Translation of an evidence-based approach to support families to have a healthy birth and baby by establishing a specialist clinic.

Becoming pregnant again after a stillbirth is an incredibly daunting prospect for women and families, usually characterised by the fear of repeating the experience. Women who have had a stillbirth are at increased risk of complications in subsequent pregnancies, including stillbirth, pre-eclampsia, placental abruption and low birthweight. It is also associated with increased psychological, emotional and social challenges. Along with the human costs the economic costs of these complications to health care systems and wider public services are substantial

In response to this, GM harnessed the academic expertise from the women and children’s research domain in the academic health science centre, combined with deep expertise in  placental growth within the University of Manchester, to develop the Rainbow Clinic model.

The Rainbow Clinic is a specialist service that supports women and their families during a subsequent pregnancy following a stillbirth or perinatal death. Care starts from the time of the postnatal appointment onwards and into a subsequent pregnancy, engaging with women early, ensuring they are on the right treatment, making any necessary referrals and providing more detailed ultrasound scanning.

The additional tests and continuity of care, provided by a small team of specialist doctors and midwives, result in improved outcomes for the baby, improved psychological wellbeing for parent and better use of NHS resources.

The first Rainbow Clinic was set up at Saint Mary’s Hospital, part of Manchester University NHS Foundation Trust (MFT) in 2013. Since opening, it has cared for over 750 families and helped to reduce the stillbirth rate by 34%. Similar clinics have followed including those at Wythenshawe Hospital, Stepping Hill and Oldham.

A retrospective case control study that reviewed the clinical outcomes for women with a history of stillbirth found that clinical outcomes were by the Rainbow Clinic with reduction in NICU admission (9% vs 14%) and subsequent stillbirth (0% vs 2%). For every £1 invested in Rainbow Clinic, £6 of value was derived including improved education for staff and reduced psychological morbidity for parents.

Health Innovation Manchester supported the scale-up across Greater Manchester maternity units, aiming to reduce the rates of maternal deaths, stillbirths, neonatal deaths and brain injuries that occur during or soon after birth by 20% by 2020 and by 50% by 2030. The charity Tommy’s also provided additional financial support as validation of the clinical progress to ensure scale and spread of the project.