29 February 2024

Twins Trust has today released a new report, 'NICE Works II: Transforming Maternity Care for Multiples'. This report builds on Twins Trust's original 'NICE Works' report (2019), which highlighted that maternity units provide better, safer care for multiple pregnancies when following NICE guidelines.

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The report demonstrates that 92% (35/36) of maternity units who took part in the charity's Maternity Engagement Project improved their adherence to NICE Guideline 137 (NG137) and NICE Quality Standard 46 (QS46). Adhering to NICE guideline NG137 is shown to improve outcomes for multiple birth pregnancies.

Twins Trust's Maternity Engagement Project supports maternity units across the UK to improve the outcomes for twin and other multiple pregnancies by ensuring multiple pregnancy care is delivered consistently and in line with NICE QS46. Participating units are audited by specialist midwives and then supported to implement an agreed action plan. Follow up audits are carried out a year later to assess the changes made and their impact.

The report 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 Twins Trust's Maternity Engagement Project.

A picture taken looking over a woman's shoulder as she holds two new born babies


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.

Across all 36 units, 168 actions were recommended following the baseline audit, 109 (65%) of these were implemented in the period between the initial and follow-up audits. These included the introduction of care plans, specialist midwife provision for multiple births and positional labelling.

Helen Peck, Head of Healthcare Engagement at Twins Trust, said: "This research shows the importance of maternity units striving to provide best practice for multiple births. By signing up for our Maternity Engagement Project, all but one unit improved their adherence to the NICE guidelines and we know that this leads to better outcomes for multiple births. Improving the care provided to multiple birth families includes the provision of a dedicated multi-disciplinary team, having the correct care plans for all types of multiple pregnancy and introducing a dedicated twins clinic as per the recommendation in the Ockenden Report. We encourage other units to follow suit; it's the wellbeing of the pregnant women and babies that's at stake."

Download the report