Alan2Professor Alan Cameron, Vice President (Clinical Quality), writes…

Over 300 people attended our Each Baby Counts launch last week, all coming together to support our new quality improvement project, which aims to reduce by 50% the number of stillbirths, early neonatal deaths and brain injuries occurring in the UK as a result of incidents during term labour by 2020.

This is the College’s flagship initiative and will be undertaken by our new Lindsay Stewart Centre for Audit and Clinical Informatics.

There was a fantastic turnout for the launch and it was great to welcome so many people all united in their commitment to reduce unnecessary tragedies which affect many families every year.

Stillbirth rates in the UK remain stubbornly high. Current estimates suggest that around 500 babies a year die or are left severely disabled, not because they are born too soon, too small, or with a congenital abnormality, but because something goes wrong during labour. Some babies who are starved of oxygen at birth survive but are left with a severe brain injury. Sadly many of these babies will not survive infancy, or will suffer with a life-long disability. Read the rest of this entry »


Alan2Professor Alan Cameron, Vice President Clinical Quality, writes…

The condition heavy menstrual bleeding is sometimes overlooked and not talked about much, but it is a serious condition and affects around one in four women aged between 15 and 50.

It can interfere with a woman’s physical, social and emotional quality of life and each year approximately 30 000 women undergo surgical treatment for heavy menstrual bleeding across England and Wales.

There are procedures to alleviate the symptoms and we are determined to improve care women receive in this area. Read the rest of this entry »

David NEWDr David Richmond, RCOG President writes…

We know that around 90% of women tear during childbirth; however some women can suffer from more severe forms of tearing, which can significantly damage the anal sphincter, the muscle that controls the anus.

Unfortunately, it is not always possible to predict or prevent these types of tears. There are certain risk factors to look out for, for example, shoulder dystocia, if the second stage of labour is longer than expected, if it is your first vaginal birth, if you have a large baby, if your labour needs to be induced or if you have an assisted birth.

In terms of prevalence, previous research I was involved in, published in BJOG, analysed the trends of perineal tearing in all NHS hospitals in England and highlighted a three-fold increase in the rate of reported third or fourth degree perineal tears (the most severe types), with the rate rising from 1.8% in 2000 to 5.9% in 2011 among first time mothers. Read the rest of this entry »

David NEWDr David Richmond, RCOG President, writes… Picture this: You are travelling home in a crowded train late on a Friday afternoon and come across a newspaper article that sends you choking with indignation over something that is happening several thousand miles away. Short of spilling your coffee and muttering to yourself, what else can you do?

That was how I felt two weeks ago when I came across the story about a pregnant Sudanese mother and doctor who was sentenced to death for apostasy.

You would think that such stories are isolated incidences but in the last week, we have seen more grave news of the maltreatment of women. We have heard of a pregnant woman who was stoned to death in front of the courts in Pakistan by an angry mob and the horrific gang rape and hanging of two Indian teenagers in rural India.

How can these acts of barbarity happen in our modern, progressive society? This issue was discussed at our recent College Council meeting over the weekend.

Read the rest of this entry »

DavidRichmondRCOG President, David Richmond, writes…

This Friday is UNFPA International Day to End Obstetric Fistula.

Obstetric fistula is almost entirely preventable and indeed, in the UK, as in most industrialised countries, it has been all but eliminated and many people won’t be familiar with it. Yet it is estimated that the condition affects approximately 2 million women and girls worldwide with between 50,000 and 100,000 new cases each year.

Obstetric fistula is a hole in the birth canal that occurs when the baby becomes stuck during labour. In nearly all cases, without access to prompt medical intervention, it results in the death of the baby and leaves the woman suffering from severe health problems, including chronic incontinence and the shame, social exclusion and economic deprivation that often go hand in hand with this. Read the rest of this entry »

IanIan Currie, RCOG Vice President, UK Affairs writes…

Yesterday was International Day for Zero Tolerance for Female Genital Mutilation.

Previous estimates are that 66,000 women resident in England and Wales have undergone FGM and over 23,000 under the age of 15, from African communities, are at risk of, or may have undergone FGM. Globally, according to the WHO, between 100 and 140 million girls and women worldwide are currently living with the consequences of FGM.

FGM is an abuse of human rights and a form of violence against children and women. We must do what we can to eradicate this harmful and unacceptable practice.

Back in November last year, the RCOG along with the RCM, RCN, Community Practitioners and Health Visitors Association (CPHVA) and Equality Now launched a ground-breaking report Tackling FGM in the UK: Intercollegiate recommendations for identifying, recording and reporting, which for the first time, openly recognised FGM as a form of child abuse.

The recommendations provide policy advice for commissioners and different service providers in the UK to better identify, monitor and protect girls and women from at-risk communities, focusing on issues such as the lack data collection and systematic sharing of information empowering frontline professionals and potential victims and holding professionals to account.

Much progress has been made over the past three years to mainstream FGM into existing strategies and close gaps in the identification, recording and sharing of information including; the Department of Health has funded a feasibility study on the inclusion of FGM data in the Hospital Episode Statistics (HES), the Home Office is producing an FGM toolkit for affected areas in the UK, the APPG on FGM successfully advocated for the inclusion of FGM in OFSTED inspections, the London Metropolitan Police Force has set up a strategy group on FGM and is proactively engaged in creating prosecution opportunities and the Department for International Development (DIFID) launched an ambitious £35 million programme towards ending FGM in Africa.

However, there have been no prosecutions to date in the UK, despite the fact that FGM has been a criminal offence under the Prohibition of Female Circumcision Act (1985) which was updated and replaced by the Female Genital Mutilation Act in 2003. This is a constant reminder of the work that still needs to be done and we must keep up the momentum.

To mark International Day for Zero Tolerance for FGM this year, we welcome the various departmental announcements that demonstrate the Government’s commitment to progressing the Intercollegiate Group recommendations, especially the Department of Health’s announcement, making it mandatory for all NHS acute hospitals to provide information on patients who have undergone female genital mutilation. It is extremely promising and we remain very positive of the activities that will spring from these announcements.

Furthermore, the Home Affairs Committee is currently conducting a new inquiry into FGM which seeks to determine why there has yet to have been a single prosecution in the UK, as well as considering what more needs to be done to protect at-risk girls. The Intercollegiate Group are submitting written evidence to this inquiry which will concentrate on our recommendations to improve integration across health and social care settings and the fact that early intervention is key to FGM prevention.

Lastly, I must reiterate that all health and social care professionals have a pivotal role to play in identifying, sharing information and reporting cases in order to end this barbaric practice. It is the duty of doctors, nurses, midwives and health visitors to identify the girls whom they believe are at-risk and to share such information in good faith with the local safeguarding networks so these girls can be monitored and protected by social services.

Healthcare professionals working in the community are key to the successful implementation of the Intercollegiate Group recommendations in the UK. Constant vigilance is needed and we must ensure we protect the girls and women entrusted to our care.


IanWe recently published a paper into the ethical considerations in relation to female genital cosmetic surgery (FGCS), procedures which change the structure and appearance of the healthy external genitalia of women, or internally in the case of vaginal tightening.

We are concerned about the growing number of women opting for cosmetic gynaecological surgery; Hospital Episode Statistics suggest the number of labial reduction procedures has risen five-fold in the NHS over the past 10 years, with over 2000 operations having been performed in 2010. However, many more procedures may be taking place in the private sector.

Our paper was produced by The RCOG Ethics Committee which considers ethical aspects and legal implications of matters of concern affecting the practice of obstetrics and gynaecology. I commend Dame Suzie Leather, the Chair of the Committee, for both her work on the paper and for playing a lead role in its successful launch. Read the rest of this entry »