Saving Babies' Lives Care Bundle

This ‘care bundle’ action plan will help NHS England to make maternity care safer, alongside guidelines to reduce preterm birth.

The Saving Babies’ Lives Care Bundle has been in operation in certain maternity units since 2016. An evaluation led by Professor Alex Heazell, Clinical Director of the Tommy’s Stillbirth Research Centre in Manchester, has shown that stillbirths fell by a fifth at the maternity units where the Saving Babies' Lives Care Bundle has been implemented.

A recent evaluation of the care bundle also highlights the need to reduce preterm birth. In the Department of Health publication Safer Maternity Care, the Secretary of State for Health made it clear that ‘we will not achieve the national Maternity Safety Ambition [to halve the rates of stillbirths, neonatal and brain injuries that occur during or soon after birth by 2025] unless the rate of preterm births is reduced’ and he set an additional ambition to reduce the national rate of preterm births from 8% to 6%.

In order to do this, and to reduce differences in care across NHS England, new guidelines, ‘Reducing Preterm Birth’ (2019), have been developed by the UK Preterm Clinical Network. These guidelines provide evidence-based recommendations for commissioning groups which will reduce the rates of preterm births. You can read more about the development of these guidelines here.

We look forward to seeing the learnings from this project put into action and the widespread implementation of the Saving Babies' Lives Care Bundle.

What is the Saving Babies' Lives Care Bundle?

An NHS ‘care bundle’ is an action plan put together by experts and carried out on all patients who meet certain criteria. Care bundles are targeted on causes of death or ill-health and are designed to save lives. The Saving Babies’ Lives Care Bundle is a group of actions that have been put together to reduce stillbirth.

Tommy’s has been heavily involved in the design of the NHS Saving Babies’ Lives Care bundle through the involvement of clinicians from our Manchester Stillbirth Research Centre, guidance of our CEO Jane Brewin and our work on a leaflet designed to raise awareness of the importance of monitoring reduced fetal movements: Feeling your baby move is a sign that they are well.

"Being aware of movements saved my son's life. Even though I did feel like I was needlessly wasting the hospital's time, I'm so glad I did call them when I felt that his movements had slowed down." Agatha

The Care Bundle focused on the following elements:

reducing smoking in pregnancy
closer monitoring of fetal growth restriction
raising public awareness of monitoring reduced fetal movement
effective fetal monitoring during labour.

Each element has a specific action plan against it. And together, these have now been shown to save babies' lives.

‘This large scale evaluation of the NHS England Saving Babies' Lives Care Bundle shows that the interventions to reduce cigarette smoking, detect small for gestational age babies, inform women about reduced fetal movements and improve monitoring of babies during labour, have been increasingly implemented in the early adopter maternity units. Over the same time period stillbirths have fallen by 20%, meaning 161 fewer stillbirths in the participating units.’Professor Alex Heazell, Clinical Director of the Tommy’s Stillbirth Research Centre

Effects of the Saving Babies’ Lives Care Bundle

The proportion of women recorded as smoking at delivery reduced from 14.3% to 11.8%.
Detection of small for gestational age (SGA) babies increased from 34% to 54%.
Units were more effective at monitoring the rates of babies’ growth in the womb and identifying when they are growing too slowly. This meant a number of other important changes in outcomes for women and their babies - including an increase in the number of ultrasound scans (by 25.7%), increases in induction of labour (by 19.4%) and birth by emergency caesarean section (by 9.5%).

‘We are delighted to have been part of an action plan that is making progress towards reducing the tragically high number of stillbirths that happen every year in the UK. When all maternity units follow these actions, fewer families will have to experience the tragedy of stillbirth which destroys so many families’ hopes and dreams.'Jane Brewin, Tommy’s CEO

Why do we need the Saving Babies' Lives Care Bundle?

In the UK, 9 babies are stillborn every day and Britain has the 24^th worst stillbirth rate out of 49 high income countries within Europe. This causes untold devastation for the parents who lose their baby.

Update: Version 2 of the Saving Babies Lives Care Bundle (SBLCBv2) has now been released