A recent report from the Royal College of Obstetricians and Gynaecologists’ (RCOG) has identified key clinical actions that should be taken to improve the quality of care given during childbirth and prevent future cases of stillbirth, neonatal death and brain injury.
Each Baby Counts
The report is the result of the RCOG’s Each Baby Counts initiative, which launched in October 2014 with the aim of halving the number of babies who die or are left severely disabled as a result of preventable incidents occurring during term labour (after 37 weeks) by 2020.
As part of the initiative, expert assessments were conducted of local reviews into the care of 1,136 babies born in the UK in 2015 – 126 who were stillborn, 156 who died within the first seven days after birth and 854 babies who met the eligibility criteria for severe brain injury.
The reviewers concluded that three quarters of these babies (76%) might have had a different outcome with different care.
Key Recommendations for Improvement
The report contains recommendations highlighting critical factors in the care of many of the Each Baby Counts babies that may prevent these incidents in the future. These recommendations are aimed at medical staff working in maternity units across the UK and centre around:
- Foetal monitoring – formally assessing all low risk women on admission in labour to determine the most appropriate foetal monitoring method; following NICE guidance on when to switch between intermittent and continuous monitoring during labour; ensuring all staff have documented evidence of appropriate annual training.
- Neonatal care – paediatric/neonatal teams informed of pertinent risk factors in a timely and consistent manner.
- Human factors– understanding ‘situational awareness’ to ensure the safe management of complex clinical decisions; key members of staff maintaining appropriate clinical oversight; seeking a different perspective to support decision making, particularly when staff feel stressed or tired.
Every Incident is a Profound Tragedy
“The Each Baby Counts programme was intended as a ground-breaking, long term inquiry that will deliver improvements to maternity care over time, and we do not waver from this challenge,” commented Professor Lesley Regan, President of the Royal College of Obstetricians and Gynaecologists.
“It is a profound tragedy whenever a death, disability or illness of a baby results from incidents during labour,” she added. “The emotional cost to each family is incalculable and we owe it to them to properly investigate what happened and ensure the individuals and the healthcare Trusts involved take the steps needed to avoid making the same mistakes again.”
Sadly, there continue to be frequent reports in the media of babies who have sustained long-term damage as a result of errors by medical staff during birth.
Only recently the Mirror reported that a child born in St Mary’s Hospital in Paddington in 2005 has received compensation amounting to over £10 million after sustaining severe brain damage at birth.
Medical errors meant that he was starved of oxygen during labour, leaving him with cerebral palsy and epilepsy. He is now reliant on full-time care.
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