Midwifery units across England are struggling to cope with “significant” increases in demand, following the launch of a new national drive to reduce stillbirths, it has been claimed.
North Bristol NHS Trust has had to temporarily close its Cossham Birth Centre, after implementing the Saving Babies’ Lives programme from NHS England.
“Our absolute priority must be the overall safety of all women and babies in our care”
The new measures introduced through the programme have led to an “unprecedented” rise in women requiring medical inductions at the trust’s midwife-led unit at Southmead Hospital. The situation has been compounded by midwife shortages at the trust.
In order to continue to keep services running safely, the trust has decided to temporarily shut Cossham and transfer the midwives to Southmead.
It has had to open an six extra maternity beds at Southmead, and is in the process of recruiting an additional 24 midwives to fill outstanding vacancies and to manage the extra workload.
North Bristol NHS Trust claimed other trusts across the country were facing similar pressures.
In a statement, the trust said: “Due to the introduction of new national maternity policy to reduce stillbirths, North Bristol NHS Trust’s obstetric services have been extremely busy in recent months.
“Like many other maternity units across the country, this policy has led to a significant increase in women being medically induced, requiring more complex and specialist care,” it said.
Interim director of nursing at North Bristol NHS Trust, Helen Blanchard, added: “Recent national changes to the way the NHS cares for women with identified risks during pregnancy have increased demand for complex and specialist care.
“To ensure we can run the safest maternity service possible, we have taken the difficult decision to temporarily close Cossham Birth Centre until we have recruited enough additional midwives,” she said.
“We recognise that any changes to a woman’s pre-planned maternity care, and the choice they have made about where to have their baby, can be disappointing,” she said.
“However, our absolute priority must be the overall safety of all women and babies in our care,” she added.
Ms Blanchard said Cossham Birth Centre would reopen “as soon as possible”.
Saving Babies’ Lives was launched as part of Jeremey Hunt’s pledge to half the rate of stillbirths in England by 2025.
The programme asks maternity staff to implement a “care bundle” made up for four evidence-based interventions:
- Reducing smoking in pregnancy;
- Risk assessment and surveillance for fetal growth restriction;
- Raising awareness of reduced fetal movement;
- Effective fetal monitoring during labour.
A two-year pilot was carried out with 19 trusts from April 2015.
The trial was independently reviewed and found that stillbirths fell by a fifth across participating sites.
However, the report (see attached) also highlighted that there was an 19.4% increase in inductions of labour and 9.5% in emergency caesarean sections at the pilot trusts.
It added: “Such increases would be an expected consequence of increased detection rates of [small for gestational age babies] and compromised fetuses and are likely to be related in some degree to implementation of the [Saving Babies’ Lives care bundle].”
The number of ultrasound scans performed also increased by 25.7%, while elective caesareans rose by 19.5%.
In July, NHS England announced that the programme would be rolled out nationally.
It said an estimated 600 stillbirths annually could be prevented if all maternity units used the care bundle.
Nursing Times asked NHS England whether it had, or was planning to, provide trusts with extra resources to implement the programme, but it did not address the question.
A spokeswoman said: “The temporary closure of a birthing unit is a measure taken by trusts to ensure that women and their families receive the safest care possible. Closures can be for a number of reasons such as staff sickness, rota gaps or patient choice.
“As far as we are aware, no other maternity providers have closed their units due to the implementation of the care bundle.”