Avoiding Brain Injury in Childbirth (ABC) Programme

Programme aims

The Avoiding Brain Injury in Childbirth (ABC) Programme addresses this challenge through a standardised, evidence‑based approach focused on two key areas of risk:

• The management of Impacted Fetal Head (IFH) during a caesarean birth, where a baby’s head becomes wedged in the mother’s pelvis.
• The detection and response to a suspected reduction in a baby’s oxygen supply, known as Intrapartum Fetal Deterioration (IFD).

The programme aims to reduce avoidable brain injury during childbirth by improving how maternity teams recognise and respond to these high-risk clinical situations, through multidisciplinary working and consistent, high‑quality clinical practice.

In doing so, the programme will improve outcomes and experiences for babies, women, and families, while also contributing to system‑wide benefits such as fewer referrals to Maternity and Newborn Safety Investigations (MNSI) and a reduction in maternity‑related litigation costs.

Objectives

Using a national train‑the‑trainer model, the programme will equip maternity staff with practical clinical skills, a shared language, and tools to improve communication with pregnant people and families.

The programme will build capability and confidence across the maternity workforce by training local clinical leaders who can deliver education within their own trusts and sites.

By supporting timely identification, escalation, and action during obstetric emergencies, the programme seeks to reduce avoidable harm, improve neonatal outcomes, and promote safer, more consistent care across maternity services.

The programme, which will run until March 2027, is being delivered as part of the Maternity and Neonatal National Patient Safety Improvement Programme (MatNeoSIP).

Activity

Health Innovation East is providing clinical leadership and delivering training to trust and site leads, ensuring consistency with the ABC Programme’s methods and evidence base.

The training covers the management of Impacted Fetal Head and Intrapartum Fetal Deterioration using standardised methods and resources. These resources are designed not only to support clinical decision‑making, but also to improve communication with women and families during emergencies.

Ongoing coaching and support are offered through remote engagement and on‑site supervision, alongside visits to trusts and sites to oversee and validate local training delivery. Monthly virtual ABC Forum sessions enable teams to access programme updates, share learning, and receive peer support.

The programme also supports trusts to integrate ABC training into mandatory staff training schedules and align it with existing maternity safety and deterioration strategies. In parallel, support is provided to make use of sustainable reporting and impact measurement systems, helping to embed learning and improvement over the longer term.

Partners

The ABC Programme is delivered through a national collaboration between the Royal College of Obstetricians and Gynaecologists (RCOG), the Royal College of Midwives, and The Healthcare Improvement Studies (THIS) Institute at the University of Cambridge.

This partnership brings together clinical expertise, professional leadership, and improvement science to ensure the programme is evidence‑based and clinically credible.

NHS England and the Department of Health and Social Care have commissioned Health Innovation East, alongside other regional Health Innovation Networks across England, to lead the national roll-out of the programme.

The programme aligns with national maternity safety priorities and draws on learning from Maternity and Newborn Safety Investigations and published evidence, including RCOG guidance on the management of Impacted Fetal Head at caesarean birth and wider assessments of risk across the maternity pathway