The Maternity Engagement Project is a world-first quality improvement project focused on improving maternity care for multiple pregnancies.

The team at Twins Trust works with maternity units across the UK to ensure that multiple pregnancy families receive the correct level of clinical care. We have worked with 40+ units throughout the UK since the project started.

What’s the aim of the project?

The aim is to improve the outcomes for multiple pregnancies by ensuring care is delivered consistently and in line with national guidance – specifically NICE Guideline 137 (NG137) and NICE Quality Standard 46 (QS46). Adhering to NICE guidelines (NG137) is shown to improve pregnancy outcomes for multiple birth families. 

Unit adoption of this standard has proven to not only be an indicator of good practice but has shown to help reduce still-births, neonatal admissions, neonatal deaths and emergency C-section rates. 

How does the project work?

We work with a team of specialist midwives who visit maternity units and conduct an audit to assess current practice. An action plan is created to provide a platform for improving care. Support is provided throughout the year, along with access to a wide range of resources. After 12 months, a re-audit is conducted to assess changes made and their impact.  A final re-audit document and bespoke action plan is produced to take forward internally.

Units see decline in multiple stillbirths and neonatal deaths

Our latest report, 'NICE Works II: Transforming Maternity Care for Multiples', shows that three years after starting the project, units, on average, saw their rates of multiple stillbirths and neonatal deaths (in multiple births) both decline by 0.3 percentage points, their rate of multiple neonatal admissions fall by 10.4 percentage points and their rate of emergency caesarean sections (in multiple births) fall by 6.7 percentage points.
It also found that there was a statistically significant improvement in overall adherence (to NICE QS46) of 16.4 percentage points for units who took part in the project.

Additional Benefits 

Taking part in the project can help units deliver the objectives from the Saving Babies’ Lives Care bundle V2 and achieve compliance with the safety action 6 in the maternity incentive scheme. Over the longer term, it can help achieve a reduction in still births and neonatal deaths and further reduce neonatal admissions and emergency caesarean sections.

‘Make a change for the better’

Our approach is focused on working in partnership with maternity units and offers coaching and resources to enable change. We work with you to help overcome barriers and highlight solutions for change. This is an exciting and innovative opportunity to instigate practice improvement and change.

Testimonials about the Maternity Engagement Project:

Baroness Julia Cumberlege - “Twins Trust is such a professional organisation. It is well connected, it is research orientated and it is savvy. What really impresses me about the Maternity Engagement Project is that it is not a wish list. What it is doing is both thorough and imaginative, shows what can actually be achieved and how units can make a change for the better.”

Unit 22 - “The Maternity Engagement Project makes you have a really good look at the care you’re giving families and it helps you to take a step back. If I had looked at NICE guidelines prior to the audit, I would have thought ‘oh yes, we meet all that’, but when you actually look at it, there are things we can improve.” 

Unit 3 - “Thank you to the Maternity Engagement Team at Twins Trust for all your hard work in undertaking such a comprehensive nationwide audit to help improve the outcomes for women and their families expecting multiples. The audit gave us the impetus to evaluate where we were, with the help of the initial audit. We then made changes and developments to our practice, care plans and documentation. Overall, we were delighted with the very positive report, so thank you very much.”

How can we sign our unit up for the Maternity Engagement Project?

We would urge all units to be part of the next phase of our Maternity Engagement Project. Please email for further information or an informal chat.