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Staff Writer
Expectant mothers who face difficult social circumstances are endangering their own and their babies’ health because they are not accessing antenatal care, campaigners warn today.

NHS guidelines published today by the National Institute for Health and Clinical Excellence (NICE) and the Social Care Institute for Excellence (SCIE), are calling on antenatal services to become flexible and supportive to women’s needs.

Dr Gillian Leng, NICE deputy chief executive, said there was a need to re-organise the services to improve access to and uptake of antenatal care for women and teenagers in poverty or who are homeless, unemployed, abused, substance abusers or who have difficulty reading or speaking English.

Pregnant women in these situations are prone to miss appointments, which puts them at increased risk of dying from complications during pregnancy or after birth. Women living in areas of high deprivation in England are five times more likely to die during pregnancy or after childbirth than women in more affluent areas, while babies born into these circumstances are twice as likely to be stillborn or die shortly after birth as those who are not.

“Expectant mothers need support throughout their pregnancy yet some groups of women do not access, or continue to maintain contact with, traditional antenatal care services,” says Dr Leng.

“They might feel scared, overwhelmed, judged, unable to communicate, or may be physically stopped from attending appointments. Although these women represent a small proportion of those having babies in the UK each year, they and their unborn children deserve the same level of care as anyone else.”

The guideline is designed to help the medical profession, social care providers, as well as charities and the police where appropriate, to develop services that will improve access to care.

Amanda Edwards, SCIE deputy chief executive, said: “Social care providers can play an important part in the design of maternity services. It is important that women receive adequate, timely, flexible care that gives them the right support throughout pregnancy, so that they and their babies are kept safe and healthy.”

The guideline is the latest in a series produced by NICE that aims to reduce complications in pregnancy.

Mary Newburn, head of research and information at National Childbirth Trust, said: “If implemented, this guidance has real potential to make maternity services more effective in reducing health inequalities.”

And more backing for the new guidelines came from the Royal College of Midwives.

But deputy general secretary Louise Silverton warned the NHS might struggle to find the staff to comply with the new advice.

She added: "It is also disappointing that most of the evidence in the guideline comes from a setting outside the UK. Consequently, this calls into question the applicability of this evidence to UK-wide services. There is also very limited evidence of the acceptability of this research to women and midwives."

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