Determining signs of life in extremely preterm babies

With thanks to Grosvenor Interiors and SiMBA for the images of birthing and bereavement suites.

It is extremely distressing for parents to find out that their baby is going to be born too early for them to survive. These videos are based on the MBRRACE-UK Signs of Life Guidance which has been developed with healthcare professionals, clinical organisations, health policy and health research experts and parent advocates to support staff in providing consistent care at this difficult time.

The guidance is designed to help healthcare professionals caring for babies born following spontaneous birth before 24+0 weeks of gestation where, following discussion with the parents, active survival-focused care is not appropriate. At this very early stage, some babies may die during labour or birth while others may show some signs of life. There has been wide variation in the reporting of signs of life. This affects whether the baby’s birth is reported as a miscarriage or registered as a live birth and then a neonatal death.

There are three videos to support the guidance:

• A film explaining the guidance to healthcare professionals in full
• A short film highlighting key stages in determining signs of life 
• A film explaining the guidance to bereaved parents and families 

This work developed following the research undertaken for the hexi.ox.ac.uk section “Losing a baby at 20 to 24 weeks of pregnancy”. You can find out about the experiences of parents whose baby died before, during or shortly after birth at 20 to 24 weeks of pregnancy by seeing and hearing parents share their personal stories on film. We talked to 38 parents from across the UK about issues such as finding something was wrong, experiences of giving birth, time with their baby and what their life has been like since their baby died. This resource is extremely valuable in sharing these parents’ stories for you to gain understanding of their experiences and concerns at this difficult time.

We have used the terms parents and baby in the guidance because this is how many people choose to describe how they feel. However we recognise every person’s experience is unique and apologise to those who find these terms upsetting and prefer to be addressed as individuals rather than parents and for their loss to be referred to as the end of their pregnancy or as a miscarriage.

If you have 2 minutes please help us by giving your feedback about the videos here. We’d really like to know whether the guidance has changed your practice as a healthcare professional.