Each Baby Counts: An Initiative to Reduce Stillbirths and Disabilities

Overview of the Program

Each Baby Counts is a program initiated by the Royal College of Obstetricians and Gynecologists in the UK, aimed at reducing the incidence of stillbirths and disabilities that occur during labor. The program seeks to achieve the ambitious goal of halving the number of babies who die or sustain brain injuries due to preventable issues during term labor.

2015 Report Findings

The report published by the Royal College of Obstetricians and Gynecologists compiles data on stillbirths, neonatal deaths, and brain injuries during labor, sourced from local investigations. This comprehensive overview aims to share insights and lessons learned. The article primarily discusses the findings from the program’s inaugural year, 2015.

In this report, the authors focused on 723,251 term babies born in the UK during 2015. After excluding ineligible cases, such as babies born without complications or those with congenital abnormalities, a total of 1,136 babies were included in the final analysis. Among these, there were 126 intrapartum stillbirths and 156 babies who were born alive but died within the first week. Additionally, 854 babies were identified as suffering from brain injuries.

Recommendations for Fetal Monitoring Management

Based on the analysis of the cases, the authors provided several recommendations to improve fetal monitoring practices:

– Women identified as low risk should undergo a formal fetal risk assessment upon admission in labor.
– Guidelines should be followed to transition from intermittent auscultation to continuous cardiotocography.
– Key management decisions should not rely solely on continuous cardiotocography but should also take into account the overall clinical picture.
– In cases where therapeutic hypothermia is considered, routine, timely, and continuous monitoring of the core temperature is essential.
– The pediatric/neonatal team must be informed about any critical conditions affecting a neonate at risk.
– All members of the neonatal care team should maintain situational awareness.
– An expert from the neonatal care team should oversee the activities of other members.
– In complex care cases, staff should seek advice from colleagues not directly involved in care, and any cases requiring multiple specialties should include a briefing for leaders.

Future Research Recommendations

To assist future researchers, the authors proposed several recommendations:

– All eligible births should be reported within five days.
– Local reviews should incorporate necessary information.
– Parents should be encouraged to participate in decision-making processes.
– All local reviews must include external panel reviewers.

The authors urge policymakers to prioritize the adequate resourcing of maternity units. Without sufficient resources, trusts, health boards, and healthcare professionals may struggle to implement the recommendations derived from the Each Baby Counts team, ultimately hindering the goal of reducing mortality and brain injuries by 50%.

Author Information

Written by Nima Makhdami, M.D.

Reference

Royal College of Obstetricians and Gynaecologists (2017). Each Baby Counts: 2015 Summary Report. [online] London: Royal College of Obstetricians and Gynaecologists. Available at: https://www.rcog.org.uk/globalassets/documents/guidelines/research–audit/each-baby-counts-2015-summary-report-june-2017.pdf.