Enhancing the Safety of Midwifery-Led Births Enquiry (ESMiE): A confidential enquiry of term, intrapartum-related perinatal deaths in births planned in midwifery-led settings in England & WAles

Summary

Every year in the UK around 400 babies born around their due date who were alive at the start of labour die during labour or in the first month of life from problems that occur during labour or birth. The aim of the ESMiE confidential enquiry is to identify ways in which care during labour and birth might be improved to prevent similar deaths in the future.

A national enquiry into these types of deaths is being undertaken this year by MBRRACE-UK. This means that panels of health professionals including midwives, obstetricians, neonatologists and others, will review the medical records of a number of these babies, and those of their mothers, to identify ways in which differences in care might have prevented their deaths.

Because most births currently take place in hospital obstetric units (OU), most of the deaths the MBRRACE-UK enquiry plans to review will have occurred in births where the mother was looked after in an OU during labour. But an increasing proportion of women now plan to have their babies in midwifery units or at home. The causes of baby deaths in these settings may be different.

ESMiE will use the same methods as the MBRRACE-UK enquiry but will focus on cases born in 2013-2016 where the woman received care in labour in a midwifery unit or at home. It will:

• Carry out an in-depth review of the quality of care of a sample of up to 100 cases to identify ways to improve care.
• Describe the quality of care received using standards set out in national clinical guidelines for comparison.
• Evaluate the quality of hospital reviews of these deaths.