Perinatal Pelvic Health Services (PPHS) support the prevention, identification, and treatment of pelvic health problems during pregnancy and for at least one year after birth. As of September 2026, PPHS are available in 34 of 36 integrated care board areas, with NHS England working with the remaining areas to achieve full national coverage. NHS England’s service specification sets standards for care, including providing women with information on pelvic health, potential problems, and how to access support during pregnancy and after birth. It also requires specialist-led training for maternity, primary care, and other relevant professionals.

NHS England’s postnatal toolkit promotes early identification and referral for women who need additional support, including access to specialist pelvic health services. The UK Chief Medical Officers’ physical activity guidelines recommend that postnatal women undertake regular physical activity and begin pelvic floor exercises when able, while the routine six to eight week postnatal general practice check provides an opportunity to discuss recovery, pelvic health, and mental health, with referral to specialist services where appropriate. Through the Women’s Health Strategy for England, the Government is also supporting integrated models of care that bring together maternity, gynaecology, primary care, pelvic health, health visiting, and perinatal mental health services to improve long-term outcomes for women.

Perinatal Pelvic Health Services (PPHS) support the prevention, identification, and treatment of pelvic health problems during pregnancy and for at least one year after birth. As of September 2026, PPHS are available in 34 of 36 integrated care board areas, with NHS England working with the remaining areas to achieve full national coverage. NHS England’s service specification sets standards for care, including providing women with information on pelvic health, potential problems, and how to access support during pregnancy and after birth. It also requires specialist-led training for maternity, primary care, and other relevant professionals.

NHS England’s postnatal toolkit promotes early identification and referral for women who need additional support, including access to specialist pelvic health services. The UK Chief Medical Officers’ physical activity guidelines recommend that postnatal women undertake regular physical activity and begin pelvic floor exercises when able, while the routine six to eight week postnatal general practice check provides an opportunity to discuss recovery, pelvic health, and mental health, with referral to specialist services where appropriate. Through the Women’s Health Strategy for England, the Government is also supporting integrated models of care that bring together maternity, gynaecology, primary care, pelvic health, health visiting, and perinatal mental health services to improve long-term outcomes for women.

We recognise the importance of tackling blood clots in pregnancy, also referred to as venous thromboembolism (VTE), as the leading cause of maternal death in England. The rate of maternal deaths from thrombosis and thromboembolism rose substantially between 2009 to 2011 and 2021 to 2023, from 1.26 to 2.13 per 100,000, in maternity, with rising rates of maternal obesity, advanced maternal age, and births by caesarean section likely contributing factors.

VTE is thought to occur in approximately one of 500 pregnancies, and the approach to minimising risk has therefore focused on universal risk assessment, targeted information, and preventative treatment for those considered to be at high risk. Last year, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK identified the need for improved VTE risk assessment, better pathways for rapid access to thromboprophylaxis in early pregnancy, and more robust training for clinicians.

NHS England published the Maternal Care Bundle in January 2026, with the aim to reduce maternal mortality and morbidity and reduce inequalities in these adverse outcomes. Element 1 requires the National Health Service to implement a new, simplified, national self-assessment questionnaire on VTE risk, for all women at their first NHS care contact with a positive pregnancy test, and ensure that those considered at highest risk have a discussion with a prescriber, and are offered low molecular weight heparin within 72 hours. Services have been asked through Element 1 of the Maternal Care Bundle to adopt Thrombosis UK’s early pregnancy blood clot risk questionnaire, which has information on the risk of VTE in pregnancy. All NHS trusts providing maternity services are responsible for fully implementing the Maternal Care Bundle by March 2027. This includes providing regular reports to the trust board on implementation.

All midwives are trained to discuss VTE symptoms with all women at the first contact in pregnancy and through to postnatal contacts, as part of the standard assessment process. Clinical guidance that directs their training includes the National Institute for Health and Care Excellence’s postnatal care guidance, reference code NG194, and Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism, reference code NG89.

Baroness Amos’ final report of her independent National Investigation into Maternity and Neonatal Services in England has recommended that the NHS commissions and delivers ‘antenatal education that reflects the realities of pregnancy and birth today’. The Government will work with the national Maternity and Neonatal Taskforce on the response to this recommendation, including on information women require regarding the risk of VTE.

Locally, some individual trusts also produce additional information for women and their families about reducing the risk of blood clots and VTE in pregnancy.

We recognise the importance of tackling blood clots in pregnancy, also referred to as venous thromboembolism (VTE), as the leading cause of maternal death in England. The rate of maternal deaths from thrombosis and thromboembolism rose substantially between 2009 to 2011 and 2021 to 2023, from 1.26 to 2.13 per 100,000, in maternity, with rising rates of maternal obesity, advanced maternal age, and births by caesarean section likely contributing factors.

VTE is thought to occur in approximately one of 500 pregnancies, and the approach to minimising risk has therefore focused on universal risk assessment, targeted information, and preventative treatment for those considered to be at high risk. Last year, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK identified the need for improved VTE risk assessment, better pathways for rapid access to thromboprophylaxis in early pregnancy, and more robust training for clinicians.

NHS England published the Maternal Care Bundle in January 2026, with the aim to reduce maternal mortality and morbidity and reduce inequalities in these adverse outcomes. Element 1 requires the National Health Service to implement a new, simplified, national self-assessment questionnaire on VTE risk, for all women at their first NHS care contact with a positive pregnancy test, and ensure that those considered at highest risk have a discussion with a prescriber, and are offered low molecular weight heparin within 72 hours. Services have been asked through Element 1 of the Maternal Care Bundle to adopt Thrombosis UK’s early pregnancy blood clot risk questionnaire, which has information on the risk of VTE in pregnancy. All NHS trusts providing maternity services are responsible for fully implementing the Maternal Care Bundle by March 2027. This includes providing regular reports to the trust board on implementation.

All midwives are trained to discuss VTE symptoms with all women at the first contact in pregnancy and through to postnatal contacts, as part of the standard assessment process. Clinical guidance that directs their training includes the National Institute for Health and Care Excellence’s postnatal care guidance, reference code NG194, and Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism, reference code NG89.

Baroness Amos’ final report of her independent National Investigation into Maternity and Neonatal Services in England has recommended that the NHS commissions and delivers ‘antenatal education that reflects the realities of pregnancy and birth today’. The Government will work with the national Maternity and Neonatal Taskforce on the response to this recommendation, including on information women require regarding the risk of VTE.

Locally, some individual trusts also produce additional information for women and their families about reducing the risk of blood clots and VTE in pregnancy.

We recognise the importance of tackling blood clots in pregnancy, also referred to as venous thromboembolism (VTE), as the leading cause of maternal death in England. The rate of maternal deaths from thrombosis and thromboembolism rose substantially between 2009 to 2011 and 2021 to 2023, from 1.26 to 2.13 per 100,000, in maternity, with rising rates of maternal obesity, advanced maternal age, and births by caesarean section likely contributing factors.

VTE is thought to occur in approximately one of 500 pregnancies, and the approach to minimising risk has therefore focused on universal risk assessment, targeted information, and preventative treatment for those considered to be at high risk. Last year, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK identified the need for improved VTE risk assessment, better pathways for rapid access to thromboprophylaxis in early pregnancy, and more robust training for clinicians.

NHS England published the Maternal Care Bundle in January 2026, with the aim to reduce maternal mortality and morbidity and reduce inequalities in these adverse outcomes. Element 1 requires the National Health Service to implement a new, simplified, national self-assessment questionnaire on VTE risk, for all women at their first NHS care contact with a positive pregnancy test, and ensure that those considered at highest risk have a discussion with a prescriber, and are offered low molecular weight heparin within 72 hours. Services have been asked through Element 1 of the Maternal Care Bundle to adopt Thrombosis UK’s early pregnancy blood clot risk questionnaire, which has information on the risk of VTE in pregnancy. All NHS trusts providing maternity services are responsible for fully implementing the Maternal Care Bundle by March 2027. This includes providing regular reports to the trust board on implementation.

All midwives are trained to discuss VTE symptoms with all women at the first contact in pregnancy and through to postnatal contacts, as part of the standard assessment process. Clinical guidance that directs their training includes the National Institute for Health and Care Excellence’s postnatal care guidance, reference code NG194, and Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism, reference code NG89.

Baroness Amos’ final report of her independent National Investigation into Maternity and Neonatal Services in England has recommended that the NHS commissions and delivers ‘antenatal education that reflects the realities of pregnancy and birth today’. The Government will work with the national Maternity and Neonatal Taskforce on the response to this recommendation, including on information women require regarding the risk of VTE.

Locally, some individual trusts also produce additional information for women and their families about reducing the risk of blood clots and VTE in pregnancy.

We recognise the importance of tackling blood clots in pregnancy, also referred to as venous thromboembolism (VTE), as the leading cause of maternal death in England. The rate of maternal deaths from thrombosis and thromboembolism rose substantially between 2009 to 2011 and 2021 to 2023, from 1.26 to 2.13 per 100,000, in maternity, with rising rates of maternal obesity, advanced maternal age, and births by caesarean section likely contributing factors.

VTE is thought to occur in approximately one of 500 pregnancies, and the approach to minimising risk has therefore focused on universal risk assessment, targeted information, and preventative treatment for those considered to be at high risk. Last year, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK identified the need for improved VTE risk assessment, better pathways for rapid access to thromboprophylaxis in early pregnancy, and more robust training for clinicians.

NHS England published the Maternal Care Bundle in January 2026, with the aim to reduce maternal mortality and morbidity and reduce inequalities in these adverse outcomes. Element 1 requires the National Health Service to implement a new, simplified, national self-assessment questionnaire on VTE risk, for all women at their first NHS care contact with a positive pregnancy test, and ensure that those considered at highest risk have a discussion with a prescriber, and are offered low molecular weight heparin within 72 hours. Services have been asked through Element 1 of the Maternal Care Bundle to adopt Thrombosis UK’s early pregnancy blood clot risk questionnaire, which has information on the risk of VTE in pregnancy. All NHS trusts providing maternity services are responsible for fully implementing the Maternal Care Bundle by March 2027. This includes providing regular reports to the trust board on implementation.

All midwives are trained to discuss VTE symptoms with all women at the first contact in pregnancy and through to postnatal contacts, as part of the standard assessment process. Clinical guidance that directs their training includes the National Institute for Health and Care Excellence’s postnatal care guidance, reference code NG194, and Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism, reference code NG89.

Baroness Amos’ final report of her independent National Investigation into Maternity and Neonatal Services in England has recommended that the NHS commissions and delivers ‘antenatal education that reflects the realities of pregnancy and birth today’. The Government will work with the national Maternity and Neonatal Taskforce on the response to this recommendation, including on information women require regarding the risk of VTE.

Locally, some individual trusts also produce additional information for women and their families about reducing the risk of blood clots and VTE in pregnancy.

We recognise the importance of tackling blood clots in pregnancy, also referred to as venous thromboembolism (VTE), as the leading cause of maternal death in England. The rate of maternal deaths from thrombosis and thromboembolism rose substantially between 2009 to 2011 and 2021 to 2023, from 1.26 to 2.13 per 100,000, in maternity, with rising rates of maternal obesity, advanced maternal age, and births by caesarean section likely contributing factors.

VTE is thought to occur in approximately one of 500 pregnancies, and the approach to minimising risk has therefore focused on universal risk assessment, targeted information, and preventative treatment for those considered to be at high risk. Last year, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK identified the need for improved VTE risk assessment, better pathways for rapid access to thromboprophylaxis in early pregnancy, and more robust training for clinicians.

NHS England published the Maternal Care Bundle in January 2026, with the aim to reduce maternal mortality and morbidity and reduce inequalities in these adverse outcomes. Element 1 requires the National Health Service to implement a new, simplified, national self-assessment questionnaire on VTE risk, for all women at their first NHS care contact with a positive pregnancy test, and ensure that those considered at highest risk have a discussion with a prescriber, and are offered low molecular weight heparin within 72 hours. Services have been asked through Element 1 of the Maternal Care Bundle to adopt Thrombosis UK’s early pregnancy blood clot risk questionnaire, which has information on the risk of VTE in pregnancy. All NHS trusts providing maternity services are responsible for fully implementing the Maternal Care Bundle by March 2027. This includes providing regular reports to the trust board on implementation.

All midwives are trained to discuss VTE symptoms with all women at the first contact in pregnancy and through to postnatal contacts, as part of the standard assessment process. Clinical guidance that directs their training includes the National Institute for Health and Care Excellence’s postnatal care guidance, reference code NG194, and Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism, reference code NG89.

Baroness Amos’ final report of her independent National Investigation into Maternity and Neonatal Services in England has recommended that the NHS commissions and delivers ‘antenatal education that reflects the realities of pregnancy and birth today’. The Government will work with the national Maternity and Neonatal Taskforce on the response to this recommendation, including on information women require regarding the risk of VTE.

Locally, some individual trusts also produce additional information for women and their families about reducing the risk of blood clots and VTE in pregnancy.

The Government and NHS England remain committed to ensuring safe, personalised, and evidence-based maternity care, grounded in informed choice.

We recognise that caesarean birth is major abdominal surgery, and that recovery can place additional physical and emotional demands on women and their families in the early weeks and months after birth. Whilst there is no specific routine, long-term follow up post caesarean section, all women who have given birth should be offered a six to eight week postnatal consultation with a general practitioner covering both physical and mental health.

The National Institute for Health and Care Excellence’s guideline on caesarean birth, reference code NG192, makes clear that women require structured postnatal support following surgery, including effective pain management, early mobilisation, monitoring of wound healing and complications, and support with infant feeding and care.

The National Health Service does not attribute the increase in the number of caesarean births to a single cause, as it is influenced by many factors, including women choosing to have a caesarean birth, higher rates of pre-existing health conditions, and more pregnancies involving complications.

The Government and NHS England remain committed to ensuring safe, personalised, and evidence-based maternity care, grounded in informed choice.

We recognise that caesarean birth is major abdominal surgery, and that recovery can place additional physical and emotional demands on women and their families in the early weeks and months after birth. Whilst there is no specific routine, long-term follow up post caesarean section, all women who have given birth should be offered a six to eight week postnatal consultation with a general practitioner covering both physical and mental health.

The National Institute for Health and Care Excellence’s guideline on caesarean birth, reference code NG192, makes clear that women require structured postnatal support following surgery, including effective pain management, early mobilisation, monitoring of wound healing and complications, and support with infant feeding and care.

The National Health Service does not attribute the increase in the number of caesarean births to a single cause, as it is influenced by many factors, including women choosing to have a caesarean birth, higher rates of pre-existing health conditions, and more pregnancies involving complications.

The Government and NHS England remain committed to ensuring safe, personalised, and evidence-based maternity care, grounded in informed choice.

We recognise that caesarean birth is major abdominal surgery, and that recovery can place additional physical and emotional demands on women and their families in the early weeks and months after birth. Whilst there is no specific routine, long-term follow up post caesarean section, all women who have given birth should be offered a six to eight week postnatal consultation with a general practitioner covering both physical and mental health.

The National Institute for Health and Care Excellence’s guideline on caesarean birth, reference code NG192, makes clear that women require structured postnatal support following surgery, including effective pain management, early mobilisation, monitoring of wound healing and complications, and support with infant feeding and care.

The National Health Service does not attribute the increase in the number of caesarean births to a single cause, as it is influenced by many factors, including women choosing to have a caesarean birth, higher rates of pre-existing health conditions, and more pregnancies involving complications.

The Government and NHS England remain committed to ensuring safe, personalised, and evidence-based maternity care, grounded in informed choice.

We recognise that caesarean birth is major abdominal surgery, and that recovery can place additional physical and emotional demands on women and their families in the early weeks and months after birth. Whilst there is no specific routine, long-term follow up post caesarean section, all women who have given birth should be offered a six to eight week postnatal consultation with a general practitioner covering both physical and mental health.

The National Institute for Health and Care Excellence’s guideline on caesarean birth, reference code NG192, makes clear that women require structured postnatal support following surgery, including effective pain management, early mobilisation, monitoring of wound healing and complications, and support with infant feeding and care.

The National Health Service does not attribute the increase in the number of caesarean births to a single cause, as it is influenced by many factors, including women choosing to have a caesarean birth, higher rates of pre-existing health conditions, and more pregnancies involving complications.

The Department does not hold this information. NHS England has published guidance written in collaboration with the Royal College of General Practitioners on the six-to-eight week postnatal check-up for all women who have given birth. This provides an important opportunity for general practitioners to listen to women in a discreet, supportive environment to provide personalised postnatal care for their physical and mental health and support them with family planning.

Local authorities have responsibility for commissioning public health services, including health visiting and services for all new parents. The Healthy Child Programme sets out the services and support families can expect and includes guidance on weighing, screening, immunisation, health improvement, wellbeing, and parenting, as well as five mandated health and development reviews.

Department officials and NHS England have worked across the South East region to develop resources. This includes a Health Visiting Development Toolkit to help share best practice and ensure consistency.

The Government is committed to raising the healthiest generation of children ever and strengthening the health visiting service. To achieve this, we must ensure that families have the support they need to give their babies and children the best start and the building blocks for a healthy life.

The Department recognises the significant physical and psychological consequences of birth trauma and the devastating impact this can have on some women. We are fully committed to improving the quality and consistency of care for women throughout pregnancy, birth, and the critical months that follow, and ensuring that when a woman experiences a traumatic birth, there is a broad range of support available.

The National Health Service is in its final year of implementing the Three-Year Delivery Plan for Maternity and Neonatal Services. As part of this plan, there is a commitment to improving postnatal care for all women and babies, including those affected by birth trauma. This includes ensuring the provision of high-quality, personalised, and joined-up care throughout the postnatal period.

NHS England has published guidance, written in collaboration with the Royal College of General Practitioners, on the six-to-eight-week postnatal check-up for all women who have given birth. This provides an important opportunity for general practitioners to listen to women in a discreet, supportive environment, to provide personalised postnatal care for their physical and mental health, and to support them with family planning. This includes an explicit reference to birth trauma for the first time. Additionally, a range of specialist mental health services have been made available to women during the perinatal period, as well as physical health services like Perinatal Pelvic Health Services. As of April 2025, 25 of the 42 local systems have perinatal pelvic health services in place, and NHS England is working closely with the remaining areas who are not compliant.

We continue to work with NHS England as it delivers its three-year maternity and neonatal plan to grow the workforce, develop a culture of safety, and ensure women and babies receive safe, personalised, and compassionate care. We know there is much more we need to do, however good progress has been made, including:

• improving access to specialist perinatal mental health services for women before, during, and after pregnancy. A record 63,345 women have accessed a specialist community perinatal mental health service or maternal mental health services in the 12 months to January 2025;
• implementing a revised package of interventions in the Saving Babies Lives Care Bundle to reduce stillbirths, neonatal brain injury, neonatal death, and preterm birth, as well as initiatives to reduce inequalities;
• establishing 14 maternal medicine networks to ensure that women with chronic and acute medical problems related to pregnancy have access to specialist management and care;
• all Maternity and Neonatal units completing the Perinatal Culture and Leadership Programme, to establish a more compassionate culture in the National Health Service;
• putting women and families at the heart of local decision making, with increased funding for Maternity and Neonatal Voice Partnerships; and
• publishing new guidance so women are offered a general practice appointment six to eight weeks after birth, to provide personalised postnatal care and to solely focus on the physical and mental health of the woman.

The National Health Service’s Three-Year Delivery Plan for Maternity and Neonatal Services sets national measures to improve maternity and neonatal services through all stages of pregnancy and beyond. Measures include making care more personalised and equitable, covering both physical and mental health, and extending postnatal care and support for new mothers.

There is now a range of postnatal and mental health support, as well as broader support available for new mothers. For example, all women who have given birth should be offered a check-up with their general practitioner (GP) six to eight weeks after giving birth. The check-up will cover a range of topics such as mental health, physical recovery, breastfeeding, and support with family planning. This check provides an important opportunity for women to be listened to by their GP in a discreet, supportive environment, to provide personalised postnatal care for their physical and mental health.

NHS England is also rolling out perinatal pelvic health services and maternal mental health services to support women with the physical and mental impact of birth. Bespoke mental health pathways support women who experience mental health difficulties as a result of labour. These services are provided through specialist perinatal mental health services, maternal mental health services, and mother and baby units.

As part of the plan, all local areas have now also published Equity and Equality Action Plans, setting out tailored interventions that will tackle inequalities for women and babies from ethnic backgrounds and those living in the most deprived areas.

The Department recognises the significant physical and psychological consequences of birth trauma and the devastating impact this can have on some women. We are fully committed to improving the quality and consistency of care for women throughout pregnancy, birth, and the critical months that follow, and to ensuring that when a woman experiences a traumatic birth, there is a broad range of support available

In relation to the psychological impact, bespoke mental health pathways support women who experience mental health difficulties as a result of labour. These services are provided through specialist perinatal mental health services, maternal mental health services, and mother and baby units. Mother and baby units are specialist, in-patient units for some women with mental health problems, designed to keep mothers and their babies together. Specialist staff nurture and support the mother infant relationship on the ward, while at the same time the mother receives treatment and care. 165 mother and baby unit beds have now been commissioned, and maternal mental health services have been set up in 41 out of the 42 local areas across England to provide care for women with moderate to severe or complex mental health difficulties, arising from birth trauma or loss in the maternity/neonatal context.

With regards to physical health, NHS England’s national service specification for perinatal pelvic health services sets out the expected standards of care to improve the prevention and identification of pelvic health issues, and to increase access to physiotherapy for pelvic health issues during pregnancy and for at least one year after birth. These services work with maternity services across England to implement the Royal College of Obstetricians and Gynaecologists’ Obstetric Anal Sphincter Injuries care bundle, to reduce rates of anal sphincter, or perineal, injuries resulting from labour and vaginal birth.

All women are now offered a general practitioner (GP) check six to eight weeks after birth that should focus on the mothers physical and mental health needs. This is an opportunity for GPs to listen to women in a discrete, supportive environment, in order to provide personalised postnatal care for their physical and mental health, and includes an explicit reference to birth trauma for the first time.