The Women’s Health Strategy for England highlights how our collaborative service across north west London is ensuring women have convenient access to postnatal contraception.
The first Women’s Health Strategy for England was published on 20 July 2022, outlining key commitments and actions to help us tackle the gender health gap and improve health outcomes for women at all stages of life.
A key topic in this document is fertility, pregnancy, pregnancy loss and postnatal support, nominated for inclusion by more than 50% of the 100,000 respondents who informed the strategy.
More specifically, the strategy explores access to contraception. Though contraception plays a vital role enabling women and their partners to fulfil their pregnancy intentions, whether that’s prevention, timing, or spacing of pregnancies, there are still barriers in accessing this service for women who have just given birth.
A study in NW London highlighted that 42% of women want to take home contraception after giving birth, yet maternity services are often not commissioned to provide this service. This means a separate appointment is required at a GP or sexual health clinic.
To address this obstacle, NHS North West London has collaborated across maternity services, sexual health, local authorities and commissioners to introduce a contraception offer within maternity services. This includes contraception counselling, information, and a choice of contraception that is compatible with breastfeeding before women leave maternity services. At this early stage the model has meant that 28% of women have taken contraception home, of which 97% were satisfied with the service.
Below are some examples of feedback we received from service users in the initial phase of the programme:
“This service was so, so helpful. After my first baby I felt lost afterwards as I was unsure where to go to get contraception…The fact it was discussed so early, it was really good and helped to plan my future.”
“I really appreciated it because if I hadn't been offered it I probably would have been lazy and not bothered to go and get contraception.”
“The team told me I could have [the Mirena coil] inserted at the time…I was really pleased and relieved. I am now 2 months postpartum and there are no complications. Thanks for a great service which I am sure will be very useful for other women too.”
Delivering this service has involved training midwives and obstetricians to provide contraceptive counselling, and ensuring there is staff in each trust who can fit contraceptive implants and coils. Staff in sexual health clinics have also been trained using a new curriculum developed by the Faculty of Sexual and Reproductive Healthcare.
Dr Edward Mullins, who has led this service, said:
“The NW London Post-birth contraception service utilised charity funding and local expertise when it launched in 2020, fuelled by enthusiasm to provide equity of access to contraception for those who had recently birthed. The success of the service would not have been possible without its dedicated champions in the Local Maternity System, 6 maternity units, SRH services, our fantastic commissioners and the Maternity Transformation Plan team.
The implementation of the service is still very much in the growth phase, upskilling our workforce in challenging times and overcoming barriers to clinical data collection. We want all women across England to benefit from this service and will continue to share our learning, materials and to collect data to support a sustainable service and ensure ongoing funding.”
We will continue to evaluate the impact of this service, both on women’s health outcomes and in terms of cost saving, though the positive impact at this early stage has already prompted other local commissioners and providers to consider implementing this service.
To learn more about the Women’s Health Strategy for England, visit the Gov.uk website.