Provide funding for STI screening at the beginning of a pregnancy

On 14/09/2023 I gave birth to my daughter, Harper Rose at 18wks 3days pregnant due to an infection. Harper Rose lived for 30 minutes before sadly passing away. 4 days later I found out that I had 2 STIs.

I want STI screening to be offered as part of routine testing at the beginning of a pregnancy.

If I had been checked at the start of my pregnancy and the STIs were found, my daughter may still be with me today.

The loss of a child in any circumstance is devastating and we send our condolences to the family of Harper Rose.

National screening programmes are recommended by the UK National Screening Committee (UK NSC). This is an independent scientific committee which advises Ministers and the NHS in all four UK countries on all aspects of screening and supports implementation. The committee makes a positive recommendation where evidence shows that a screening programme will, on balance, benefit the population to whom it is offered.

Currently pregnant women are offered screening (via a blood test) for three infectious diseases (HIV, syphilis and Hepatitis B) that can be transmitted sexually. Screening happens at around 10 weeks’ gestation so any treatment and care can be started early to reduce the risk of women passing on the infection to their baby. Further details can be found online at https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby/infectious-diseases

The UK NSC has previously reviewed evidence and considered screening programmes for chlamydia and for genital herpes, but concluded in each case it should not be recommended. This was due to there not being enough evidence on:

· the accuracy of the test and effectiveness of treatment for genital herpes; and, · whether chlamydia screening would have a negative effect on a pregnancy, whether it would benefit the pregnancy or baby, and whether there are adverse effects of treatment during pregnancy.

The UK NSC has previously also reviewed screening for HTLV (human lymphotropic virus 1) and recommended not to screen.

The UK NSC recognises that screening programmes are not static. Over time they may need to change to be more effective, and new screening programmes may be introduced. New programmes could be population based or targeted at specific groups at higher risk. Changes to a current screening programme or suggestions for new conditions can be submitted to the UK NSC for consideration via its annual call process (https://nationalscreening.blog.gov.uk/2023/08/15/uk-nscs-next-annual-call-for-topics-will-open-on-1-july-2024/).

Information on NHS.UK (https://www.nhs.uk/pregnancy/keeping-well/infections-that-may-affect-your-baby/) advises that if a pregnant woman has any reason to think she or her partner may have a sexually transmitted infection (STI), she should ask her GP or midwife about being tested – even if she does not have symptoms. Testing is also offered at sexual health clinics. Information on symptoms is available on NHS.UK (https://www.nhs.uk/conditions/sexually-transmitted-infections-stis/)

STIs can also affect a woman’s ability to get pregnant. If there is any chance a woman or her partner may have an STI, it is important to get tested when planning a pregnancy.

There are STI-specific clinical guidelines on management and treatment during pregnancy (either as part of wider guidance, or as standalone guidance), including those provided by the British Association for Sexual Health and HIV (BASHH).

Dedicated sexual health services play a key public health role in diagnosis, early treatment and management of STIs. Individual local authorities are responsible for funding and commissioning decisions about the sexual health services that best meet the needs of their local populations, including STI testing for pregnant women.

As a priority for implementing the Women’s Health Strategy for England, the Department of Health and Social Care is investing £25 million in women’s health hubs so women can get better access to care and essential services. Screening and treatment for STIs, HIV screening, and cervical screening are among the core services that hubs are expected to provide. Hubs link into existing care pathways for maternity and screening services and aim to improve access and user experience of existing services for eligible people.

Department of Health and Social Care