Clinical leadership team of the yearBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h1888 (Published 08 April 2015) Cite this as: BMJ 2015;350:h1888
- Nigel Hawkes, freelance journalist, London, UK
Antenatal care initiative
Sometimes problems conceal themselves in plain view. Stillbirth rates in the UK have been the highest in Western Europe and have remained unchanged for 20 years. “Two thirds of these deaths were classified as unexplained, and many took that to mean unavoidable,” says Jason Gardosi, director of the Perinatal Institute, a national not-for-profit organisation set up to improve the quality of maternity care. “People just shrugged their shoulders. It took a long time to change that and raise the profile of stillbirth.”
The institute conducted research that identified unrecognised growth restriction in the womb as a major cause of stillbirth, and developed individualised growth charts that could be used by midwives and doctors to detect babies at risk by accurately plotting their rate of growth. “Detection is important as the only treatment we have is inducing labour at the appropriate time. These babies need to be delivered from danger, before they die,” said Gardosi.
A pilot programme in the West Midlands saw stillbirth rates falling to their lowest ever levels. The customised growth charts have now been rolled out nationally and in 2013 there were 500 fewer stillbirths in England compared with the average for …