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108 Maternity and Obstetrics 2020 | NMH Annual Rep t Mairéad Kilbride and Simon O'Connor with their newborn baby Emma. T he Poppy Clinic commenced as a postnatal maternal morbidity clinic in March 2013. It is run by Dr Laoise O'Brien and Advanced Midwife Practitioner (AMP), Caroline Brophy. It was initially established to deal with minor postnatal complications e.g. wound infections. It then expanded to include mothers who have had complicated deliveries at 6 weeks postnatal e.g. Preterm birth, HELLP Syndrome, PET, Caesarean section under general anaesthesia, postpartum haemorrhages. Notes are reviewed and a provisional plan is made for a next delivery All patients who have a third degree tear are seen at six weeks. This is to assess how these patients are and if there are any issues on history and examination then the routine referral to the Perineal Clinic is expedited. Any patient who is readmitted in the postnatal period is also reviewed in the clinic. Many women seem to understand what is happening while an inpatient but naturally their baby is the main point of focus at this time. The Poppy Clinic allows women to discuss events surrounding their delivery and this often allays fears about a subsequent pregnancy. Many women value this opportunity as questions often arise when patients go home. Patients are referred from the wards in conjunction with the postnatal ward rounds which take place on the wards twice weekly. GPs and PHNs can also refer patients as well as Non-Consultant Hospital Doctors (NCHDs) when they encounter a wound infection on call. Attendances at the clinic continue to rise annually with a decrease in the DNA rate this year to 15.8%. We now have a Registrar and an SHO at every clinic. Many of our patients are seen on more than one occasion and a few are seen 4-5 times in the postnatal period. 20 patients had a General Anaesthesia for revision of episiotomies/ removal of granulation tissue. The Postnatal Clinic and ward rounds are run with advice and guidance from Dr Susan Knowles (Consultant Microbiologist). Clinic Activity Attended Did Not Attend DNA rate 2013 122 30 19.7% 2014 425 106 20.0% 2015 411 96 18.9% 2016 505 107 17.5% 2017 544 171 23.4% 2018 621 148 19.2% 2019 667 125 15.8% 2020* 720 89 11.6% *includes 40 virtual attendances A separate Postnatal Debriefing Clinic run by Consultant Obstetrician, Dr Michael Robson and Labour and Birthing Unit Manager, Martina Cronin is provided for women who have had a traumatic delivery and offers a relaxed environment and generous time allocation to facilitate open discussion and debriefing. Caroline Brophy became an Advanced Midwife Practitioner (AMP) in August 2020 and runs her own AMP clinic weekly as well as the Poppy Clinic above. This clinic facilitates registrar debriefing clinics so that NCHDs can see patients whom they cared for directly. Wounds are seen on the wards when readmitted and there is a service to see a perineum or caesarean section wound daily in the emergency room. Postnatal Poppy Clinic