal and postnatal care to women and babies on the Mother and Baby Unit. Supports maternity teams to deliver personalised care to women and their families to optimise their mental health. Case holds the most vulnerable, complex pregnant women experiencing serious mental health concerns.

Domestic abuse/ homelessness/ migrant health Delivers training to maternity colleagues. Case holds women experiencing high risk domestic abuse including those living in refuges, vulnerable migrants and the most vulnerable homeless clients. Supports and advises midwifery colleagues caring for clients with complex social concerns and acts as the midwifery MARAC representative.

Guideline for Routine Midwifery Antenatal Appointment This schedule is for women with no problems or complications. Some women will require additional visits Having your First baby Up to 12 weeks Appointment Type Midwifery booking appointment. Individual health and social needs discussed and plans for care agreed. Offer screening tests, CO monitoring. Discuss healthy lifestyle, emotional wellbeing. Make appropriate referrals. Contact details explained. . Records shared with GP’s, health visitors, FNP and BF peer support teams. Second and following pregnancies Up to 12 weeks 16 weeks Antenatal assessment. Review screening test results. Discuss healthy lifestyle and emotional wellbeing Discuss prophylactic Anti D with Rh negative women. CO monitoring. Make appropriate referrals Discuss breastfeeding, skin to skin, rooming in and responsive feeding 16 weeks 25 weeks Antenatal assessment. Discuss healthy lifestyle and emotional wellbeing Discuss breastfeeding, skin to skin, rooming in and responsive feeding Offer Maternity Support Worker home visit 28 weeks Antenatal assessment. Offer. screening tests Offered Anti D to Rh Negative women. Discuss healthy Lifestyle WHO Mental Health Assessment and discussion regarding emotional wellbeing Consider continence pathway 31 weeks Antenatal assessment. Review screening test results Discuss positioning and attachment, hand expression, effects of dummies, teats and reasons to avoid formula. Discuss emotional wellbeing 34 weeks Antenatal assessment Recalculate BMI Review screening test results Discuss healthy lifestyle and emotional wellbeing Discuss positioning and attachment, hand expression, effects of dummies, teats and reasons to avoid formula. Give Mothers’ Guide to read Check home visit by maternity support worker booked Make appropriate referrals 34 weeks 36 weeks Antenatal assessment Offer screening tests CO monitoring Discuss healthy lifestyle and emotional wellbeing Discuss options around preferred place of birth / birth plan Discuss postnatal care, home / clinic, nipe / hearing tests 36 weeks 38 weeks Antenatal assessment Review screening test results Discuss healthy lifestyle and emotional wellbeing Place of birth discussed. 38 weeks 40 weeks Antenatal assessment Discuss healthy lifestyle and emotional wellbeing Offer Vaginal examination and membrane sweep Place of birth discussed. 41 weeks Antenatal assessment Discuss healthy lifestyle and emotional wellbeing Offer Vaginal examination and membrane sweep 41 weeks 28 weeks

Booking letter

Prescription Requests

Vaccinations • Flu Vaccine – any time in pregnancy during flu season • Whooping Cough Vaccine – From 16 weeks onwards Women are encouraged to contact their GP practice for vaccinations. NUH now have 2 vaccinators based in antenatal clinic across both sites, however please be aware that both are part time and cover is not provided everyday.

Smoking in pregnancy CO monitoring is completed by the midwife at booking, 16 weeks and 34 weeks. There are currently no smoking cessation services within Nottingham City Women are now directed to https: //www. nhs. uk/livewell/smoking/pages/st opsmokingnewhome. aspx

Alcohol in pregnancy Audit C performed by community midwives at booking and 28 weeks. Questions How often do you have a drink containing alcohol? How many units of alcohol do you drink on a typical day when you are drinking? How often have you had 6 or more units if female, or 8 or more if male, on a single occasion in the last year? Scoring system 0 1 2 3 4 Your score Never Monthly or less 2 – 4 times per month 2 – 3 times per week 4+ times per week 1 -2 3 – 4 5 – 6 7 – 9 10+ Never Less than monthly Weekly Daily or almost daily Monthly Any woman deemed high risk will be seen by the substance and alcohol misuse midwife.

Weight Management in pregnancy BMI 30 and above • Higher dose of folic acid • Antenatal Glucose Tolerance Test at 28 weeks • Fortnightly BP, Urine and SFH measurements from 28 weeks BMI 35 and above • Same as above • Referral to CLC BMI 40 and above • Same as above • AGTT as early as possible • Anaesthetic appointment • Referral to Healthy Lifestyle Clinic

Healthy Lifestyle clinic The healthy lifestyle clinic runs on Friday afternoons at both the QMC and City hospital. The clinic sees women with a body mass index of 40 or more. Women with a BMI of 40 -44 will usually be offered a review in the clinic during the third trimester of their pregnancy. Women with a BMI of 45 or more will be offered review in the clinic on a number of occasions during their pregnancy.

Postnatal Care Women receive a visit at home the day after discharge from hospital. They will then receive a further two (minimum) contacts either at home or in a clinic depending on their individual needs. The usual contacts are as follows: • Day 5 -8 • For postnatal discharge, arranged between days 10 and 28

Contact Numbers Nottingham Community Midwifery contact details Team NHS. net Phone Number Arnold NUHNT. Arnold 0115 8831700 Beeston NUHNT. Beeston 0115 9254281 Bestwood/Sherwood NUHNT. Bestwood 0115 8761890 Carlton NUHNT. Carlton 0115 9617616 Clifton NUHNT. Clifton 0115 8783601 Cotgrave NUHNT. Rushcliffe. North 0115 9893241 Hucknall/Eastwood NUHNT. Hucknall 0115 8832127 Keyworth NUHNT. Rushcliffe. South 0115 8837000 Mary Potter NUHNT. Mary. Potter 0115 8838411 Radford NUHNT. Radford 0115 8834027 Specialist Team NUHNT. Specialist. Midwifery 0115 8242315 St Anns NUHNT. St. Anns 0115 8838700 Stapleford NUHNT. Stapleford 0115 8754900 Strelley/Bulwell NUHNT. Strelley 0115 8833368 Teenage Team NUHNT. Teenage. Pregnancy 0115 8833215 West Bridgford NUHNT. West. Bridgford 0115 8837300 Wollaton NUHNT. Wollaton 0115 8833117 Team Mobile 07817 108213 07967 204126 07817 108207 07817 107940 07817 107904 07817 107936 07817 107970 07817 107949 07973 376626 07817 108012 07817 108009 07967 836291 07817 108063 07817 108204 07817 108175

Self referral to Community midwifery team • Contact details of all midwifery teams available on Signposting health and F 12(obstetric /maternity tab) • https: //nottingham. signpostinghealth. com/mi dwifery/ • Reception/Patient checklist on Signposting- aids decision about GP/Midwife signposting

Perinatal Mental Health Lesley Cookson & Katherine O’Connor RCGP Clinical Champions A 1 hour teaching session at your practice, timing to fit around you. We will provide education on Perinatal Mental Health and information regarding local services and resources Contact us with your availability cookson. lesley@nhs. net katherineo’connor@nhs. net