The Royal College of Obstetricians and Gynaecologists (RCOG) has today released its latest Each Baby Counts progress report.
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.
Every year in the UK over 1,000 babies die or are left with a brain injury during term labour. These are investigated at a local level by a hospital or maternity unit. The Each Baby Counts team had collated the results of these local investigations to make recommendations to improve future care on a national level.
Its report explains that different care could have led to different outcomes in almost three quarters of stillbirths, neonatal death and severe brain injury cases.
The investigation revealed that in almost half of these cases (45%), best practice and clinical guidelines were not followed – and the reasons given included gaps in training, lack of recognition of problems, communication issues, heavy workload, staffing levels and local guidelines not being based on best available evidence.
Of the nearly 700,000 babies born in 2016, 1,123 babies fulfilled the Each Baby Counts criteria. There were 124 stillbirths, 145 babies who died early and 854 babies who sustained severe brain injuries during labour at term (babies born after 37 completed weeks of gestation).
Nicky Lyon, a parent representative on the Each Baby Counts Advisory Group and co-founder of the Campaign for Safer Births, said:
“I feel the pain and sadness of the loss of my son, Harry, every day. Since its launch four years ago the RCOG Each Baby Counts project has gained incredibly valuable insight and information – information we did not previously have. This ground breaking project is now allowing us to understand the reasons why these tragedies occur and this report gives further recommendations for action. Nothing will change my situation or that of the families who have suffered loss like me, however we now have the knowledge and power to ensure others do not suffer.”
The RCOG is now calling for a national centre of excellence for maternity care in the UK, and has identified key areas of care in which improvements should be made, 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. The College has also called for the findings of local investigations to drive improvements in maternity care, and for all parents are invited to take part in reviews.
Professor Lesley Regan, President of the Royal College of Obstetricians and Gynaecologists, said:
“Now is the time to establish a national centre dedicated to make sure the UK is the safest place in the world for women and their babies. By bringing together the shared expertise and experience of women and families, frontline maternity teams, academics and policymakers would be a significant step forward in driving improvement across the country.”
In order to achieve this vision the RCOG, in partnership with the Royal College of Midwives and the Department of Health and Social Care are establishing a four-year programme of work with a number of maternity teams, focused on:
- supporting multi-professional learning and team working
- the translation and delivery of services against national strategy
- developing sustainable improvements in maternity services by disseminating best practice and learning locally and across the NHS.
In 2017 the National and Perinatal Audit highlighted the importance of obstetricians, midwives and neonatologists working collaboratively to deliver improved outcomes for women and their babies.
In response to the latest report, Health Minister, Jackie Doyle-Price, said“Whilst this report acknowledges that important progress has been made, there is still more to do to ensure every mother and child receives the world-class care they deserve as part of our ambition to halve the rates of stillbirths, neonatal deaths and brain injuries caused during and after birth by 2025. We are giving staff the support they need to continue to improve maternity safety and have made the largest every investment in midwifery training to ensure the NHS has the skills it needs.”
Doula UK recognises the unquestionable value of continuous and consistent care for all women, and wholeheartedly supports the Each Baby Counts initiative and the creation of a national centre of excellence for maternity care in the UK.
Read the full report here: https://www.rcog.org.uk/eachbabycounts
The Each Baby Counts definition of severe brain injury is based on information available within the first 7 days after birth. It is not yet known how many of these babies will have a significant long-term disability as a result of the injuries sustained during birth, but the fact that the majority of these infants require active therapeutic cooling – an intensive intervention requiring sedation and admission to the neonatal unit – reflects the serious clinical condition of these babies.
Each Baby Counts is the RCOG’s national quality improvement initiative to reduce by 50% the number of babies who die or are left severely disabled as a result of incidents occurring during term labour by 2020. The project has had a 100% participation rate with UK NHS Hospital Trusts. The development of the Each Baby Counts programme was supported by a grant from the Department of Health and a generous legacy donation from Dr Lindsay Stewart to the Royal College of Obstetricians and Gynaecologists. For more information, visit: https://www.rcog.org.uk/eachbabycounts
The Royal College of Obstetricians and Gynaecologists (RCOG) is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision. For more information, visit: https://www.rcog.org.uk/
Nicky, mother of Harry
“My son, Harry, was born with profound brain damage due to lack of oxygen at birth after what should have been a ‘normal’ hospital labour. I was ‘low risk’, had no problems during pregnancy and did everything I could to be healthy and protect my baby. I went into labour at 10 days overdue, rang the hospital and went in when advised.
“When Harry was born, he was resuscitated and put on a ventilator. When Harry was 4 weeks old, we were told he had profound brain damage due to the lack of oxygen at birth and were given the devastating news that he would never walk, talk or be able to feed normally.
“An investigation concluded that the CTG (heart trace) had not been read correctly and NICE guidelines for care in labour had not been followed.
“After a difficult life of tube feeding, constant sickness, fits and discomfort, our son died of a chest infection aged 18 months. As a family we have been left devastated at the loss of our beautiful boy.
“I’m so pleased that the RCOG has decided to take action on this issue with the Each Baby Counts project. Success of this project will mean hundreds of babies’ lives will be saved and families will not have to experience the terrible pain and heartache that we have suffered.”