14 January 2021

We’re calling on NHS Trusts throughout the UK to ensure they have Twins Clinics for multiple birth families as we know they deliver good care.

Women expecting twins, triplets or more are always classed as ‘high risk’ and whilst they are potentially more complicated, much more could be done to reduce the risks for mums-to-be and their babies.

A report by MBRRACE, released on 14 January 2021, looked at 50 twin pregnancies in 2017 where one or more baby died. The aim was to review the quality of care to determine whether different care may have made a difference for the babies and their mother.

The care the babies and their mothers received during pregnancy, labour and afterwards, was compared to care outlined by NICE multiple birth guidance by a panel of clinical experts.

High-quality care was only found in a minority of the deaths which were reviewed and analysis showed that most deaths may have been prevented with better care.

Clinical experts assessed the care as 'good' in around one in five deaths.

In around half of the baby deaths, the care was poor. If care had been better it may have prevented the baby from dying.

For 60% of the mothers' care after their baby/babies died was poor. If it had been better it may have meant bereaved mothers were likely to have been better supported in their physical and emotional health.

Keith Reed, CEO of Twins Trust, said:

This is a shocking and sad report. We are going to hold NHS Trusts to account and Government and health professionals must take action now to avoid further unnecessary deaths.

 “It is critical that maternity units adhere to NICE multiple birth guidance and our T-MEP quality improvement project can help them do this - and save lives.  Urgent change needs to happen now and more Twin Clinics need to be established. We know that maternity units with these clinics deliver better care, but less than half of all maternity units in the UK have them.

“Forty per cent of the women were not looked after by a multidisciplinary team of doctors, midwives and sonographers who were experts in twin pregnancies. Sadly, only half of the women had a discussion with health professionals about the individual risks in their twin pregnancy.

“We are eager to roll out our project nationwide. From the first phase of the project where we worked with 30 maternity units in England, there has been a 7% reduction in stillbirths and an 18% reduction in neonatal deaths. Funding would enable us to roll this programme out nationwide and to save the lives of future multiple birth babies.

National policies promoting good care are not clear enough. NICE multiple birth guidance, which was published ten years ago, is not being followed by enough Trusts.

“We don’t want to see further failings in care for the multiple birth community because the trajectory is showing that, after brilliant results between 2014 and 2016 where twin stillbirths were cut by 50%, standards have been falling.”