Information about every baby who dies or is seriously brain injured as the result of an incident during birth is now being collected across the UK as part of the Each Baby Counts (EBC) initiative. Launched by the Royal College of Obstetricians and Gynaecologists in October 2014, EBC aims to reduce by half the number of babies affected by such incidents by 2020. While the number of babies involved is usually quoted as 500/year, Professor Zarko Alfirevic, the EBC lead, has suggested it could be much higher, at around 1000/year. The online registration system went live at the end of January, and by the end of February 49 babies had been registered.
One issue that is already apparent is the inconsistency of reviews of babies’ deaths by the local health teams. Speaking at an NHS meeting in Liverpool, Professor Alfirevic said that the first 2 years of the project could focus on improving the quality and consistency of investigations, with the aim of achieving good-quality reviews for all babies. Sands and the Department of Health have organised an expert working group to develop a web-based tool that could support this work and, at the time of press, we are awaiting confirmation of funding.
Many people and organisations have asked the EBC team why its remit is so narrow – why aren’t they including all stillbirths or unexpected stillbirths that happen at term, for example. According to Professor Alfirevic, the team would like to extend the scope of the project, but has to develop its project systems and methods with a relatively small group of babies. If the project is successful in its aim of identifying ways of reducing incidents that cause a baby’s death or harm during birth, then Sands hopes that the project can be extended to include more babies. In the mean time, MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) is carrying out a confidential enquiry into the deaths of apparently healthy babies at the end of pregnancy, and will publish its report in December this year.