Table 4 Psychological, social and health care needs of parents following MAC with clinical recommendations

Psychological

Potential anxiety in pregnancy

• Increased awareness of potential psychological distress and adjustment difficulties amongst health professionals in maternity services who provide care for individuals pregnant after MAC

• Psychological service provision which validates the potential psychological challenges within this client group

• Clinical Health Psychologists embedded within maternity services to disseminate psychological thinking, provide containment and intervention on an individual and systemic level

• Training for health professionals in identifying, monitoring and screening of emotional well-being for all individuals who successfully achieve pregnancy following MAC

• The offer of psychological support during MAC and resultant pregnancy to help individuals integrate and process their experiences, if required

• Consideration of the longer-term psychological needs to be considered incorporating difficulties relating to transition in identity and role. This could be achieved via psychologically informed antenatal and parenting groups or the offer of one-to-one therapeutic sessions focusing on the parent-infant relationship and bond

Social

The possibility of feeling excluded and marginalised

Possible reluctance to share distress and experiences due to fear of judgement, shame and stigma

• Normalisation and peer support groups to be offered to help reduce feelings of exclusion

• Incorporation of sociocultural factors such as religious values and beliefs when conducting assessment

• Individuals to be signposted to appropriate support services, if required

Healthcare

Reassurance and containment

• Promotion of consistency of care with MAC-aware midwives (in the absence of indication for consultant led care) antenatally and postnatally where individuals can develop trusting relationships with familiar health professionals

• Specialist training provided to midwives and consultants in relation to pregnancy and parenting after medicalised conception and infertility

• Health professionals to be proactive in fostering non-judgemental spaces, enquiring about the impact of MAC, validating experiences