Felicity Jones

Background: The role of named midwife for teenagers was implemented in Royal Surrey County Hospital NHS Foundation Trust in order to improve outcomes for teenage mothers and their babies. The role comprised a dedicated midwife-led teenage antenatal clinic, antenatal and postnatal home visits and tailored antenatal education. Aims: This project monitored the outcomes of teenage mothers following implementation of the role, to assess improvements in outcomes. Methods: During this service development project, 31 teenage mothers aged ≤ 19 years received midwifery care and their obstetric outcomes were monitored. These outcomes were compared with 52 teenage mothers who had previously given birth. Findings: Comparing teenagers who gave birth in February–August 2014 with those who gave birth in the same period in 2013, there was an increase in the rate of spontaneous vaginal deliveries, a decrease in instrumental deliveries and increase in induction of labour; however, induction of labour for intrauterine growth restriction decreased. The rate of caesarean section increased but remained lower than in the general population. An increase in birth weight and intention to breastfeed were also observed. Conclusions: This project indicates that the role of a dedicated midwife for teenagers has a place in the care of teenage mothers.

Background: Unintentional injuries are a leading cause of preventable death and a major cause of ill health and disability in children under five years of age. A health promotion mobile phone application, ‘Grow up Safely’, was developed to support parents and carers in reducing unintentional injuries in this population of children. Methods: A prototype of the mobile application was developed to deliver health education on unintentional injury prevention linked to stages of child development. In order to explore the usability of the app and refine its content, three focus groups were conducted with 15 mothers. Data were analysed using thematic analysis. Results: The majority of participants reported previous use of health apps, mainly related to pregnancy, and recommended by health professionals. The app was considered user‐friendly and easy to navigate. Participants in two focus groups found the app informative, offered new information and they would consider using it. Participants in the ‘young mum's’ group considered the advice to be ‘common sense’, but found the language too complex. All participants commented that further development of push‐out notifications and endorsement by a reputable source would increase their engagement with the app. Conclusion: The ‘Grow Up Safely’ mobile phone app, aimed at reducing unintentional injuries in children under five, was supported by mothers as a health promotion app. They would consider downloading it, particularly if recommended by a health professional or endorsed by a reputable organisation. Further development is planned with push‐out notifications and wider feasibility testing to engage targeted groups, such as young mothers, fathers and other carers.

Aim: To evaluate the effectiveness of prescribed postnatal exercise on postnatal depression. Prescribed exercise was defined as any physical activity that was carried out in the postnatal period with the objective of reducing postnatal depression, as determined by identified scales. Background: Research has identified that regular physical exercise interventions are beneficial to mental health conditions such as depression and anxiety. Design: A systematic review and narrative analysis of randomised controlled trials (RCTs) reporting on the effectiveness of prescription postnatal exercise on postnatal depression. Data sources: Selection criteria included full text, academic articles written in English comparing exercise retrieved from MEDLINE, CINAHL, PsycINFO, EMBASE and SPORTDiscus. Research focusing on postnatal or postpartum exercise or physical activity; depression or mood swings, published between 2008 and 2016 was included. The search was refined to include females aged eighteen years or more. Review methods: Forty-seven articles were initially identified and full text analysis was performed by two members of the research team. Twelve articles were identified as meeting the inclusion criteria and were distributed for scrutiny and assessment amongst the five members of the research team. Methodological quality was assessed using a Quality Assessment Tool for Quantitative Studies published by the Effective Public Health Practice Project (EPHPP) (1998). Finally the articles were redistributed amongst the team for a second assessment and verification. Discrepancy of ratings for a paper between the reviewers was resolved by a third reviewer through reassessment of the paper and further discussion. Results: Eight studies were included in the final systematic review carried out using the EPHPP assessment tool; the review identified six quality RCTs meeting the inclusion criteria. Conclusions: The findings indicate that a tailored exercise intervention can effectively alleviate postnatal depressive symptoms, benefiting women both physically and psychologically. Social support experienced by participants in relation to the exercise intervention was seen to have a positive impact.