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The role of genomics in midwifery

For Genomics Conversation Week 2022, Angela Crosby, Antenatal and Newborn Screening Coordinator, United Lincolnshire Hospitals NHS Trust (ULHT), talks about the role of her team and the impact genomics has in their work.

Angela Crosby heads up a small team providing the NHS antenatal and newborn screening programmes to individuals accessing maternity care at the Trust.

The team work with women and families who are identified as being at an increased chance of, or are known to have babies with, potential genetic conditions. They ensure they receive the appropriate care, support and specialist information from the start of pregnancy into early postnatal period.

Angela and her colleagues provide support to around 200 midwives within the Trust, equipping them with the knowledge and training so they can confidently offer the appropriate screening programmes.

All midwives need to have a basic understanding of genomics – that’s how our genes, including DNA, interact with our health – as questions or concerns relating to it can surface at any point during pregnancy.

Angela Crosby
Angela Crosby and colleague Stacey
Angela (right) alongside her Antenatal & Newborn Screening Midwife, Stacey Harris

“Indeed, at the woman’s first midwife appointment, also called the booking appointment, the midwife asks whether the woman has any health issues, and also if there are any health issues in her family. Technological advances mean that women and their families can be offered a wider range of screening and testing.”

“As midwives we need to understand the science behind the tests we are offering, to ensure that the women and families we offer care to, understand the screening they are being offered and make an informed choice about whether they wish to enter a particular screening pathway. All midwives receive an annual update on antenatal and newborn screening, to ensure they fully understand and can explain to families any new programmes. This training involves discussions surrounding inheritance patterns of the conditions we screen for in pregnancy, for example haemoglobinopathies (Sickle cell and Thalassaemia).”

“We also receive referrals from genetics departments for women in early stages of pregnancy, when a clinical geneticist is aware of a potential prenatal concern or condition that midwives and the obstetric teams need to be aware of. They can then put a comprehensive pregnancy care plan in place for the woman and her baby. Genomic testing may also need to be offered at any point in a pregnancy, particularly if there are concerns after a fetal anomaly scan; this can help confirm a condition for the family and allows the multi-disciplinary team to plan the woman and baby’s care.”

“We offer support for families through this time, along with our obstetric consultants and genetic counsellors when necessary. If a baby is diagnosed with a condition then the genetics team will lead discussions with the woman and we will be there as a support.”

The advances in screening and genomic testing, including pre-natal testing enable women and their families to have access to more information, if they want it.

Angela

She added:

"It allows those women to have a greater knowledge, which in turn allows them make informed choices about their pregnancy and understand what the results mean for their baby.”

“The role of an antenatal and newborn screening coordinator has certainly increased over the years. It is an ever changing area of midwifery. The advances in screening and genomic testing, including pre-natal testing enable women and their families to have access to more information, if they want it; and allows them to have a greater knowledge, which in turn allows them make informed choices about their pregnancy and understand what the results mean for their baby .”

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About the team

Angela is the Antenatal & Newborn Screening Coordinator for ULHT and leads a small team comprised of one other Midwife and a clerical support officer. The team liaise closely with the specialist teams at Nottingham University Hospitals NHS Trust and United Leicester Hospitals NHS Trust as needed.

About the Trust

United Lincolnshire Hospitals NHS Trust (ULHT) is one of the largest Trusts in the country. It provides a comprehensive range of hospital-based medical, surgical, paediatric, obstetric and gynaecological services to the 700,000 people of Lincolnshire.

Lincoln County Hospital and Pilgrim Hospital Boston provide a full range of obstetric services. Alongside these are a hospital at Grantham and three community hospitals (Skegness, Spalding and Gainsborough) which offer antenatal and community care to families accessing maternity care in Lincolnshire.