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Better way of working
Postnatal contraception provision in an inpatient perinatal mental health unit
  1. Gabriella Bathgate1,
  2. Chelsea Sharp1,
  3. Emma Yates2,
  4. Pauline Curnock1,
  5. Olivia Protti2,
  6. Sue Mann1
  1. 1 Sexual Health, Homerton University Hospital NHS Foundation Trust, London, UK
  2. 2 Perinatal Psychiatry, East London NHS Foundation Trust, London, UK
  1. Correspondence to Dr Gabriella Bathgate, Sexual Health, Homerton University Hospital NHS Foundation Trust, London, UK; g.j.bathgate{at}doctors.org.uk

https://doi.org/10.1136/bmjsrh-2022-201578

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    Key messages

    • A sexual health outreach programme focused on postnatal contraception education and provision was introduced on the East London Mother & Baby Unit.

    • The programme offers a time-intensive but well-organised, equitable, accessible service delivered by experienced sexual health clinicians to women with previously limited direct access to postnatal contraception.

    • The programme’s success illustrates the relevance of proactive local service development to meet unmet clinical need.

    Background

    Increasing postnatal contraception (PNC) uptake supports effective interpregnancy spacing, prevents unplanned repeat pregnancy following childbirth, improves subsequent obstetric outcomes and is a topical service development focus in sexual and reproductive healthcare.1 Provision offers high return on investment in postnatal women as well as the general population.2 3

    Recent years have seen substantial progress in increasing PNC provision through coordinated programmes in the UK, particularly via maternity services.4–7 However, across the UK there is a long way to go to realising universal direct, convenient access to the full range of contraceptive methods for PNC, including long-acting reversible contraception (LARC) for eligible women desiring these methods.8 Improving access for women poorly served through mainstream sexual health, maternity and primary care services remains a particular priority. A key group for whom unintended pregnancy may pose significant obstetric and psychosocial risk are women with chronic psychiatric illness or previous serious perinatal mental illness.9 10

    Here we report on an initiative designed to offer direct PNC to women admitted to a Mother & Baby Unit (MBU). While similar initiatives run elsewhere, reporting on their setup, outcomes and patient and staff experiences of their delivery has been limited.

    The East London Mother & Baby Unit sexual health outreach programme: how was the idea developed?

    Our service based at Homerton Hospital is one of two integrated sexual health service providers serving inner city East London, and incorporates an active outreach arm.

    Co-located with the service’s main clinic is the City & Hackney Centre for …

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    Footnotes

    • Contributors CS is the nurse lead for outreach services and leads the clinical service, with support from EY and PC. GB was the article lead author. OP and SM provided guidance on content. All authors contributed to the final draft and approved it for publication.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.