The Rainbow Clinic: Improving maternity care following a previous loss

Rainbow Clinics provide specialist maternity care for women who are pregnant again following a previous stillbirth or neonatal death. We want to know more about the impact of these clinics and see if we can find ways to improve care further.
  • Authors list

    Professor Alexander Heazell, Emma Tomlinson, Dr Nicole Graham, Dr Gauri Batra

  • Research centre

  • Research status

    Ongoing projects

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 care and emotional support throughout the pregnancy. However, the standard of care given to these women and their 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 provided care for over 900 families. This model of care is now being rolled out to other maternity units in the UK; there are currently 17 active Rainbow Clinics around the country, with 11 more ready to launch and a further 14 in development. It is important that we collect data to show how effective these clinics are at improving outcomes for mothers and their babies.  

What’s happening in this project?

Tommy’s researchers are carrying out the National Rainbow Clinic Study in order to assess the impact of these clinics. The team will record the outcomes of pregnancy for mothers and babies who have been cared for at a Rainbow Clinic and will also look at the psychological impact that Rainbow Clinics have on parents who are going through pregnancy after loss. 

Rainbow Clinics are also giving our researchers the opportunity to find out more about the risks associated with pregnancy after stillbirth, which is helping them develop a model to identify the women who are most likely to experience complications. In one study, 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. In a separate study of over 500 women, the team carried out an ultrasound scan of the placenta at 23 weeks and found that women with a smaller, thicker placenta or with abnormal blood flow to the uterus were more likely to experience complications.

What difference will this project make?

Our hope is that more and more women 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 receive when they are pregnant again after a stillbirth or neonatal death.