Inducing labour after the due date slightly lowers the risk of stillbirth or infant death soon after birth compared with watchful waiting. But the overall risk is very low. Induced deliveries may reduce admissions to the neonatal intensive care unit.
Pregnant women having induced labour are less likely to have a caesarean section than those who wait for labour to begin naturally. They may have a slightly higher chance of needing an assisted vaginal birth (for example, using forceps or vacuum extraction).
Many pregnancies continue for longer than the average 40 weeks. Because of the risks to infants, women are often offered the option of induced labour at between 41 and 42 weeks. However, induction also carries risks to mother and baby, which must be weighed against potential benefits.
The findings from a large review of 30 trials are in line with NICE guidance and may help women to make informed choices about whether or when to induce labour.
NHS England have published a supporting offer to CCGs enabling them to make improvements against the maternity indicators chosen for the CCG Improvement and Assessment Framework. The document covers bespoke support plus initiatives in 9 work streams.
NHS England commissioned research indicates an estimated 600 stillbirths annually could be prevented if maternity units adopt national best practice. Evaluation of the implementation of the Saving Babies’ Lives Care Bundle in early adopter NHS Trusts in England shows that stillbirths fell by a fifth at the maternity units where national guidance, known as the Saving Babies Lives Care Bundle, had been implemented. Clinical improvements such as better monitoring of a baby’s growth and movement in pregnancy, as well as better monitoring in labour, meant maternity staff helped save more than 160 babies’ lives across 19 maternity units.
Read the NHS England blog entry, with additional links to a reduced fetal movements video and leaflet here
Go direct to Saving Babies’ Lives Care bundle overview here
This is the fourth MBRRACE-UK perinatal mortality surveillance report and provides information on extended perinatal deaths in the UK and Crown Dependencies arising from births during 2016. The report was carried out by Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK), a collaboration led from the National Perinatal Epidemiology Unit at the University of Oxford. The analysis focused on rates of stillbirth and neonatal death across the UK for all babies born at 24 weeks of gestation or more. In 2016, there were 780,043 births, 3,065 stillbirths and 1,337 neonatal deaths. According to the report, although the stillbirth and neonatal deaths rates overall are reducing over time, the reduction in these rates between 2013 and 2016 is only around 6.5%.
MBRRACE-UK webpage here Download the report and infographic etc here
Read the RCOG statement in response to MBRRACE-UK report on stillbirths and neonatal deaths here
The House of Commons library has published The Investigation of Still birth. This briefing document deals with the way stillbirth is investigated at present and the Government announcement about independent investigations in future.
The Department of Health has now published Safer Maternity Care: the National Maternity Safety Strategy progress and next steps. This document reports on progress and next steps with implementation of the safer maternity care action plan and sets out measures for further and quicker improvement. The Department has also published ‘Brain injury report’ which provides a working definition of brain injuries occurring during or soon after birth, and presents national annual brain injury rates from 2010 to 2015 for England
Families who suffer stillbirth or life-changing injuries to their babies will be offered an independent investigation to find out what went wrong and why. The government is also bringing forward from 2030 to 2025 the ambition to halve rates of stillbirths, neonatal and maternal deaths, and brain injuries occurring during or soon after birth.
Download the full report here Read the DH press release here Royal College of Midwives press release here
This report from MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) looks at the quality of care received by babies who were either still born or who died shortly after birth. It provides a picture of current challenges faced by maternity and neonatal units and an opportunity to improve services for women and families and prevent similar deaths in the future. This type of death occurred in 225 pregnancies in 2015 in the UK. Findings from the report include:
The rate of term, singleton, intrapartum stillbirth and intrapartum-related neonatal death has more than halved since 1993 representing a reduction of around 220 intrapartum deaths per year.
Capacity issues were identified as a problem in over a quarter of the cases undergoing panel review. The majority of staffing and capacity problems were related to delivery suite.
The panel consensus was that in nearly 80% of deaths improvements in care were identified which may have made a difference to the outcome for the baby
There is an increasing proportion of births to mothers who have risk factors associated with an increased risk of perinatal death
As well as the full report available here, you can read a lay summary here
an executive report and lay summary here
an infographic here.
The Royal College of Paediatrics and Child Health (RCPCH) have responded to the report here.
A joint response from the Royal College of Obstetricians and Gynaecologists/Royal College of Midwives is also available here