BEYOND BARRIERS: REIMAGINING ACCESS TO POST-PREGNANCY CONTRACEPTION THE CASE FOR CHANGE
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In line with their commitment to shift to digital NHS systems and the introduction of the Single Patient Record in 10 Year Health Plan, the Government should oversee the improvement of electronic notes systems to ensure adequate, timely documentation of contraceptive discussions with women throughout the pregnancy journey. This should include digital alerts of previous PPC discussions when admitted for delivery. Maternity is rightly being prioritised in the Single Patient Record roll-out and the Government should ensure PPC is included in this . Better data is crucial to improving the quality and coverage of PPC services in England. National data sets should be amended to collect and record essential data related to PPC. For example, healthcare professionals delivering post-pregnancy care are currently asked to record previous pregnancies of the patient but not when they were. We recommend that: a. At a minimum, routine SRH and abortion data should include the date of the end of the last pregnancy. b. Additionally, routine maternity datasets should be modified to include fields on the London Measure of Unplanned Pregnancy, women’s antenatal choice of postnatal contraception and what contraception was provided post-pregnancy. c. This will allow the better monitoring of pregnancy planning and PPC at a national level to understand the choices and services available to women at this important time of their reproductive life.
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Recommendations for the NHS, ICBs and the wider health system:
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National Institute for Health and Care Excellence (NICE) guidance on Contraception after Childbirth should be renamed Contraception after Pregnancy to reflect the importance of women’s access to the full range of contraceptive methods in all pregnancy outcomes. This guidance has not been updated since 2016 and trends in contraception along with best practice of PPC provision have changed considerably since then.
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NHS England should publish its delayed guidance on women’s postnatal care, giving clear direction and recommendations for best practice including the provision of PPC.
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NHS guidance should be made clearer to support information pathways at a local level. Women in the local community should know where, when and how they can access contraceptive services, either via physical or electronic guidance. a. Information outreach to pregnant women should be improved via promotion of the NHS digital inclusion framework. 7 ICBs should meet their responsibilities to commission maternity services that enable safe, equitable, and personalised maternity care for local populations and commission care in line with NICE guidelines. a. As per the NICE guideline Contraception after childbirth , commissioners should ‘ensure that maternity services give women information about and offer them a choice of all contraceptive methods as soon as possible and within 7 days of delivery, and refer them to a contraceptive service if contraception cannot be provided immediately.’ b. Commissioners should establish integrated pathways of care to make sure women are provided with their preferred method of contraception in a place of their choosing, in line with the Hatfield Vision: Goal 3/Action 4.
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7 Inclusive digital healthcare: a framework for NHS action on digital inclusion
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