This post is the text of an article I wrote earlier this year, around the time Better Births, the report of the National Maternity Review, was published. The original title was ‘Stillbirth: what politicians and the media fail to understand.’ What I think many fail to understand is figures and their context – and research evidence more broadly.
It seems to me that we can only have consistently evidence-based health policy when we have a shared commitment in public life, and in public discussion, to a National Information Standard for talking about research evidence, and indeed for promoting public health messages.
Why do I keep tweeting NICE CG138 s1.5.24 – which is a National Information Standard, if people will choose use it? Those of you who have read ‘Thinking Fast and Slow‘ will understand why we need it: thinking about risk often involves ‘shortcuts’ and ‘rules of thumb’ that serve well in some cases, and less well in others (another blog post is needed to explore the topic!) We can, of course, support Each Baby Counts and the work of MBRRACE-UK, and acknowledge that addressing stillbirth rates is very important, while being equally clear that each and every time data is presented it must be properly contexualised. It serves women, their babies, and their families, poorly to present information without using absolute figures, framed both ways, (when possible) in a variety of formats.
So I wrote this article to express my frustration – that the public is so often presented with partial information, or information without context. And that this ‘problem with figures’, and indeed with understanding research evidence more broadly, seems to extend to, and affect, public policy initiatives. Continue reading
My second CG190 blog on monitoring the fetal heart rate – this time focusing on CTG use and trace interpretation. What is the evidence, and what is new and different about these recommendations? (Please do also read my previous post to understand this summary in context.) Again, I am assuming a basic familiarity with the evidence.
While writing this post, I have come across this fabulous resource of which I was unaware! Here on NCBI is a fully interactive version of Chapter 10 including Appendix P (all the Appendices are there!) Recommendations below are from the NICE online version and the Full guideline is here (with Appendices) on the NICE website, along with pathways, and the Quality Standard.
Note that significant sections of the CG190 fetal monitoring recommendations have been brought within the scope of the Intrapartum Care guideline for women at higher risk of complications currently being developed – see link below (under ‘Resources’) for full details. See introduction to my previous post too.
(28 May 2016, published 5 June 2016) Continue reading
In a previous post I promised to blog NICE CG190 ‘Intrapartum Care for healthy women and babies’– care during labour & childbirth (the national clinical guideline in England & Wales) chapter by chapter. Let’s have a quick look first at what NICE guidance is, and how it is made. (8 May 2016)
Making national guidelines for health and social care is a national process in which everyone has a stake. The public are people who use health and social care services – so what guidelines say will affect the choices you are given, the outcomes for you and the experiences you have. If you are a health or social care professional, the guidance will shape your work. Continue reading
The starting point for this post is an article about birth, from The Guardian, in December 2014. It was published in response to the updated clinical guideline NICE CG190 Intrapartum Care – care of healthy women and their babies during childbirth.
The Guardian article:
We talked about this article on the #MatExp Facebook group in September this year. This is an edited version of what I said in reply to concerns there that the tone of the article might be seen as offensive towards the medical profession: Continue reading
Calling all midwives, maternity lay advocates, doulas, obstetricians and other doctors concerned with birth, and students too! And commissioners and Clinical Commissioning Group clinical advisers too – so important.
You need to read the recommendations. Really, you do.
Because after that we’re going to do the updated chapters of the full guideline, chapter by chapter.
It’s fun. And it’s important.
Take the cup of tea challenge!
Cup of Tea
Read the NICE #IPCare recs Link here
Tweet something! #IPCareTea
Catherine Williams@BerksMaternity #MatExp #mslc
Great news that the 2006 Department of Health MSLC guidelines are being updated – publication of the new guidelines expected soon. Reflecting on where we are now, with thanks to Midirs for permission to post, here is my article from April 2015 on MSLCs.
What are MSLCs? How do they work? What do they contribute in maternity? Also includes some thoughts on the experience of being a NICE Lay Member (Intrapartum Care, CG190, 2014)
Essentially Midirs April 2015 – Collaborative Working – MSLCs