Maternity guidance for doctors in training

This factsheet from NHS Employers, provides guidance for doctors in training who need to plan maternity leave. The factsheet includes information on timelines for telling your employer you are pregnant, when to take maternity leave, maternity pay and advice for doctors in training who may be moving between employers. It also includes a helpful flowchart, which gives an indication of actions to take and what to expect when planning maternity leave.

NB: Employers need to be aware of the potential for overpayment in circumstances where a doctor moves on rotation at a late stage of the pregnancy when SMP and NHS maternity pay may be paid by different employers. The two employers involved will need to liaise closely to ensure that total pay is at the correct level.

Maternity issues for doctors in training

Eyes on Evidence: Weight management during pregnancy

Feet on ScalePregnancy is thought to be an ideal time for health professionals to discuss weight management because women are motivated to make changes that will benefit themselves and their baby.   Across Europe and the USA, up to 40% of women gain more than the recommended weight in pregnancy (Thangaratinam and Jolly 2010). Excessive weight gain during pregnancy is associated with a number of serious health problems, including hypertension, gestational diabetes, and pre-eclampsia.
 
Current advice: There are no evidence-based UK guidelines on recommended weight-gain ranges during pregnancy. NICE recommends that weight loss programmes should not be used during pregnancy as they may harm the health of the unborn child. However, health professionals are advised to dispel any myths about what and how much to eat during pregnancy. For example, there is no need to ‘eat for 2’ or to drink full-fat milk. Energy needs do not change in the first 6 months of pregnancy and increase only slightly in the last 3 months (and then only by around 200 calories per day).
 
NICE advises that women stay active during pregnancy. Moderate-intensity physical activity will not harm a pregnant woman or her unborn child. At least 30 minutes of moderate intensity activity is recommended each day.

NICE News in December

    NICE local formularies guide will “reduce variation in prescribing”

    December 17, 2012

    NHS should offer early pregnancy services seven days a week

    December 12, 2012

    Greater awareness of hepatitis B and C needed

    December 12, 2012

    Recent press releases: Dec 18 2012

    Andrikopoulou M.; Sridhar A.N.; Nausheen S: BJOG: June 2012

    A complicated case of small bowel obstruction in pregnancy: A case report and review of literature

    BJOG: An International Journal of Obstetrics and Gynaecology, June 2012, vol./is. 119/(106-107), 1470-0328 (June 2012)

    Author(s): Andrikopoulou M.; Sridhar A.N.; Nausheen S.

    Institution: (Andrikopoulou, Sridhar, Nausheen) Macclesfield District General Hospital, United

    Conference Information: 10th International Scientific Congress of the Royal College of Obstetricians and Gynaecologists, RCOG 2012 Kuching, Sarawak Malaysia. Conference Start: 20120605

    Publication Type: Journal: Conference Abstract

     

    Extracts from BMJ: June 14 2012

    Srividya Seshadri, Pippa Oakeshott, Catherine Nelson-Piercy, and Lucy C Chappell

    Aumeer, R: Obesity Reviews, May 2011

    Audit on body mass index in pregnancy
    Citation: Obesity Reviews, May 2011, vol./is. 12/(199), 1467-7881 (May 2011)
    Author(s): Aumeer R.
    Introduction and background: Obesity during pregnancy is a risk factor for many adverse outcomes such as stillbirth, macrosomia, and gestational diabetes, among others.
    Objective: To assess the quality of care and management of obese pregnant women at Dudley Hospital, United Kingdom.
    Design: A retrospective audit study.
    Setting: Dudley Hospital, Birmingham, United Kingdom.
    Standards and criteria: All pregnant women should have their body mass index (BMI) measured and recorded at their first prenatal visit. All pregnant women with BMI > 30 should have postprandial blood tests at 20 weeks and 26 weeks to screen for diabetes. All pregnant women should receive advice about sensible diet and exercise, which should be documented in their medical notes.
    Methods: Medical records for all patients with delivery dates between December 2008 and January 2009 were audited post delivery.
    Participants: Pregnant women (N = 91).
    Results: BMI is recorded for 98% of patients. Over a quarter of women with BMI > 30 did not have postprandial blood tests at 20 and 26 weeks.
    Conclusion: BMI is calculated and recorded for most patients, but uptake of postprandial blood tests is suboptimal in patients with BMI > 30.
    Recommendations: To add a section on obesity in the maternity notes.
    Institution: (Aumeer) East Cheshire NHS Trust, Macclesfield, United Kingdom