Maternity services

Dear patient,

Congratulations on your pregnancy and welcome to the Mid and South Essex NHS Foundation Trust maternity service. We are extremely proud of our maternity service, which operates as a single service across three hospital sites, the William Julien Courtauld birthing unit site, and numerous other community sites, covering a very large part of Essex.

Location of birth

We understand and appreciate that you may wish to give birth at a particular location. As a Trust, we will endeavour to provide you with your preferred birth location; however, this may depend on several varying factors such as how you choose to have your baby, and the demand on our maternity units and staffing at the time. We will only ever ask you to move away from your preferred location for birth to keep you and your baby safe.

You can discuss your birth preferences with your midwife or obstetrician during your antenatal care. Most of our patients receive their maternity care from their community midwifery team and their local hospital site (Basildon, Broomfield, or Southend hospitals).

Discussion on birth location

We understand that many factors may influence your decision, including work schedules, childcare for other children, transportation, and financial considerations. We aim to accommodate your needs and preferences as much as possible, but we recognise that our first responsibility is to keep all of our patients and their babies safe.

Your midwife will discuss your preferred birth location with you early in your pregnancy journey.

Specialist care and apointment timeliness

There are times when you may receive some of your maternity care at a site that is not your preferred location or local hospital. This may be necessary to ensure you receive specialist care or to ensure you get an appointment within the correct timeframe.

Occasionally, for medical reasons or due to high demand at your local site, you may be asked at short notice to have your baby at a different hospital. This is particularly true if you are having an elective caesarean section or induction of labour, where hospital stays can be expected to be longer. In this circumstance, you will be contacted by a senior midwife, maternity manager, or obstetrician to discuss available options.

Temporary movement of antenatal/pregnancy appointments from William Julien Courtauld Birthing Centre 

Please be aware, that from August 30, 2024, for 12 months, pregnancy and antenatal appointments will temporarily move from William Julien Courtauld Birthing Centre (WJC) to Braintree Community Hospital due to construction of the new Community Diagnostic Centre (CDC) next to WJC.

Women and birthing people coming for births or postnatal care will use a separate entrance to minimise noise and ensure safety, although temporary closures may be necessary during disruptive work. 

Midwives will be contacting women and birthing people about the changes and those who wish to birth at WJC to inform them of the potential for noise during the building works. Please contact your midwife if you have any questions or concerns.

Healthcare travel cost scheme (HTCS)

If you have a low income, you may be eligible to get help with NHS costs and travel expenses. You can apply:

online at: www.nhsbsa.nhs.uk/nhs-low-income-scheme.

By phone: 0300 330 1343

If you have any concerns, please do not hesitate to discuss this with your community midwife.

Once again, congratulations on your pregnancy and welcome to the Mid and South Essex NHS Foundation Trust.

Check out our maternity data to learn more about our maternity services: Maternity data (mse.nhs.uk)

The Mid and South Essex Maternity and Neonatal Voices Partnership (MNVP) is a team of women, birthing people and their families, commissioners and providers (midwives and doctors) working together to review and contribute to the development of local maternity care. The MNVP welcomes your feedback on your maternity service experience; it is used to make direct improvements to the local services offered.  

If you would like to give feedback via the MNVP about your maternity care, you can email MSESSEXMNVP@gmail.com.

If your baby needs special care after birth, learn more about our neonatal teams on our Premature and sick babies (Neonatal) page.

If you have experienced the loss of a baby, our bereavement team is here to support you.

Learn more about the support we offer on our Bereavement support page.

If you are a current smoker or have quit since finding out you are pregnant a referral is automatically made to our specialist maternity smoking cessation team, following your booking appointment. The team will contact you to discuss the right way in which we can support you, and your household to become smoke free.

Alternatively you can self-refer via the email address at any gestation. Please include your name, date of birth, contact details, address and booking site: Mse.maternitysmokingcessation@nhs.net.

For some further information regarding smoking in pregnancy please visit the Royal College of Obstetricians and Gynaecologists: https://www.rcog.org.uk/media/rvljrnjz/pi-smoking-in-pregnancy.pdf

We are committed to improve the care we provide to the women/birthing people and their families, which is why we offer our service users the chance to get involved in clinical research studies. Below is a list of some of the research studies we offer. 

If you are interested on participation or getting more information from any of the studies, contact your health care professional. 

Basildon Hospital

1. Imperial College London- Early versus late monitoring among women and birthing people with a history of gestational diabetes – Observational multicentre cohort study. 

Profound biochemical and physiological changes are observed throughout the pregnancy, and some of the hormonal changes can cause the body not to be able to produce enough insulin or their body is more resistant to insulin causing blood levels to remain high and in pregnancy this is called gestational diabetes. 

Although, NICE guidance suggests that we should offer the pregnant person/women with a history of GDM with early monitoring of blood glucose testing with a full oral glucose tolerance test at 16-28 weeks, the reality is that the practice across the UK vary, and it is not clear which approach is more effective at reducing the short- and long-term risks of GDM in pregnancy.  

The aim of the study is to study two groups of women/birthing people: early blood glucose monitoring and later glucose monitoring and determine, if there is a difference in short- and long-term outcomes.  

Taking part in the study we do not expect you to change what you do during the pregnancy. If you decide to participate, we will continue to observe and after birth we collect the data of your pregnancy, birth and baby and contact 6weeks postnatally. All the information will be pseudonymised.  

For further information please contact the diabetic midwife. 

Broomfield Hospital

1. OBS UK

Every year 50,000 women and birthing people in the UK lose 1 litre of blood or more during childbirth with 28% requiring a blood transfusion. Bleeding is the leading cause of maternal death and there have been no improvements in maternal morbidity due to postpartum haemorrhage (PPH) in the last 15 years. PPH can have long term psychological consequences for women/birthing people and their birth partners. 

Following on from a promising pilot study across 12 sites in Wales, OBS UK aims to implement an obstetric bleeding strategy (OBS) PPH care bundle to evaluate a new way of managing heavy bleeding during childbirth.

Anyone who has a baby at Broomfield Hospital in Mid Essex will be included in a research project to improve the quality of care. You’ll always have a choice about what care you accept or refuse, and it’s a good idea to talk this over with your midwife or healthcare provider.

This care project includes four main steps:

1. Checking for bleeding risks: When someone is admitted or goes into labour, we’ll check if they’re at higher risk for heavy bleeding.
2. Measuring blood loss: After every birth, including home births, all blood loss will be carefully measured.
3. Acting quickly if needed: If bleeding reaches certain levels, or if we’re concerned, the right team will be called in to help.
4. Special blood tests: If someone loses 1 litre of blood and the bleeding continues, a quick blood test will be offered along with regular lab tests. This will be repeated after each additional 500ml of blood loss or if blood products are given. This test is only available in the labour ward, so anyone giving birth outside of the ward would be offered a transfer to Broomfield Hospital if heavy bleeding is detected or if there are other concerns.

The care team will review the results to decide if blood products are needed to help with clotting. This may not be suitable for everyone, such as people with certain bleeding disorders like Immune thrombocytopenia (ITP).

Please talk to your midwife to see if a referral to a specialist is needed for more advice.

Women and birthing people may be approached by the research team to discuss taking part in the psychology and cost effectiveness sub studies. Further information can be found here: (www.obsuk.org).  

Southend Hospital

1. LOCI Trial – Women/people diagnosed with polycystic ovary syndrome (PCOS)   

Infertility affects one in six couples, with 25% of infertility being due to anovulation (not releasing eggs from the ovaries). Polycystic ovary syndrome (PCOS) is also very common; (approximately 10% of women of reproductive age in the UK have this condition) and it is responsible for 85% of anovulation. Invasive treatments, such as an operation called ovarian diathermy or In-vitro fertilisation (IVF), may overcome anovulation from PCOS, but are associated with significant risks and costs.  

This trial is investigating the effectiveness of two different drugs (letrozole and clomifene) with metformin or placebo on fertility, in woman/people with anovulatory PCOS and infertility on live birth rate ≥34 weeks of gestation. 

Recruitment eligibility: 

• Women/people diagnosed with PCOS (according to Rotterdam criteria) and evidence of anovulation (irregular cycles lasting <21 or more than 35 days or less than 8 periods per year OR absence of raised serum progesterone greater than 20nmol/L 7 days prior to a period) 
• Presentation with infertility or wishing to conceive. 
• Male partner with normal sperm count (≥ 15 million) and progressive motility (≥32% in the last 3 years).  

For more information about the trial, please visit the LOCI trial website: LOCI trial - University of Birmingham.

2. CaPE Trial   

Calcium supplementation for prevention of pre-eclampsia in high-risk women/birhting people. 

Pre-eclampsia complicates around 1 in 30 pregnancies every year in UK. The underlying cause of preeclampsia remains still unclear. It is thought to occur secondary to poor placentation and endothelial cell damage, resulting in widespread vasoconstriction, abnormal coagulation, and poor organ perfusion.   

The aim of the CaPE trial is to find out whether taking calcium tablets, alongside usual antenatal care, reduces the risk of women developing pre-eclampsia.  

Trial participants will be randomised to receive either an oral calcium supplement for 2gm per day plus usual care (including aspirin) or a placebo plus usual care (including aspirin), to be commenced anytime from 12- 22 weeks of gestation until delivery. 

For any further information of the study please visit: The CaPE trial - University of Birmingham 

3. ASPRE-T                        

Preeclampsia (PE) which results in premature birth is a serious complication of pregnancy and a major cause of short and long-term maternal and perinatal morbidity and mortality.  This is a trial which is involving MCDA and DCDA twins, and the findings show that rate of PE is about 9% which is 3 times higher than in singleton pregnancies.  

The aim of the study is to examine if the prophylactic use of low-dose aspirin from the first trimester of pregnancy in women/birthing people with twin pregnancy can reduce the incidence of PE.  

This is a double-blind randomised placebo-controlled trial. The participant who meets the eligibility criteria will be offered the trial at the first hospital visit 11-13 weeks gestation in pregnancy.  

For further information of the study please visit:  aspre-t.org. 

4. Imperial College London- Early versus late monitoring among women and birthing people with a history of gestational diabetes – Observational multicentre cohort study. 

Profound biochemical and physiological changes are observed throughout the pregnancy, and some of the hormonal changes can cause the body not to be able to produce enough insulin or their body is more resistant to insulin causing blood levels to remain high and in pregnancy this is called gestational diabetes. 

Although, NICE guidance suggests that we should offer the pregnant person/women with a history of GDM with early monitoring of blood glucose testing with a full oral glucose tolerance test at 16-28 weeks, the reality is that the practice across the UK vary, and it is not clear which approach is more effective at reducing the short- and long-term risks of GDM in pregnancy.  

The aim of the study is to study two groups of women/birthing people: early blood glucose monitoring and later glucose monitoring and determine, if there is a difference in short- and long-term outcomes.  

Taking part in the study we do not expect you to change what you do during the pregnancy. If you decide to participate, we will continue to observe and after birth we collect the data of your pregnancy, birth and baby and contact 6weeks postnatally. All the information will be pseudonymised.  

For further information please contact the diabetic midwife. 

5.  SNAP2 study, University of Oxford- The aim of the study is to develop and test the clinical and cost-effectiveness of an intervention to support self-management of antihypertensive medication following a hypertensive pregnancy. The intervention aims to improve long-term blood pressure control and thereby reduce adverse cardiovascular outcomes and associated costs to the NHS.

Pregnant women and birthing individuals in the postnatal period who require antihypertensive treatment can participate in the study. The study consists of two arms:

• Intervention Arm: Blood pressure self-monitoring using a validated monitor and self-titration of antihypertensive therapy guided by a digital intervention overseen by clinicians.
• Control Arm: Usual care pathway provided by the trust.

For further information, please contact the maternity research team. Find more information about the SNAP2 study on the here: https://www.phctrials.ox.ac.uk/studies/snap2. 

We have a perinatal pelvic health service consisting of specialist midwives and physiotherapists working at each of the Trust's three sites, which women/birthing people can access up to one year postpartum.They work in close collaboration with consultants and urogynae nurses to help provide a multidisciplinary approach to improving women/birthing people's pelvic health.

The specialist midwives' role is to provide perinatal care with the promotion of education regarding how to reduce the negative effects of childbirth through pelvic floor exercises, perineal massage, positions in labour. The team can also help provide ongoing support with bladder and bowel dysfunction in both the antenatal and postnatal periods, when the pelvic floor is at its most vulnerable.

Please speak to your midwife at your antenatal appointment, your health visitor postnatally, or your GP for a referral to these services. For further information, please email us at mse.pphsmidwives@nhs.net.

We are dedicated to enhancing the pelvic health care you receive from the NHS during and after pregnancy. Your feedback is important to us, so please share your thoughts: Your experiences of NHS pelvic healthcare during and after pregnancy (office.com).

Self-referral for perinatal physiotherapy

Easily access perinatal physiotherapy through self-referral for support during pregnancy and up to one year after birth. We provide help with:

Antenatal (before birth):

• Current or previous pelvic pain
• Rib pain and sciatica
• Abdominal muscle separation
• Past third or fourth degree tears
• Previous complex or traumatic perineal tears
• Symptoms of pelvic floor problems (e.g. urinary or bowel issues, pelvic organ prolapse)
• Difficulties with intimate examinations

Postnatal (after birth):

• third or fourth degree tears or complex perineal tears
• Postnatal pelvic pain
• Pain during intercourse
• Ongoing perineal pain
• Postnatal bowel incontinence
• Postnatal urinary incontinence
• Pelvic organ prolapse.

Contact us

Call 0300 443 4444.

Resources

• Fit for Birth - essential exercises and helpful advice:  https://thepogp.co.uk/_userfiles/pages/files/POGP-FFBirth%20(1).pdf
• Perineal tears during childbirth:  https://www.rcog.org.uk/for-the-public/browse-our-patient-information/perineal-tears-during-childbirth-patient-information-poster
• Perineal health in pregnancy, birth and beyond: https://www.rcog.org.uk/media/m2el4y0h/antenatal-information-for-women-v5-aug-2023_final.pdf
• Squeezy App:  https://squeezyapp.com