New report shows deaths during childbirth reduce by half

In their latest report, co-authored by a researcher from our Department of Health Sciences, a team of academics, clinicians and charity representatives, called MBRRACE-UK*, has looked at the quality of care for stillbirths and neonatal deaths of babies born at term who were alive at the onset of labour, singletons (sole births) and who were not affected by a major congenital anomaly.  This type of death occurred in 225 pregnancies in 2015 in the UK.

It is important to study the deaths of these babies as any normally formed baby who is alive at the onset of labour at term would be expected to be alive and healthy at birth.

A random representative sample of 78 of these babies who were born in 2015 was selected. The care provided for these mothers and babies was reviewed in detail against national care guidelines by a panel of clinicians, including midwives, obstetricians, neonatologists, neonatal nurses and pathologists who considered every aspect of the care.

Issues the report highlights include:

• The rate of term, singleton, intrapartum stillbirth and intrapartum-related neonatal death has more than halved since 1993 representing a reduction of around 220 intrapartum deaths per year.
• Capacity issues were identified as a problem in over a quarter of the cases undergoing panel review. The majority of staffing and capacity problems were related to delivery suite.
• The panel consensus was that in nearly 80% of deaths improvements in care were identified which may have made a difference to the outcome for the baby
• There is an increasing proportion of births to mothers who have risk factors associated with an increased risk of perinatal death.

Professor Elizabeth Draper (pictured), Professor of Perinatal and Paediatric Epidemiology at our University said:  “The premise of the enquiry was that these babies would be born alive and healthy. Findings from the panels indicated that improvements in care may have made a difference to the outcome for almost 80% of cases.

“The main issues identified were care before labour was established including induction, monitoring during labour, delay in expediting birth, heavy workload of the units, a lack of joint obstetric and neonatal input into bereavement care and a lack of rigour in the local review of the deaths.”