RCM and RCOG combine supporting reduction in stillbirths and pre-term births

By Colin Beesley on 31 August 2022 Midwifery Midwives Midwifery Workforce Child Mortality Infant Mortality Maternity Services Neonatal Death Premature Birth RCOG - Royal College of Obstetricians and Gynaecologists

A study to evaluate a new tool - with input from the Royal College of Midwives (RCM) and the Royal College of Obstetricians -  supporting midwives, obstetricians and other health professionals to reduce stillbirths and pre-term births has been published in the BMC open access journal. It aims to drive a reduction in stillbirth and preterm births by improving care around placental dysfunction.

The Tommy’s Clinical Decision Tool is a product of the Tommy’s Centre - a collaboration between the RCM, RCOG and pregnancy charity Tommy’s alongside leading UK Universities- and has been developed with midwives, obstetricians, scientists and women using maternity services.

There are wide variations in stillbirth and pre-term birth levels across the UK and these are particularly high in women from ethnic minority and socially deprived groups. Reducing the impact of these inequalities by having more tailored and personalised care and risk assessments for women is a key element of the tool.

“Assessing risk during antenatal care is not a straightforward process, it should be personalised and holistic, when often it is only based on a simple checklist, a method which has been in place since the 1970s,” said Lia Brigante, the RCM’s Policy and Practice Advisor. This approach labels around 25-30 per cent of all pregnant women at booking as ‘high risk’ with no weighting of risk factors involved and no ability to identify a numerical risk – just a binary high risk or not. If a woman were to ask us just what her actual risk of experiencing a preterm birth was, we couldn’t tell her.  The toolkit gives midwives and their colleagues the information they need to contribute to improvements in safety, care and outcomes.”

The tool fills a gap that left healthcare professionals without the information, support, and resources to provide the best care, an issue identified in a number of national reports says the RCM.

Currently the tool is being piloted at four early adopter sites in the UK. The study published today is a roadmap for evaluating the effectiveness of the tool, with a view to rolling it out and making it available nationally in the future.

“Essentially, the Tommy’s App is a regulated medical device, an online tool that enables health care professionals to access the latest evidence-based technology and use it to improve risk assessment in antenatal care. The technology used by the Tommy’s device allows us to more accurately identify women with a higher chance of giving birth prematurely or of developing complications that can lead to stillbirth,” said Lia Brigante. “It is also a source of information for women with links to reliable sources of information for them.

Once the evaluation of the pilot sites has taken place and hopefully when it is available nationally, it will be invaluable in our collective efforts to keep reducing stillbirth and pre-term birth rates and make care safer and better for women and their babies.”

The study can be read at The Tommy’s Clinical Decision Tool, a device for reducing the clinical impact of placental dysfunction and preterm birth: protocol for a mixed-methods early implementation evaluation study | BMC Pregnancy and Childbirth | Full Text (biomedcentral.com).