BEYOND BARRIERS: REIMAGINING ACCESS TO POST-PREGNANCY CONTRACEPTION A GUIDE FOR BEST PRACTICE
4. Fostering Collaboration Across Disciplines, and Establishing Clear Care Pathways to Support While nurses and midwives are the best suited role as conduits for PPC, they should be supported collaboratively by colleagues across maternity services, primary care, sexual health services, particularly in terms of administering contraceptives such as the coil and implant with leadership from local SRH professionals. This emerged strongly as a requisite for delivering effective PPC provision: “PPC services need to be fully multidisciplinary, not just midwifery and sexual health, they must also include medical staff – many of the women for whom pregnancy planning and spacing is the most important come under consultant led care and it is important that doctors also take an interest in contraception choices and not just leave it to someone else.” Public Health Midwife, South Tees This shared multidisciplinary approach avoids responsibility for PPC provision sitting with one individual: The roll out of the Service relied heavily on a passionate individual who had to take on and drive much of the work in isolation.” PPC provider, Hertfordshire In East Sussex the PPC service was supported by: “An enthusiastic and collaborative working group. The training reflected a joint Maternity, Public Health and Sexual Health approach to the planning and delivery of training, working across traditional boundaries.” This was also evident in Portsmouth, where setting up the PPC service involved significant collaboration across local public health, maternity services, sexual health services, and family nurse partnership health visitors. By creating strong partnerships outside of traditional boundaries, services can be established and maintained: “Some services, like the Family Nurse Partnership within the health visitor provision have also been really key to support ongoing contraception for our vulnerable parents under 25 years old.” Public Health Principal, Portsmouth Bedfordshire also utilised existing pathways to involve health visitors in the provision of PPC, and this resulted in improved uptake amongst the most vulnerable women, too: 4
The contributions to this report demonstrated that, with sufficient support, training, and resources, it is possible for midwives to be conduits for PPC. For example, results from a survey of midwifery staff delivering PPC in Gloucestershire revealed that 93% of respondents believed the model to be sustainable in the medium to long term: “With additional support from specialist midwives, it is achievable even with our current workload. The training gave me the confidence to have these conversations.” Midwife, Gloucestershire This is echoed across other services, including Northwest (NW) London: “We need to encourage and increase professional development options for midwives in areas that they want to pursue, to help avoid burnout and losing even more midwives from the profession. I see development in contraception and sexual health as a complementary specialism for midwives who want to maintain their midwifery skills and remain in the maternity workforce whilst creating more variety in their day to day working lives.” Gillian Matthews, Specialist Midwife, NW London Post-birth Contraception Service It is important to note additionally that individuals who experience outcomes such as miscarriage, abortion, or ectopic pregnancy may not encounter maternity or midwifery services. This is another reason why it is essential that PPC is delivered through a coordinated, whole-system approach that integrates services and commissioning structures to prevent gaps in care, information provision and ensure equitable access for all post- pregnancy outcomes. Recommendation 3 Establish Nurse or Midwife as a Conduit for PPC Provision A nurse or midwife should be the conduit for PPC provision. Due to their unique position, they can support women throughout their pregnancy journey, allowing opportunity to build trust, normalise discussion about contraceptive options and give pregnant people the space they need to consider what works best for them.
17
Made with FlippingBook Digital Proposal Creator