AQW 19442/22-27
Mrs Michelle Guy
Alliance Party
Lagan Valley
Tabled Date: 05/12/2024
Answered On Date: 20/12/2024
Priority Written: No
Question:
To ask the Minister of Health to detail any additional specific support being provided to parents with multiples, both pre-birth and post-birth.
Answer:
Support varies from Trust to Trust, therefore I have provided a response from each Trust below: Belfast HSC Trust: The Royal Jubilee Maternity Service provides dedicated specialist Twins and Multiples Antenatal Clinics which are led by Consultant Obstetricians who specialise in multiple pregnancy care. There is a dedicated antenatal twins and multiples specific antenatal education programme provided for women and their families. The Service provides dedicated twins and multiples infant feeding advisory support in Maternity and Neonatal settings. South Eastern HSC Trust In terms of antenatal care - there is a twin specific educational parent-craft evening every 3 months, these are in addition to all the other parent-craft and supports we have in place for every pregnant patient. From an antenatal perspective all parents of multiples are seen at the twins/multiples clinic in Maternity Out Patients Department, which is consultant led. There are two midwives allocated to this clinic to provide continuity and these midwives provide an antenatal education class tailored to the needs of parents expecting multiples. The classes are also supported by a consultant obstetrician, a member of the neonatal team and a representative from the Charity ‘Tiny Life’. Parents are also encouraged to attend the other antenatal education classes breastfeeding workshops within the Trust to help them prepare for birth and the early postnatal period. Mothers are also directed to the ‘Twins Trust’, which is active in Northern Ireland and can provide ongoing support. Postnatal hospital care is tailored to the individual needs of the babies and that of the mother. Community midwives will offer postnatal visits as required on an individualised basis to offer advice and support. Northern HSC Trust: Northern Trust have a dedicated multiples clinic run by a specific team of staff including Obstetricians with a special interest in multiples, midwives and a dedicated sonographer who works alongside the clinic. Parents receive support from a team of staff who they see regularly and receive the benefits of continuity care, have early access to the clinic upon confirmation of a multiple pregnancy and have regular, specialised care in accordance with their pregnancy. This clinic has benefited from working with the Twins Trust and successfully completed an audit to measure the clinic against the recommendations detailed in NICE guideline for multiples NG137. In addition, there are antenatal education sessions which are specifically tailored to provide information for multiple pregnancies. This is coordinated by the antenatal education midwife alongside the midwife working in the clinic, with input from Tiny Life, a charity for premature babies. Southern HSC Trust The Southern Health and Social Care Trust run six information evenings for all multiple pregnancy ladies pre-birth. These face to face sessions are delivered by the inter disciplinary team, consisting of: SHSCT Midwife/ (Mum of twins/Top tips 10.) Consultant Obstetrician- talking about the birth and labour ward setting. Neonatal Unit Nurse- to discuss neonatal service in case baby needs to go there. Physiotherapists talk specifically about multiple births. Breastfeeding Lead Midwife- information regarding feeding multiple babies. Twins Trust specialist Health visitor support. Tinylife charity- talk in case baby comes early. Closing question time. Parents are encouraged to join other workshops for psychological support, (Getting Ready For Baby and Hypnobirthing Programme) and have access to antenatal education midwifery team email, if they have any questions/queries or concerns. For Postnatal ladies and babies there is no specific additional support provided to parents, however they will be aware of support available from midwife, health visitor and signposted to community organisations Western HSC Trust There is a dedicated antenatal clinic for women with twin pregnancy (higher order multiples are delivered in Belfast Trust - this is a regional agreement). All women pregnant with twins are seen at every antenatal appointment by a consultant with a special interest in multiple births/ high risk pregnancy. A midwife is in attendance at these clinics to offer support. Detailed ultrasound is performed at every visit, and tailored plans for delivery are made in conjunction with the woman. Parent education classes are offered but not specific to multiple pregnancies at this time. Midwives link with Health Visiting team for women with multiple pregnancies and offer an antenatal visit where possible. From a neonatal services perspective, Western Trust try to keep twins together, in the same room and in beds beside one another. Once they are well enough, if there are no contraindications, twins will be nursed in the same cot, for short periods of time. Western Trust try to discharge home at the same time if both babies are ready for discharge around the same time, but this isn’t always possible. If one baby goes home first the Trust facilitate visits, with the other baby, to the unit after discharge, and encourage them to room in together unless there is a contraindication. They also have discreet signage which acknowledges if the baby has been a multiple and lost a sibling before or after birth. There is no specific additional support offered at this time in the postnatal period, unless the babies are born prematurely when there would be support available from Tinylife.
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