Evaluating the Saving Babies Lives Care Bundle Version 2
Research type
Research Study
Full title
Evaluating the effectiveness of the Saving Babies Lives Care Bundle Version 2 on reducing perinatal mortality (eVOLVE)
IRAS ID
325846
Contact name
Alexander Heazell
Contact email
Sponsor organisation
University of Manchester
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
The NHS offers some of the safest maternal and neonatal outcomes in the world and England is making significant progress towards the Government’s target of halving the rate of stillbirths and neonatal deaths by 2025. However, there remains worrying variation in the quality of maternity care meaning that not all mothers experience the safe delivery of a healthy baby.
To improve the quality and reduce variation in maternity care for women and their babies, in 2016 NHS England developed a new set of guidelines for maternity providers called the Saving Babies Lives Care Bundle (SBLCB). The care bundle was specifically designed to reduce stillbirth and neonatal death by improving care for women in the areas of smoking in pregnancy, fetal growth restriction, reduced fetal movements and fetal monitoring in labour. Although adoption by maternity units was variable, the care bundle is widely recognised to have contributed to the historical decline in stillbirth rates in England. Version two of the care bundle (SBLCBv2) was released in 2018 and introduced a new focus on reducing preterm birth. Every maternity provider in England is now mandated to implement SBLCBv2.
This study, funded by NHS England, aims to qualitatively determine the factors that influence whether the care bundle interventions are effectively implemented, including behaviour and process change. It will survey and interview women (who have given birth in the last 12 months) to determine their views and experiences of pregnancy and birth in relation to the care bundle. Women will be recruited in 40 NHS Trusts and in the community. All healthcare professionals who deliver care bundle interventions will be invited to participate in surveys and interviews to determine their views and experiences of service delivery. As many participants as possible will be included. The study will run for a duration of 12 months.Summary of results
The death of a baby is an incredibly heartbreaking event for any family. Sadly, in England, about 1 in every 250 babies are stillborn, meaning they die after 24 weeks of pregnancy.The UK has a higher rate of stillbirths compared to some European countries. To address this, NHS England created a set of guidelines in 2016 called the Saving Babies Lives Care Bundle. These guidelines aim to identify and help women at risk of stillbirth during pregnancy and labour. They include five main strategies: helping pregnant women stop smoking, identifying small babies, monitoring baby's movements, reducing lack of oxygen (hypoxia) during labour, and preventing premature births.
The guidelines have helped lower stillbirth rates, but there hasn't been much research on what mothers and healthcare workers think about the updated version of these guidelines introduced in 2018. This study, carried out by the University of Manchester, looked into how hospitals are using this new version. We surveyed 1,140 women who gave birth at 28 different NHS maternity units in England to find out what kind of care they received during their pregnancies. We also surveyed 633 healthcare professionals in the same hospitals to understand their experiences in providing this care. Some of the mothers and healthcare workers were interviewed for a deeper understanding of their experiences.
The study found that most healthcare staff are using the care bundle and that most women are receiving the recommended care, which is an improvement from the first version. However, some mothers felt their care was too routine and not personalised, and some felt their voices weren't heard or respected when making decisions. Many healthcare professionals felt the guidelines added extra pressure to an already stretched system. Despite this, the care bundle was generally seen as helpful in making clinical decisions.
There were differences in how hospitals and healthcare workers implemented the care bundle, indicating that implementation may vary by location. This suggests that understanding these differences is important for successfully delivering future updates of the care guidelines.
REC name
London - City & East Research Ethics Committee
REC reference
23/LO/0697
Date of REC Opinion
25 Aug 2023
REC opinion
Further Information Favourable Opinion