MBRRACE Perinatal Confidential Enquiry - Stillbirths and neonatal deaths in twin pregnancies report published on 14th January 2021

Who are MBRRACE?

MBRRACE stands for Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK.  They are a part of a research unit that was established at the University of Oxford.

What’s the report about?

The report presents the findings of the fourth perinatal confidential enquiry carried out as part of the MBRRACE-UK programme of work and focuses on stillbirths and neonatal deaths in twin pregnancies.  

This enquiry looked at 50 twin pregnancies in 2017 where one or both of the babies died. The aim was to review the quality of care, as it was recorded in the medical notes, in a sample of pregnancies when one or both twins died and to determine whether different care may have made a difference for the babies and the mother.

This is the first time that MBRRACE has focussed on twins or more.

What did the report find?

The report found that ‘in around 1 in 2 baby deaths, the care was poor. If care had been better it may have prevented the baby from dying.’  It also found that ‘less than half the women were looked after by a multidisciplinary team of doctors, midwives and sonographers who were experts in twin pregnancies’.  This is contrary to the NICE guidance NG137 first issued in 2011. Further findings revealed that ‘only 1 in 5 deaths were reviewed by the hospital, and these reviews were poor quality’.

Do you know which hospitals cases were reviewed?

No, we don’t know which hospitals were involved with the research.

How do I know if it’s safe to give birth at my local hospital? 

We have developed a checklist that’s available on our website to help families ensure that that they are receiving care according to National Institute for Health and Care Excellence (NICE) guidelines. It also covers the recommendations made in the report.

This data has worried me, what help can you provide?

We understand that this is worrying, we’re here to support you.

In addition to the checklist, it’s worth checking with your hospital to ask if they have a twin and multiples clinic. There is lots of data suggesting that hospitals with a specialist twins and multiples clinic provide better care.

What happens if my hospital doesn’t have a twins clinic?

Speak to your hospital about whether the care you are receiving is from healthcare professionals that are specially trained in multiple birth pregnancies.  If not they should be getting advice from health care professionals from a different hospital where they do have specialists  If this isn’t the case, please do get in touch with us and we’ll happily chat through your options with you. They should still be using the checklist to ensure you’re receiving the correct care.

This data was from 2017, do you know if care has improved?

Sadly, we know from other more recent published data that the situation isn’t improving but Twins Trust is committed to changing this over the next year and beyond.

I’m already worried about giving birth due to Covid, why have you released this data now?

The data has been published by an external research unit. Twins Trust felt that it was important that we told our families about the report to ensure that families could check the care they are receiving aligns with NICE guidelines.

Hospitals are extremely busy but should still be delivering maternity care according to the NICE guidelines. Our website has a useful Q&A section on pregnancy during Covid.

What are Twins Trust doing about this?

We are writing to all hospital trust Chief Executives to highlight the data that has been published and ask them how they’re going to implement the recommendations. We will offer to support units with implementing the recommendations. In addition, we’re contacting the Department of Health, government officials and the relevant healthcare professional organisations to ask for their support with the implementation of the recommendations.

Please remember we’re here to support you

We understand that it’s a particularly worrying time to be having babies but we’re here to support you. If you need a listening ear, our freephone helpline is available. You can also contact us via email  [email protected] Alternatively, visit our forum to chat to other parents that are expecting twins, triplets or more.