Understanding Multi-disciplinary approaches and Parental Input in perinatal mortality Review
The UMPIRE Study is inviting parents to share their views about the review that is done by the hospital when their baby is stillborn or dies shortly after birth.
When a baby dies in hospital around the time of birth, the hospital carries out a review to try to understand what happened. Midwives, doctors who specialise in maternity care (obstetricians), doctors who specialise in the care of newborn babies (neonatologists) and any other relevant healthcare staff who are part of what is known as the multi-disciplinary team, carry out the review. The review aims to understand as much as possible about what happened and why the baby died.
However, recent research has shown that some parents are unaware that a review may be taking place after their baby has died and that their views or questions about care are often not considered in the review team. To help hospitals improve how baby deaths are reviewed The Perinatal Mortality Review Tool or ‘PMRT’ was introduced in the UK at the beginning of 2018. This tool supports a robust review process, and is used as part of a perinatal mortality review meeting when professionals meet to discuss and to try to understand why a baby has sadly died and if anything could have been done to prevent that death.
The UMPIRE study (Understanding Multi-disciplinary approaches and Parental Input in perinatal mortality Review) is exploring how the introduction of the PMRT affects the multidisciplinary review of care by the team and whether the views of bereaved parents are included in reviews of babies who die in England. Understanding more about this subject could inform professional guidelines around improved multi-disciplinary review and help us better support and include bereaved parents. Sands is supporting this study by helping UMPIRE to reach bereaved parents who might wish to add their views to research about perinatal mortality review.
More information
Why do we need this research?
When a baby dies in hospital around the time of birth, the hospital carries out a review to try to understand what happened. Midwives, doctors who specialise in maternity care (obstetricians), doctors who specialise in the care of newborn babies (neonatologists) and any other relevant healthcare staff who are part of what is known as the multi-disciplinary team, carry out the review. The review aims to understand what happened and why the baby died. However, recent research has shown that some parents are unaware that a review may be taking place after their baby has died and that their views or questions about care are often not considered in the review. The same research also showed that the quality of reviews varies from one hospital unit to another .
The Perinatal Mortality Review Tool or ‘PMRT’ was introduced in England at the beginning of 2018 to help hospitals improve how baby deaths are reviewed and to try to ensure that parents are supported in understanding how they can contribute their own perspective or views of their care, and any questions they may have about their care, as part of the review.
Currently, however, we only know a little about how hospitals are using the PMRT to carry out reviews or whether there is meaningful communication with bereaved parents now the PMRT is being used.
What are the aims of this study?
The UMPIRE study (Understanding Multi-disciplinary approaches and Parental Input in perinatal mortality Review) is exploring how bereaved parents are informed about hospital review, and if and how they are given the opportunity to have their views and questions about their care, included as part of the review. It is also exploring how different health professionals – obstetricians, midwives, any specialists – contribute as part of the review team.
What will the researchers do?
The lead researcher, Jo Dickens, is a bereavement midwife by background and has a number of years’ experience of supporting families when a baby has sadly died around the time of their birth.
The study will take place in a small number of NHS maternity and neonatal hospital units in England over two years and will involve the researcher observing perinatal mortality review meetings in each Trust to explore how the reviews are carried out and who is involved. This will be followed by interviews with healthcare professionals who are part of the review team and bereaved parents who wish to take part in the study, so that their personal experiences of the review process can be explored.
What will the findings of this study mean for babies and families?
We will aim to publish the results of this study in a research journal but also to share them with the public and policy makes. The findings of this study will ensure a better understanding of how multi-disciplinary input into reviews impacts the quality of a hospital review and what parents’ experiences of review are. This could inform professional guidelines and support resources around how to better support bereaved parents throughout the hospital review process, when their baby has been stillborn or died shortly after birth.
Project lead: Dr. Jo Dickens
Organisation: University of Leicester
Funder: University of Leicester
Timescale: 2021 - ongoing