Victoria's Safer Baby Bundle Linked to Reduced Stillbirth and Perinatal Mortality
Research on Victoria’s Safer Baby Bundle, led by Dr. Keeth Mayakaduwage, has found that the program's implementation was associated with a reduction in stillbirth and a statistically significant reduction in overall perinatal mortality.
The Safer Baby Bundle consists of evidence-based clinical guidelines and educational resources developed by the NHMRC Centre of Research Excellence in Stillbirth for clinicians and pregnant women, aimed at preventing stillbirth.
The program's implementation in Victorian maternity services was associated with a reduction in stillbirth and a statistically significant reduction in overall perinatal mortality, without an increase in unintended harms.
Comprehensive Evaluation Published
Dr. Mayakaduwage, with senior author Associate Professor Miranda Davies-Tuck, evaluated the program in three linked studies published in The Australian and New Zealand Journal of Obstetrics and Gynaecology. The research examined whether the Safer Baby Bundle reduced stillbirth and perinatal mortality, changed the causes of perinatal death, and whether its benefits were experienced equitably across population groups.
Key Findings: Success Without Unintended Harms
Dr. Mayakaduwage, lead author of the research, stated that the findings provide evidence to guide safe, effective, and equitable national implementation. He noted that the program's implementation in Victorian maternity services was associated with a reduction in stillbirth and a statistically significant reduction in overall perinatal mortality, without an increase in unintended harms such as caesarean section, induction of labor, preterm birth, or neonatal intensive care admission.
Stillbirths attributed to unexplained causes and specific perinatal conditions declined in Safer Baby Bundle sites, suggesting improvements in antenatal detection and management of fetal risk.
Addressing Inequities: Acknowledged Challenges
However, Dr. Mayakaduwage also reported that the benefits were not observed across all population groups, with no improvement seen among several migrant groups and an increase in perinatal mortality among Indigenous women during the study period.
The NHMRC Centre of Research Excellence in Stillbirth has since adapted the Safer Baby Bundle for Indigenous women and for migrant and refugee communities in Australia. Dr. Mayakaduwage mentioned that the evaluation was conducted before the rollout of these culturally adapted bundles, and ongoing evaluations will be critical to determine whether these adaptations improve outcomes and equity for these groups.
Safer Care Victoria and the Consultative Council on Obstetric and Paediatric Mortality and Morbidity were acknowledged for their leadership in rolling out the Safer Baby Bundle across Victoria. The bundle forms part of the National Stillbirth Action and Implementation Plan.