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Adopt national initiative to stave off annual stillbirth toll, urges NHS England

Stillbirths fifth lower at maternity units where Saving Babies Lives Care Bundle implemented

Caroline White

Monday, 30 July 2018

An estimated 600 stillbirths could be prevented every year if maternity units adopted national best practice, calculates NHS England (NHSE) in the wake of an independent evaluation of the Saving Babies Care Bundle.

The detailed analysis shows that stillbirths fell by a fifth at the maternity units where the Saving Babies Lives Care Bundle had been implemented, with more than 160 lives saved across 19 sites.

The best practice guidance, which includes better monitoring of a baby’s growth and movement in pregnancy, and during labour, is now being introduced across the country. It has the potential, if these findings were replicated, to prevent an estimated 600 stillbirths, says NHSE.

The Saving Babies Lives Care Bundle is part of plans by NHSE to make maternity care safer and more personal.

Dr Matthew Jolly, national clinical director for maternity and women’s health at NHSE, said: “These findings show significant progress in the reduction of stillbirth rates. This is thanks to the dedicated maternity staff who have developed and implemented the clinical measures we recommend as national best practice. We know more can be done to avoid the tragedy of stillbirth and as we develop the 10-year plan for the NHS, we want to build on the progress we’ve made to make maternity services in England among the safest in the world.”

Health and social care secretary Matt Hancock, added “There is nothing more devastating than losing a child so this improvement is welcome and testament to the incredible NHS maternity staff who do everything they can to improve care; saving many babies’ lives as a result.

“We still have more to do but these results demonstrate really positive progress towards our ambition to halve the rates of stillbirth, neonatal death and maternal death by 2025.”

Jane Brewin, CEO at Tommy’s Centre for Stillbirth Research, which was involved in devising the Saving Babies Care Bundle, said: “When all maternity units adopt this programme, fewer families will have to experience the tragedy of stillbirth which destroys so many family’s hopes and dreams. We are finally making progress towards making this country the safest place to give birth in the world and that’s something really worth striving for.”

There are currently around 665,000 babies born in England each year, but despite falling to its lowest rate in 20 years, one in every 200 is stillborn.

The analysis showed a 59 per cent increase in the detection of small babies attributed to better monitoring and scanning in pregnancy and better awareness of a baby’s movement in pregnancy, with high numbers of women attending hospital due to reduced movement.

Carbon monoxide testing for smoking in pregnancy, which is strongly associated with stillbirth, was almost universal.

The Smoking in Pregnancy Challenge Group, a coalition of health organisations, welcomed the progress made, but insisted that work still needed to be done to ensure a consistent approach around the country, including providing effective support to help women quit smoking during pregnancy.

The latest government data shows that while a number of NHS clinical commissioning groups are bringing rates of maternal smoking down rapidly, rates in some are stalling. As a result, the overall national rate has been stuck at just under 11 per cent for the past three years, which is some way off the government’s ambition of less than 6 per cent by 2022.

Professor Linda Bauld, deputy director of the UK Centre for Tobacco and Alcohol Studies and co-chair of the Smoking in Pregnancy Challenge Group, said: "Too many places are still not implementing best practice for supporting women to quit smoking. This has a real cost in babies’ lives. It's good to see this NHS initiative is having an impact but eight years after national guidance was issued there is no excuse for variation in practice."

Last week Public Health England published a new analysis of maternity data showing that women from the most deprived postcodes and in the youngest age group are the most likely to smoke before and during pregnancy.

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