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Achieving safer childbirth on a global scale


    Abigail Ringer reports about this year’s PROMPT Symposium – a collaboration of doctors and midwives who are at the forefront of driving up standards in maternity care.

    By Abigail Ringer

A couple of weeks ago, I had the pleasure of attending the 2017 PROMPT Symposium, in the Assembly Rooms in Bath. The symposium was organised by the PROMPT Maternity Foundation, dedicated to making childbirth safer on a global scale. It was attended by midwives, obstetricians and anaesthetists from all over the world.

More about the PROMPT Maternity Foundation

PROMPT or Practical Obstetric Multi-Professional Training all began in response to the findings of the Confidential Enquiry into Maternal & Child Health (CEMACH 1997) which reported that there was evidence of substandard care in more than half of all maternal deaths in the UK. The PROMPT training package was designed to provide training to doctors and midwives on how to deal with emergencies that can arise during childbirth.

The introduction of the PROMPT training package in Southmead Hospital, Bristol, led to an astonishing 50% reduction in the number of babies affected by injuries to the brain caused by a shortage of oxygen and a 70% reduction in the number of injuries to the baby following shoulder dystocia. Shoulder dystocia occurs when the baby’s body is prevented from being delivered after the head because one of the baby’s shoulder’s gets stuck on the mother’s pelvis. Shoulder dystocia can result in injuries to the brachial plexus, a network of nerves which supply the muscles of the arm and also brain injury if the baby is stuck against the pelvis for too long and deprived of oxygen.

PROMPT around the World

After such an encouraging start, PROMPT became adopted by most maternity units across the UK and began to spread across the globe. During the symposium, we heard from PROMPT representatives from the Philippines, Zimbabwe, China, Spain and Singapore.

One American Hospital started to use PROMPT in August 2008. At that time, 3 in 100 births complicated by shoulder dystocia resulted in a brachial plexus injury. 5 years after implementing PROMPT, this figure had reduced to 0.

Better Births

Another highlight of the symposium was listening to Professor Dunkley-Bent share the vision and recommendations from the National Maternity Review, entitled Better Births, which was published last year.

The remarkable thing about this review is that it was informed by the opinions of over 9,000 mothers and NHS staff. The plan was to implement change that women really wanted to see and the vision now includes maternity services become safer and more family friendly.

Our experience

As a lawyer acting for children who have suffered injuries as a result of the mismanagement of obstetric emergencies and seeing the lifelong effects of such injuries, I can only hope that the successes of PROMPT and the vision of the National Maternity Review will be the driving force for a safer future for babies everywhere.


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