The Rainbow Clinic: Improving maternity care following a previous loss
Professor Alexander Heazell, Emma Tomlinson, Dr Gauri Batra, Dr Jack Wilkinson
Start date: 2020
End date: 2026
Why do we need this research?
For parents whose babies have been stillborn or died shortly after birth, a subsequent pregnancy can be very daunting. There is a higher risk of pregnancy complications and these parents often need extra support throughout their pregnancy. However, the support given to these families varies across the country, often with no continuity of care. Parents have to endure the distress of telling health professionals about their previous loss over and over again.
The Tommy’s Rainbow Clinic is a specialist service for parents who have suffered a stillbirth or neonatal death that provides the best possible care to help and support them through a subsequent pregnancy. The clinic was opened in 2013 at St Mary’s Hospital in Manchester and has since looked after over 900 families – it is led by Professor Alex Heazell. This model of care is now being rolled out to other maternity units in the UK; there are currently 25 active Rainbow Clinics around the country, with 3 more ready to launch and a further 10 in development. There is also a Rainbow Clinic at Mount Sinai Hospital in New York, which was set up with support from Professor Heazell.
It is important that we collect data from these clinics so that we have evidence of how well they improve outcomes for women, birthing people and their babies.
What’s happening in this project?
Tommy’s researchers are carrying out the National Rainbow Clinic Study to assess the impact of these clinics. The team are recording the outcomes of pregnancy for mothers and babies who have been cared for at a Rainbow Clinic and are also looking at the psychological impact that Rainbow Clinics have on parents who are going through pregnancy after loss. Over 1,100 women are currently participating in the study.
Our researchers are also using information gathered from the Rainbow Clinics to develop a model that can identify the women and birthing people who are most likely to experience complications when pregnant after stillbirth. For example, our researchers looked at data from over 250 women who were treated at the original Rainbow Clinic in Manchester to find out whether there was a link between the cause of a previous stillbirth and the risk of complications in another pregnancy. The team found that women with a pre-existing medical condition were twice as likely to experience complications in a subsequent pregnancy, while women whose stillbirth was related to problems with the placenta were around ten times as likely to experience complications. Now, the team are looking at ultrasound scans from over 500 women – taken at 23 weeks – to find out which measurements are most useful at predicting whether the baby will need to be delivered early or will be smaller than expected at birth.
What difference will this project make?
Our hope is that more and more women and birthing people who are pregnant again after loss will be able to access the specialist care that Rainbow Clinics provide. By carrying out this research, we will have more evidence to demonstrate the positive impact of these clinics, which should encourage other maternity units around the country to set up their own Rainbow Clinics. The Rainbow Clinics are also providing us with a vast amount of information that can help us to improve and personalise the care that women and birthing people receive when they are pregnant again after a stillbirth or neonatal death.