Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what assessment his Department has made of the adequacy of specialist obstetrician care provided to mothers expecting multiple births; and if he will make a statement.

Evidence based advice on the care of women with multiple pregnancies is set out in the National Institute for Health and Care Excellence (NICE) clinical guidelines ‘Multiple Pregnancies – The management of twin and triplet pregnancies in the antenatal period’. In line with these guidelines, we would expect clinical care for women with twin and triplet pregnancies to be provided by a nominated multidisciplinary team consisting of a core team, including named specialist obstetricians, who have experience and knowledge of managing twin and triplet pregnancies. The Department has not undertaken an assessment of the effectiveness of the implementation of the NICE guidelines. It is for local maternity care providers to determine how best to deliver services for women with multiple pregnancies in their area. In doing so we would expect them to give due regard to NICE guidance.

MBRRACE-UK published (on 10 June 2015) a Government funded Perinatal Mortality Surveillance report for 2013. This found that, multiple births were associated with significantly high rates of mortality, with an almost fivefold increase in the neonatal mortality for twins (4.86 deaths per 1,000 live births) and over a twelve fold increase for triplets and higher order births (12.43 deaths per 1,000 live births). Preterm delivery is a major factor in multiple birth and we have included low birth weight as an indicator in the Public Health Outcomes Framework. NHS England is undertaking a major review of the commissioning of National Health Service maternity services, in line with commitments made in the NHS Five Year Forward View. The review will assess current maternity care provision and consider how services should be developed to meet the changing needs of women and babies.