RCM part of coalition launching videos to support health staff on signs of life in extremely pre-term babies 

By Colin Beesley on 29 June 2022 Midwifery Midwives Midwifery Workforce Bereavement Care Child Mortality Infant Mortality Maternity Services Neonatal Death Premature Birth RCOG - Royal College of Obstetricians and Gynaecologists Sands MBRRACE

Two videos to help health professionals in assessing, identifying, and documenting signs of life in extremely preterm babies have been published by a coalition of health organisations including the Royal College of Midwives (RCM). 

The videos were produced to support staff to navigate the signs of life guidance published in 2020. The guidance is designed to help healthcare professionals caring for babies born following spontaneous birth before 24 weeks of gestation where, following discussion with the parents, active survival-focused care is not appropriate. At this very early stage, some babies may die during labour or birth while others may show some signs of life.  A short video highlights key stages in determining signs of life and a longer one provides a fuller explanation about the guidance.  

“This is a desperately sad and tragic time for parents and will also be very distressing for staff. That is why it is so important for midwives to be aware of the processes and systems in place to determine signs of life, such as what happens, how it is done, and when. The guidance and videos will support midwives and the multi-disciplinary team in their discussions with parents and although we cannot take away their pain, we may be able to help make this terrible time a little easier to bear for them,” said Lia Brigante, Quality and Standards Advisor at the RCM and its lead on the project. “Having clear guidance and pathways will also help staff to deal with these very difficult events and situations.”

The coalition that has produced the videos is led by MBBRACE-UK, an Oxford University based collaboration appointed by the Healthcare Quality Improvement Partnership (HQIP) to run the national Maternal, Newborn and Infant clinical Outcome Review Programme, and includes MBBRACE-UK.  Also in the coalition are the University of Leicester, the RCM, the Royal College of Obstetricians and Gynaecologists, baby loss charity Sands, and the College of Paramedics. It has been supported by the Dipex Charity which works to make health and social research available to the public and professionals. 

There are also wide variations in reporting of signs of life. This can affect whether the baby’s birth is reported as a miscarriage or registered as a live birth and then a neonatal death. The team behind the guidance and videos say they hope they will help to reduce this variation.

The coalition has also developed a video for parents to support and inform them about what happens when their baby is born before 24 weeks and is not expected to survive. It has been produced to reduce the confusion and distress experienced by parents and increase the consistency of the registration of births and deaths. 

“Every midwife should watch the videos and read the guidance because the knowledge and skills you will gain from this could make all the difference to the experiences of parents. It will also help you to navigate more confidently through this process, and communicate more effectively with parents,” said Lia Brigante. 

The Signs of Life Guidance and videos can be accessed at Home | Signs of life | MBRRACE-UK (le.ac.uk).