Working to reduce stillbirths for multiple pregnancies.

Published on: 11/04/2019

A new study shows that more babies would survive if hospitals in the UK provided different care, or personalised care plans, to mothers expecting twins, triplets, or other multiples in their pregnancy. Currently in England, multiple pregnancies are more likely to end in a stillbirth or neonatal death, than those carrying a single baby.

A Three year project in Thirty Maternity Units

The project was run by the Twins Trust (formerly TAMBA) and was sponsored by The Department of Health and Social Care. They found that guidelines which have been suggested by the National Institute for Health and Care Excellence (NICE) in 2011 and 2013, had not been adhered to consistently throughout the NHS.

If the NICE guidelines were to be implemented, this could result in:

. Approx 634 less Emergency Caesarean Sections each year
. Up to 100 less stillborn babies from a multiple pregnancy
. A saving of around £8 million a year for the NHS 

The project also noted that if all Maternity Units in the UK began to adhere to the NICE guidelines, we could see neonatal admission numbers fall by 1,308 within a year. This would relieve some of the pressures that our maternity services are currently battling against to provide the best care all pregnant mothers are entitled to.

What care should you expect to receive?

There are extra guidelines and quality standards that you are entitled to as part of your care, if you are carrying twins and multiple babies. Ask your maternity care team about:

. Access to specialist multiple pregnancy midwives, doctors, and ultrasound operators.
. A defined care plan that is personal to you and your baby.
. Extra ultrasound scans as needed.
. Foetal Medicine Expert involved if the pregnancy is classed as higher risk.
. Signs of premature birth should be discussed by 24 weeks gestation.

TAMBA have been working alongside specialist multiple midwives in order to support current NHS employees to start implementing these guidelines, and to empower pregnant women of multiple babies with the knowledge of the basic care they should be receiving.

Evidence and Stats from Twins Trust (formerly TAMBA)

St. George’s Hospital in London is an early adopter of the NICE guidance in the care of multiple pregnancies, who saw a 70% reduction in their stillbirth rate over 5 years, from 14 babies in 1000 in 2012, down to 4 babies in 1000 in 2016.

As part of the study, Units were audited and then revisited 12 months later to evaluate how the influence of these alterations had improved the care provided by the Unit.

Keith Reed, chief executive of TAMBA, said:

“We know, and now have the evidence to prove, that following Nice guidance on multiple pregnancies works.”

“We urge the NHS to ensure local maternity teams are aware that this project can make a considerable contribution to meeting the Government’s ambition to reduce stillbirths, neonatal deaths and preterm births.”

A Department of Health and Social Care spokesman said:

“We want the NHS to be the safest place in the world to have a baby and as part of the NHS long term plan, backed by an extra £33.9 billion a year by 2023/24, the number of stillbirth and neonatal deaths over the next five years is planned to halve.”

“TAMBA’s excellent research, funded by the department, demonstrates how many lives can be saved when the NHS follows latest clinical guidelines.”

For more information about Twins Trust (formerly TAMBA) and how they are working to save lives and support families, please visit

References: WalesOnline. Twins And Multiple Births Association.