This document discusses improving maternal and neonatal health outcomes through engaging families. It notes that in 2012 there were nearly 700,000 births in England but the NHS only had enough midwives for 565,000 births, and midwives were getting older on average. The complexity of pregnancies is increasing as well due to factors like obesity. A family-centered app called Maternity Assist aims to relieve pressure on midwives by providing pregnancy information to families online and engaging them throughout the process.

1. Improving Maternal and Neonatal Health
Outcomes by Engaging the Whole Family
Duncan Fisher, OBE
Luis Figueira
| CEO, Maternity Assist
| Cloud Lead, Boxfusion Consulting
Oracle Open World
San Francisco, September 29th 2014

3. In 2012, there were the equivalent of
20,935 full-time midwives working in the
NHS in England.
https://www.rcm.org.uk/sites/default/files/State%20of%20Maternity%20Services%20report%202013.pdf
In 2012 there were 694,241
babies born in England
The RMC’s assessment of the shortage of
midwives in the NHS in England in 2012 is
around 4,800.
but the number of midwives
working in the NHS in that
year was only really suitable
for 565,245 births
meaning there were 128,996
more births than the service was
designed to cope with.
+23%
+23%

4. NHS midwives in England are
getting older. The largest age
group in 2001 was midwives
aged between 35 and 39; the
largest age group in 2012 was
those aged 45 to 49.
https://www.rcm.org.uk/sites/default/files/State%20of%20Maternity%20Services%20report%202013.pdf

5. https://www.rcm.org.uk/sites/default/files/State%20of%20Maternity%20Services%20report%202013.pdf
The effect of the higher number of births is multiplied by the growing complexity of pregnancies. For example:
Increase in the number of births to older
women
Older women require more assistance
from midwives. They have a perfect right
to all that additional care, of course, but
it has an undeniable knock-on effect on
workload.
+12345678050%

6. https://www.rcm.org.uk/sites/default/files/State%20of%20Maternity%20Services%20report%202013.pdf
The effect of the higher number of births is multiplied by the growing complexity of pregnancies. For example:
Obesity in pregnancy
The incidence of maternal obesity in the first three months
of pregnancy in England more than doubled from 7.6% to
15.6% between 1989 and 2007.
The result is extra women requiring more demanding care.
7.6%

7. “[…] things are beginning to change – with a range of pressures making the work of
midwives ever more challenging, unrewarding, and potentially dangerous for patients.”
“[…] As such, it is not just a change in the birth rate that increases the work load for
midwives, but the management of the array of needs for each individual woman.”
http://www.independent.co.uk/life-style/health-and-families/health-news/a-call-from-the-midwife-why-i-am-resigning-after-10-years-in-the-nhs-9035417.html

8. Slide with 55 items that need to be covered in the 45 min appointment

9. Quality issues
For patients:
Access of content online (where current generation lives)
Curation of information
Well-scheduled interactive information spread through the pregnancy instead of a barrowful of
leaflets at the start
Convenience / preference – easy ways to ask questions and raise worries outside antenatal
appointments
For NHS:
There are concerns about the quality of information found on the internet
Public health concerns, antenatal education, youth services for young parents, … introducing
people to local services (housing, benefits)
Save midwives’ time for higher risk families
Identify concerns of patients and their families early before they escalate

10. “Due to understaffing I regularly
work for nearly 13 hours without
a break […]. These tasks are
essential to maintain the safety
of women and their babies.”

12. Policy
Automation
Service Cloud Platform

13. Policy
Automation
 Dynamic Interviews
 Compliance Management
 Rule Modeling
 Policy Lifecycle
 Policy Analytics
 Policy APIs
Service Cloud Platform
 Extensibility & Integration  Experience Management  Hosting & Operations

14. Maternity Assist
Features
 Expectant mothers nominate other family members
 Self-help questionnaires
 On-line 24/7 content library
 “Ask-a-midwife” a question
 Linked to hospital records
 Multi-channel: email, twitter, phone, …

15. Maternity Assist
Features
Benefits
 Relieving Expectant overload mothers of nominate communications other family to families
members
  Making Self-help maternity questionnaires
services more accessible
  Systematically On-line 24/7 content communicating library
health/social
 information
“Ask-a-midwife” a question
  Engaging Linked to the hospital whole records
family
 Multi-channel: email, twitter, phone, …

16. Demo

17. [Demo of:
- Registration process for mothers & F&F
- Pregnancy information on midwife’s console: friends and family, relationship to baby
- Segmentation based on above
- Look at how different types of users receive different information]

18. [Demo of:
- Segmentation based on weeks pregnant
- Mailings on different pregnancy stages to different people]

19. Liverpool Women’s Hospital
Case Study

23. Screenshot of article with Mr and Mrs Fletcher video

24. Family centred care: the evidence
Social networks and smoking reduction
• Smoking throughout pregnancy is one of the single most important avoidable causes of adverse
pregnancy outcomes.
• Approximately one quarter of German mothers smoked during pregnancy.
Aveyard, P., Lawrence, T., Evans, O., & Cheng, K. K. (2005). The influence of in-pregnancy
smoking cessation programmes on partner quitting and women's social support
mobilization: a randomized controlled trial ISRCTN89131885. [Article]. Bmc Public Health,
5. doi: 10.1186/1471-2458-5-80
Nguyen, S. N., Von Kohorn, I., Schulman-Green, D., & Colson, E. R. (2012). The Importance
of Social Networks on Smoking: Perspectives of Women Who Quit Smoking During
Pregnancy. [Article]. Maternal and Child Health Journal, 16(6), 1312-1318. doi:
10.1007/s10995-011-0896-4

25. Family centred care: the evidence
Engaging fathers saves babies’ lives
• Men‘s dominance in household and community decision-making
in Niger, coupled with their lack of knowledge about the
advantages of clinical care in childbirth, mean that many women
are continuing to give birth at home, unattended. A mother dies
in childbirth, and 6 newborn babies die, every two hours in Niger.
• A total of 1600 men are now involved in the scheme. In one
district […] the rate of attended childbirth [rose] from 15% to 74%
of births
http://www.fatherhoodinstitute.org/2013/case-study-husband-schools-in-niger/

26. Family centred care: global interest
“To prevent mental health disorders, we need to prevent
childhood adversities, and for this we need family-focused
policies that strengthen the capabilities of parents to reduce
violence, illness, and poor functioning.”
Prof Panter-Brick, Yale University, at UN Forum in June 2014, "The Significance of Parents for Human Development”
Report on UN Forum, "The Significance of Parents for Human Development”, June 2014
http://www.upf.org/global-day-of-parents-2014/5943-forum-at-the-un-discusses-the-significance-of-parents-for-human-and-societal-development