Delay between pregnancy confirmation and sickle cell and thalassaemia screening: a population-based cohort study

Community-based maternity care in 2008

“…Sure Start programmes and Children's Centres, established to offer local services to the most vulnerable families, have caused a major reorganisation of community-based care, and these services are likely to develop further. 12 A coordinated response to maternity service policy challenges is lacking, as demonstrated by the papers in this issue of the journal, [13][14][15] and other sources: pregnant women still routinely attend first to their GP before being referred to the midwife, 1 continuing the duplication of early pregnancy care services despite the rhetoric of midwifery-led care. We are still however, reading about the neglect of mental health issues, despite the evidence of its' the principle benefits of the National Programme for IT.…”

“…As well as the inevitable duplication of care and confusion for women and staff, this has the potential to result in delayed screening tests; 15,24 delayed referral to specialists if the midwife has to refer first to the GP; confusion over who communicates test results to women; 14 and lack of clarity in responsibility for assessing and responding to concerns about women's mental health. 13 Women need access to a prompt and effective maternity service.…”

“…Inconsistent information and communication around antenatal screening tests seems to be common. 15 In addition, women still experience a lack of consistent, good quality breastfeeding support despite positive recommendations for change. [19][20][21] Midwifery-led units seem to close almost as often as they open, in spite of their potential to offer valuable, low-intervention, local care.…”

Commissioning maternity care: little room for manoeuvre?

“…5 Previous papers from this study had established that threequarters of all women consulted for pregnancy before 10 weeks' gestation, but that fewer than 5% had received screening by that time. 6 Introducing two different models where screening was offered at the first consultation, and before the midwife booking consultation, increased the proportion screened by 10 weeks from 2% to 24% and 28%. 7 Here they conclude that the additional benefit which results from earlier screening comes at a cost of £13 per woman screened.…”

Screening for sickle cell and thalassaemia in primary care: a cost-effectiveness study

“…There is, of course, no guarantee that earlier screening will lead to more women choosing prenatal tests or terminations, but it is known that many at-risk pregnant women, and fathers of their babies, are offered SCT screening too late in pregnancy to allow any reproductive choice. 1 The SHIFT (Screening for Haemoglobinopathies In the First Trimester) trial was a response to this concern and sought to assess the effectiveness, costeffectiveness, feasibility, and acceptability of offering universal antenatal SCT screening in primary care when the pregnancy is first confirmed. Three alternative approaches to SCT screening were compared:…”