Case study: Royal Jubilee Maternity Hospital

Twins Trust's Maternity Engagement Project is a world-first quality improvement project focused on improving maternity care for multiple pregnancies.

Mary Murnaghan, Consultant Obstetrician and Gynaecologist at the Royal Jubilee Maternity Hospital in Belfast, talks about why they signed up for the project, the improvements they have seen and why they think other units should take part.

Tell us why you signed up for the Maternity Engagement Project?

We're a unit in Northern Ireland and are the regional maternal-fetal medicine and Neonatal Intensive Care Unit. We set up our dedicated twin clinic in September 2014.

This is a two consultant clinic and we deliver approximately 100 twins and five to six sets of triplets per year. Most of these are booked in Royal Jubilee Maternity Service and so have their care transferred from other units following a complication i.e. fetal anomaly, selective FGR, TTTS, etc.

So to benchmark ourselves against equivalent services, we decided to get involved in the Maternity Engagement Project, as there are no other obstetric units with the number of multiple deliveries in Northern Ireland.

Since taking part in the project, what improvements have you seen in your unit?

We've seen an improvement in midwifery support to the clinic. On the advice of our assessment, a second midwife has been identified. We've reinstated the multiples' antenatal education sessions which paused over Covid.

We've also started to use virtual methods of communication which allow families to engage with information at a time and speed that works best for them. We've presented the reports to the service management team and evidenced areas of good practice.

What did you learn from the Maternity Engagement Project/what barriers were you able to overcome?

We still struggle to provide all of the service inputs that the Maternity Engagement Project would recommend. However, we now have a breastfeeding specialist midwife who works in the Neuro Neonatal Intensive Care unit (NNICU) who will support parents if their babies require admission.

Why would you encourage other units to sign up for the project?

Given the challenges that we have in a remote part of the UK getting information and data to benchmark ourselves against, I would definitely recommend the project.

I'd say that we did not find the reports critical but rather focused on areas of good practice and support for change where this was recommended.