Ensuring safe beginnings: The imperative of patient safety in maternity and newborn care

As we mark World Patient Safety Day on 17 September 2025, I want to share a few reflections on the continuing imperative for safety in maternity and newborn care.

We all recognise that the condition of a baby at, or shortly after, birth plays a major role in their ongoing health and development. Prematurity remains the single biggest contributor to longer-term health needs for babies and children. However, complications at birth can be equally significant in shaping a child’s future.

Among term babies, the most common challenges are those associated with poor perinatal adaptation, the complex transition from a fluid-filled intrauterine environment to life on “dry land.” These include hypoxic–ischaemic encephalopathy (HIE), persistent pulmonary hypertension of the newborn, congenital pneumonia, and neonatal hypoglycaemia. It is imperative to promptly and correctly identify and act on these conditions in order to prevent lifelong consequences for the baby and their family.

To reduce such risks, it is vital that multidisciplinary teams are trained together to:

• recognise antenatal and intrapartum signs of fetal distress,
• expedite birth where necessary, and
• initiate resuscitation and stabilisation without delay.

In practice, this requires clinicians to continually ask: What is the most likely reason this baby is presenting in this way? Could there be an underlying problem? Building a culture of curiosity, vigilance, and suspicion for harm, especially in the context of antenatal risk factors is key.

Adequate staffing of maternity, obstetric and neonatal services is essential. Equally, ensuring that all team members are competent in basic neonatal life support and confident in initiating those first crucial steps is fundamental to safe care. Clear, reliable communication across teams is also critical and this becomes more effective when professionals have already trained together in a multiprofessional setting.

We know that hypoxic ischaemic encephalopathy affects between 1.0 and 3.5 per 1,000 live births in the UK (BAPM, 2020). Interruption of oxygen supply not only affects the brain but can also injure other organs, leading to severe lifelong disability or death.

Minimising perinatal risks around birth maximises babies’ potential for normal development. It also reduces the trauma and anxiety for parents who may otherwise face separation from their baby during neonatal unit admission. Supporting safe beginnings creates the conditions for bonding and early parental education, which in turn improves outcomes.

So, the question remains: what are you, whether as an organisation or an individual clinician, in maternity and newborn care doing to ensure that staffing, training, communication, and learning from events remain central to patient safety? Now is the time to reflect and prioritise these foundations so that every baby has the safest possible start to life.