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Quality at CM Health chart pads plus a copy of the ‘Guidance For Healthy Weight Gain 2014’ were available in all clinic rooms as these are well used by self-employed LMC midwives. The resources were also distributed to the community midwife clinic rooms and midwives, local self-employed LMC midwifery groups and some GP practices. They were also disseminated via the Access Holders meetings and all self-employed LMC midwives were informed of the availability through the ‘Our Maternity Monthly’ eUpdate. The healthy weight gain chart clearly explains the importance of establishing an accurate baseline recording of weight and not to rely on self-reporting plus it has a simple chart to inform self-employed LMC midwives of the appropriate weight gain to advise women during pregnancy based on their pre pregnancy weight. A letter was enclosed explaining what the resources were and included the MoH website to enable the midwives and GPs access further resources as required. Research to Help Understand What Can be Done to Support Healthy Mothers and Babies CM Health is supporting research to trial new approaches to weight management in pregnancy. The ‘Healthy Mums and Babies Study‘(HUMBA), is a randomized controlled trial of a multi-faceted nutritional intervention and probiotics/placebo to reduce gestational diabetes mellitus, pregnancy weight gain and infant adiposity in overweight and obese pregnant

53 women in the CM Health region. HUMBA is a demonstration study that it is hoped will gather useful information around women’s diet and physical activity during pregnancy. The study also aims to identify whether intervening with a multi-faceted nutritional intervention, with or without probiotics, will have a positive effect on pregnancy weight gain and optimise infant birth weight. This is the first study of this kind being trialled in Counties Manukau Health area and recruitment began mid-April 2015. The aim is to involve 220 women in the pilot study. CM Health community health workers have received full training by the National Heart Foundation (Certificate of Nutrition). They have also had full training on healthy conversations to improve health literacy among our population by Gravida (Liggins Institute). They will have a HUMBA standard operating procedure manual and a HUMBA handbook for the women in the active nutritional arm of the trial. The women will receive four community health worker visits to assist them with their diet and physical activity, as well as text messages for encouragement. The women in the best practice arm will receive the MoH pamphlets on ‘Eating for Healthy Pregnant Women’ and ‘Healthy Weight Gain in Pregnancy’. All women will be randomised either probiotics or placebo. The probiotics and placebo will be taken from the date of recruitment and throughout the whole of the pregnancy.

Diabetes in Pregnancy Diabetes is a significant and growing problem in Counties Manukau due to the challenges our population face with weight control and the associated socioeconomic drivers which can mean choosing less costly high sugar, fat and carbohydrate food and beverages. Diabetes in pregnancy (DIP), which includes both Gestational Diabetes (GDM) and pre-existing diabetes, represents a significant risk for poorer pregnancy outcomes and has implications for the future health of both mother and baby. Concern has been expressed locally and internationally about the increasing prevalence of diabetes in pregnancy. The percentage of women who birth at a CM Health facility identified with diabetes in pregnancy has increased from 3.1% (246) of all births in 2006 to 8% (584) of all births in 2014. The largest volume of diabetes in pregnancy cases continues to be women of Pacific ethnicities with 259 Pacific women identified has having diabetes in pregnancy in 2014 (Table 17).

2014 2015 maternity quality and safety programme  

This Annual Report (2014-2015) covers the continued progress and initiatives undertaken over the last 12 months as part of the Maternity Qua...

2014 2015 maternity quality and safety programme  

This Annual Report (2014-2015) covers the continued progress and initiatives undertaken over the last 12 months as part of the Maternity Qua...