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• Scheme forms part of government’s ambition to urgently improve maternity outcomes for women and babies
• Backed by £7.8 million in government funding, training will help maternity staff better identify and act quickly when babies are in distress during labour

NHS maternity staff in England will take part in a new pilot programme to help reduce avoidable brain injuries in childbirth, the government has announced.

The Avoiding Brain Injury in Childbirth (ABC) pilot is launching today (7 October 2024) across 9 maternity units at NHS trusts and aims to improve maternity outcomes for women and babies.

The programme will help maternity staff to better identify signs that the baby is showing distress during labour so they can act quickly. It will also help staff deal with important obstetric emergencies that occur where the baby’s head becomes lodged deep in the mother’s pelvis during a caesarean birth.

The ABC programme aims to improve clinical practice, communication and care for women and families and result in better outcomes and experiences, while reducing variation and inequality of care. 

The most recent data from the Neonatal Data Analysis Unit at Imperial College London shows around 2,490 babies received at least one episode of care for a brain injury during or after birth (in 2021) equating to 4.2 per 1,000 live births. 

The programme could be rolled out nationally next year if the pilot is successful.

Baroness Gillian Merron, Minister for Patient Safety, Women’s Health and Mental Health, said: 

This is a critical step towards avoiding preventable brain injuries in babies, as we work to make sure all women and babies receive safe, personalised and compassionate care.

This government is working with the NHS to urgently improve maternity care, giving staff the support they need to improve safety and ensure women’s voices are properly heard.

The scheme is also expected to reduce the rising cost of clinical negligence. At present, maternity cases account for around 10% of clinical negligence claims and equate to more than 50% of the total value of clinical negligence payments. In 2018 to 2019, claims related to brain damage at birth had a value of £1.86 billion, with individual cases costing up to £30 million. 

So far, the Department of Health and Social Care has contributed £7.8 million to the ABC consortium, which consists of the Royal College of Obstetrics and Gynaecologists, Royal College of Midwives (RCM) and The Healthcare Improvement Studies Institute. 

Dr Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists, said: 

The ABC programme will help maternity teams to improve safety by giving them the tools, resources and training they need to respond effectively when a baby might be deteriorating during labour and to handle a major obstetric emergency. Including support for teamwork and culture, ABCmakes best practice easier and puts those in labour and their birth partners at the centre of their care.

Donald Peebles, NHS national clinical director for maternity, said:

We welcome the opportunity to further enhance the skills of NHS staff so they can provide the best possible care for women and babies. 

The NHS is already making progress on reducing rates of brain injuries in childbirth and we look forward to continuing this work with royal colleges and other partners as part of our commitment to improving services.

Professor Mary Dixon-Woods, Director of The Healthcare Improvement Studies Institute, said: 

Any effort to improve care must put families at the centre. The ABCprogramme has been developed in partnership with women, birthing people and their birth partners and reflects the importance of listening, inclusion and respect as part of keeping those in labour and their babies safe.

Gill Walton, Chief Executive of the RCM, said:

Improving the safety of maternity services by supporting staff is a priority for the RCM and something we are absolutely committed to working in partnership to achieve. Any event of avoidable brain injury is devastating for the mother, for the families and for all the staff involved. Improving multidisciplinary training is key to improving pregnancy outcomes, equally sharing good practice, and learning from mistakes is crucial.

We are confident that the ABC tools and training will equip maternity staff at these pilot sites with the skills they need to ensure best outcomes for both mother and baby.

Background information

The selected sites that are participating in the pilot of impacted fetal head during caesarean birth are: 

• Countess of Chester Hospital NHS Foundation Trust
• East Lancashire Hospitals NHS Trust
• Lancashire Teaching Hospitals NHS Trust
• Liverpool Women’s NHS Foundation Trust
• Warrington and Halton Teaching Hospitals NHS Foundation Trust
• Wirral University Teaching Hospital NHS Foundation Trust

The selected sites that are participating in the pilot of detection and response to fetal deterioration are: 

• Croydon Health Services NHS Trust
• Epsom and St Helier University Hospitals NHS Trust
• St George’s University Hospitals NHS Foundation Trust