Perinatal mental health services: Recommendations for the provision of services for childbearing women

Royal College of Psychiatrists, July 2015

This report describes the provision of good-quality mental health services to childbearing women. It makes various recommendations and will assist those providing and planning services for pregnant and postpartum women across a range of disorders and severities at all levels of service provision. It outlines the particular importance of perinatal mental health problems and the need for specialised services.

Click here for further information and to download the report.

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Financial incentives for smoking cessation in pregnancy: randomised controlled trial

BMJ, 27 January 2015

The objective of the research was to assess the efficacy of a financial incentive added to routine specialist pregnancy stop smoking services versus routine care to help pregnant smokers quit.

612 self reported pregnant smokers in NHS Greater Glasgow and Clyde who were English speaking participated in the study.  The control group received routine care, which was the offer of a face to face appointment to discuss smoking and cessation and, for those who attended and set a quit date, the offer of free nicotine replacement therapy for 10 weeks provided by pharmacy services, and four, weekly support phone calls. The intervention group received routine care plus the offer of up to £400 of shopping vouchers: £50 for attending a face to face appointment and setting a quit date; then another £50 if at four weeks’ post-quit date exhaled carbon monoxide confirmed quitting; a further £100 was provided for continued validated abstinence of exhaled carbon monoxide after 12 weeks; a final £200 voucher was provided for validated abstinence of exhaled carbon monoxide at 34-38 weeks’ gestation.

Recruitment was extended from 12 to 15 months to achieve the target sample size. Follow-up continued until September 2013. Of the 306 women randomised, three controls opted out soon after enrolment; these women did not want their data to be used, leaving 306 intervention and 303 control group participants in the intention to treat analysis. No harms of financial incentives were documented. Significantly more smokers in the incentives group than control group stopped smoking: 69 (22.5%) versus 26 (8.6%). The relative risk of not smoking at the end of pregnancy was 2.63 (95% confidence interval 1.73 to 4.01) P<0.001. The absolute risk difference was 14.0% (95% confidence interval 8.2% to 19.7%). The number needed to treat (where financial incentives need to be offered to achieve one extra quitter in late pregnancy) was 7.2 (95% confidence interval 5.1 to 12.2). The mean birth weight was 3140 g (SD 600 g) in the incentives group and 3120 (SD 590) g in the control group (P=0.67).

This phase II randomised controlled trial provides substantial evidence for the efficacy of incentives for smoking cessation in pregnancy; as this was only a single centre trial, incentives should now be tested in different types of pregnancy cessation services and in different parts of the United Kingdom.

Click here to read the full text paper.

Children, Families and Maternity e-bulletin

Department of Health, August 2014

The August edition of the Children, Families and Maternity e-bulletin includes items on Flu leaflets, the Refreshing the NHS Outcomes Framework consultation, the UK Girl Summit, Support for Children and Young People with SEND and the Children and Young People’s Mental Health Taskforce.

Click here to view the bulletin.

Doctors told to seek court orders in good time for expectant mothers who lack capacity

British Medical Journal, 3 September 2014

UK doctors caring for expectant mothers who are thought to lack the capacity to make their own decisions on childbirth have been told that they must seek court authorisation in good time if there is…

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