Occupational therapists have an important contribution to make to the health and well-being of women during pregnancy and in the postnatal period. A small (but growing) number of occupational therapists work in specialist services for women who experience mental health issues during or after pregnancy. Elsewhere occupational therapists support new and expectant mums with physical disabilities and long-term physical or mental health problems, and parents whose babies are premature, disabled or unwell. The role of occupational therapy in the maternity care pathway is, however, not well recognised or understood.
In May 2018 I was asked to contribute to a project to understand the contribution that Allied Health Professionals (AHPs) and psychologists make to the maternity care pathway. The project was commissioned by Beverly Harden, AHP lead for Health Education England (HEE) and Janet Flint, HEE programme lead for population health, prevention and maternity, and undertaken by Allied Health Solutions. It supports a recommendation from the National Maternity Review to ensure “multi-professional working, breaking down barriers between midwives, obstetricians and other professionals to deliver safe and personalised care for women and their babies”. This AHP project was driven by the recognition that “there is limited awareness, understanding and visibility of the roles of AHPs and psychologists working across the maternity care pathway. These professional groups are seldom referred to in local maternity workforce plans, with the exception of paramedics in the antenatal stage, operating department practitioners during the intrapartum phase and physiotherapists during post-natal care” (HEE 2019, page 4). My task was to describe the contribution that occupational therapists make to the five stages of the maternity care pathway (pre-conception, antenatal, intrapartum, post-partum, and the first year post birth) and to source case studies illustrating good practice in our various roles.
It was a fascinating project and involved some research, reading through previous editions of OTnews and contacting individuals and services that might have information to share. I was delighted with the response from occupational therapists who contacted me following my call-out on social media. The final report includes a description of our role throughout the maternity care pathway:
|
Maternity care pathway stage |
Examples of occupational therapists’ role |
|---|---|
|
Pre-conception |
Enabling women to consider the implications of known physical or mental health conditions on pregnancy, birth and motherhood |
|
The antenatal period |
Fatigue management, preparing for a change in role, workplace adjustments, facilitating home adaptations |
|
Intrapartum |
Ensuring equipment is in place for a safe and dignified delivery |
|
Postpartum |
Supporting positive co-occupations between mother and baby, and enabling parents of infants who are premature, sick or unwell to support their baby’s self-regulation and development |
|
The first year of life |
Enabling mothers to develop healthy routines for themselves, their baby and family, and promoting mothers’ physical and mental health through a range of individual and group interventions |
The report also includes eight occupational therapy case studies illustrating the diversity and value of our role across the maternity care pathway. Case studies were provided by occupational therapists working in neurorehabilitation, in a mother and baby unit, in a social care setting and in a special school for children with autism.
RCOT and the report authors hope that the guide (which is now published on the HEE website) will raise the profile of the role (and potential role) of occupational therapy in the maternity care pathway. The guide should also inform local maternity workforce plans and the improvement of maternity services so that women, particularly those with additional physical, learning and mental health needs receive support to fulfil their parenting roles and to optimise outcomes for them, their babies and families.
- Dr Sally Payne | Professional Adviser – Children, Young People and Families
- @RCOT_Sally