NHS England has published ‘Saving Babies’ Lives Care Bundle’, its new guidance aimed at reducing the number of stillbirths in England each year. NHS England estimates that there are over 3,000 stillbirths each year in England – about one in every 200 babies. The aim of the guidance is to halve the current rate of stillbirths within 15 years.
The guidance focuses on four key elements of care where NHS England considers that better guidance and procedures will make a difference and reduce the incidence of stillbirth. NHS England involved the Royal College of Obstetricians, the Royal College of Midwives, and Sands, the stillbirth and neonatal death charity which provides support to those suffering stillbirth, in developing the guidance.
The four key interventions outlined include:
- Advice to pregnant women who smoke about the risks it presents and support them to stop smoking.
- Enhancing detection of fetal growth restriction – better monitoring of growth of babies and clear guidelines for parameters about monitoring and further action needed. The guidance highlights that, of the one in 200 babies who are stillborn, growth-restricted babies are the single largest preventable group.
- Improving awareness of the importance of fetal movement – women and their partners should be better informed and more empowered to monitor their baby’s movements by clear, consistent advice. An information and advice leaflet on reduced fetal movement will be provided to all pregnant women and protocols should be implemented to manage care effectively for women who report reduced movement.
- Improving fetal monitoring during labour – looking at training and also the sharing of responsibility for monitoring.
Simon Stevens, the Chief Executive of NHS England, said: “As the Sunday Times has rightly argued, we could cut the chances [of stillbirths] happening if all pregnant mums were encouraged to quit smoking, if proper monitoring takes place during pregnancy, and if maternity providers listen carefully when pregnant women report worries about their baby’s movements. That’s what this new NHS ‘care bundle’ – developed by obstetricians, midwives, and parents – now recommends as the best standard of care everywhere. It brings together evidence-based best practice to support midwives and doctors and is a key step in driving forward safer care as set out in the recently published national Maternity Review.”
Philippa Luscombe, partner in the clinical negligence team, comments: “We welcome this new guidance as we deal with a number of clinical negligence claims each year, mostly against hospitals, for parents who have suffered the trauma and loss of a stillbirth due to negligent medical care. The issues often relate to antenatal monitoring and failures to identify abnormalities or provide enough advice to mothers about when they should be concerned. But we are also seeing more stillbirths arising because of poor labour and delivery care – particularly for women in hospital giving birth out of hours and at the weekend when they may not receive the senior input that they need.
“Although bringing a claim enables parents to raise their concerns, get answers and, hopefully, achieve some learning within hospital trusts, the cases are heart-wrenching and compensation can never make up for the loss of their baby. We are therefore pleased to see a project aimed specifically at highlighting the steps that can be taken to reduce the number of stillbirths.”