Identify mothers who may need further support or specialist referral regarding their oral health and refer them to oral health specialists. Hormonal changes in pregnant women link to periodontal problems, smoking is also risk factor for periodontal disease.
Provide general advice: Brush teeth at least twice daily with fluoride toothpaste (1350 -1500ppm fluoride). After brushing spit out paste but do not rinse out. Healthier eating advice should be routinely given to reduce both the amount and frequency of consuming foods and drinks that contain free sugars.
Support referrals into and engagement with specialist alcohol and drug treatment services. You can find details of your patient’s nearest specialist alcohol or drug treatment service by going to the FRANK website and searching using their postcode.
Provide women with problems with alcohol or drugs with name and phone number of a midwife or doctor who has special experience in the care of pregnant women with alcohol or drug problems. They should also be put in touch with an alcohol or drug treatment programme.
Make yourself aware of local specialist alcohol and drug services via your local authority public health team, or use this alcohol and drug services search facility.
Complete the misuse of illicit drugs and medicines e-learning session. This brief interactive e-learning has been developed to increase the confidence and skills of health and care professionals, to embed drug misuse prevention in their day-to-day practice.
Refer individuals with suspected or known severe mental illness to a secondary mental health service, preferably a specialist perinatal mental health service, for assessment and treatment.
Ensure a collaborative care planning approach is embedded in your workforce to safeguard equitable access across operational mental health pathways that improves the wellbeing of people with a mental illness and reduces mental health inequalities.
Frontline staff have the skills and ability to be confident and competent in recognising signs of signs of mental distress and ability to appropriately support people to improve their mental health, including referral to mental health services.
Invest in perinatal mental health services, including preconception care, community outreach clinics and specialist services to achieve a green map of services available across all areas in England.
Provide pregnant women who are in situations of parental conflict are provided with information on the support and services available and safeguarding process followed. Language and literacy needs are supported.
Ensure protocols are in place to deal with situations on health service premises or home visits which arise out of parental conflict. Key staff are regularly trained in these protocols.
Pregnant women who are victims or at risk of domestic violence are provided with information on the support and services available and local safeguarding pathways are followed.
Protocols are in place to deal with high risk situations related to perpetrators of domestic violence which occur on health premises. Key staff are regularly trained in these protocols.
Pregnant women subject to FGM receive specialist clinical midwifery assessment which includes physical health assessment; mental health assessment; safeguarding assessment.
Ensure pregnant women who may be sentenced (to custody) are provided with information on the support and services available for women in prisons, including information about MBUs, and answers to frequently asked questions. Language and literacy needs are supported.
Ensure protocols are in place to deal with high risk and emergency births, miscarriages and serious incidents. Key staff are regularly trained in these protocols.
Offer Bacillus Calmette-Guérin (BCG) vaccination to all babies up to 1 year old who have a parent or grandparent who was born in a country where there is a high rate of TB.
Collaborate and work across boundaries to address complex needs, including flexible commissioning and supporting the third sector. Ensure to include agencies that provide housing and other community services to enhance care for women living in complex circumstances. Involve local community leaders, third sector organisations and lay groups, including the Maternity Voices Partnership, to actively co-produce the design of universal and speciality services will ensure they are accessible, acceptable, appropriate and not stigmatising.
Audit local outcomes using national indicators such as ethnicity, language status, country of birth and migrant status to drive changes to services in order address areas of greatest local need.