Thread by @OBsleepmerchant

@Eltonchris presents at @OAAinfo @SOAPHQ joint session on strategies to implement national & institutional change in response to CEMACH & @mbrrace findings. #OBAnes #SOAPAM2023

@mbrrace the latest in a lineage of maternal mortality reports. Access the latest from November 2022. Delivered annually with a three yearly cycle of focus - #OBAnes due this year. How it works! #SOAPAM2023

GMC requires participation in confidential enquiries. HSIB the FBI of #patientsafety - less confidential, but mandatory participation. @NHSuk resolution requires reporting. So you know the data is robust. #OBAnes #SOAPAM2023

In addition to @mbrrace, if there’s a strong signal independent reviews can be ordered (reading these should be mandatory for #OBAnes even outside UK). @OckReview has started the latest review on Nottingham University Hospitals. #SOAPAM2023

2022 @mbrrace report notes racial disparities with black women 5x higher risk of dying in pregnancy. This is not new - 2002 report showed similar findings. But no one acted on it. #SOAPAM2023

The NHS is something the UK are proud of - where health care is available for all (remember 2012 Olympics?) However, it is currently breaking… #SOAPAM2023

Looking at the last few years @mbrrace reports, mortality for black parturients is rising. But that’s not the whole story - maternal mortality has been rising in most deprived populations. #SOAPAM2023

While the maternal mortality rate is still significantly lower than USA, it has risen 24% since 2017-19 reports. More women from deprived areas are dying. Black and Asian women more likely to die. 11% of women who died had severe and multiple disadvantage. #SOAPAM2023

Work from @LateralTilt @noolslucas @SQuashie @Marianfknight, as well as @AllisonLeeNYC & @ArviPalanisamy recently published in @Anaes_Journal address ethnicity and #OBAnes care. #SOAPAM2023

The government appears to have the will to address the issue. March 2023 saw the @HouseofCommons report on Black maternal health, looking at better funding of maternity services as well as better data and targets based on the same. #SOAPAM2023

FIVExMORE training to have improve cultural sensitivity and badges to identify those who had the training to allow communities to identify “safe spaces”. @Eltonchris gives a breakdown of the population of Leicester. The JANAM app provides a culturally sensitive resource for… twitter.com/i/web/status/1…

Speaking of apps and resources to overcome communication barriers: @cardmedic, local Leicester NHS and @labourpainsOAA (@OAAinfo’s own) provide an excellent base. #SOAPAM2023

Cardiac disease remains a leading cause of maternal mortality. ESC guidelines for management of cardiovascular disease were issues in 2018. @WHO classification risk stratified maternal cardiac disease.@maloumeng’s work on #OBAnes care of pregnant patient with CVS disease for AHA… twitter.com/i/web/status/1…

Another advance in maternal care: Maternal medicine networks. Patients risk stratified and treated at appropriate centres. A sickle cell disease example. Bidirectional flow of patients and knowledge expected. #SOAPAM2023

A final summary from @Eltonchris. Accurate data NB, requires compliance & most importantly action. Need to tackle racism in all its forms to address inequity. More complex pregnancies require more complex care from appropriate institutions. #SOAPAM2023