Sands is a member of the MBRRACE-UK (Mothers and Babies: Reducing Risk through Audit and Confidential Enquiries) collaboration. MBRRACE-UK is a national audit programme and is commissioned by all UK governments to collect information about all late fetal losses, stillbirths, neonatal deaths and maternal deaths across the UK. The programme tracks information about where and why babies and mothers die. It takes around 18 months after the end of the year for MBRRACE to collect and analyse all information on deaths in a particular year. This means that its latest report for baby deaths in 2017 was published on 15th October 2019, and is available here: https://www.npeu.ox.ac.uk/mbrrace-uk/reports
- We contribute the perspective of women and families in all aspect of MBRRACE-UK's work
- We put forward ideas for confidential enquiries into certain deaths (at term for instance, or during labour) and issues around care, we believe are particularly relevant
- We help define standards for bereavement care which are used by confidential enquiry panels, so that the quality of care women and families receive can be measured against Sands most up to date, best practice recommendations
- We contribute to the writing of the plain English and infographic versions of MBRRACE-UK reports, so that can be read by parents, families, the media and the general public
- We provide our own short, easy-to-read summaries of MBRRACE-UK reports and put the work in context with other initiatives to reduce baby deaths in the UK, so anyone can see how the work sits in the bigger picture of understanding where care could be improved and deaths potentially prevented. See below
MBRRACE-UK collects information from all UK hospitals on babies who have died before, during or shortly after birth in a particular year. Their annual reports include national maps showing how different rates of baby death across the country compare with eachother, taking the national average as a benchmark. Trusts and Health Boards who deliver maternity and neonatal care with rates above the national average are recommended to look at what is happening in their area and to introduce improvements to reduce the number of deaths. These improvements may include using the the Perinatal Mortality Review Tool to understand their deaths better, and service improvement tools such as the Saving Babies Lives Care Bundle. Areas with lower rates are encouraged to reduce their rates to levels seen in some European countries. The UK's rate of stillbirth (for babies after 28 weeks gestation) ranks about middle for similar hi-income countries. Sands feels this is too unacceptably high.
All reports and summaries, including infographic and lay reports, are available here
MBRRACE-UK also carries out what are known as 'confidential enquiries' into the deaths of particular groups of babies - all babies who die of a particular condition, say, or all babies who are stillborn at 37 weeks or more, before birth. This means that clinical experts look at medical case notes to see if there were any problems with the care the mother or baby/babies received to ensure their care followed national and local guidelines.
Two recent enquiries into babies who died, both before, during and shortly after birth towards the end of pregnancy (term) found that better care might have changed what happened for between 6 to 8 out of 10 babies who died. The recommendations of both these enquiries have led to improvements in maternity care.
The confidential enquiry reports with lay and infographic versions are here
The current confidential enquiry is looking at babies who were part of a twin pregnancy and died. This will report in 2020.