This report presents key findings and recommendations based on the analysis of data from 2016 relating to the care given to mothers and babies throughout the UK, to ensure each baby receives the safest possible care during labour. The report makes a number of recommendations including addressing workload issues, an individualised management plan for women during antenatal, labour and postnatal care, and ensuring local guidelines are updated in line with national guidance. Each Baby Counts is a clinical quality improvement programme that aims to halve the number of stillbirths and babies who die or are left severely disabled due to incidents during term labour by 2020.
The Nuffield Trust has published an ‘explainer’ Understanding the health of babies and expectant mothers. This article looks at the possible reasons why progress on stillbirths and neonatal and infant mortality has slowed down in the UK in recent years and what can be done about it.
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.