Blencowe H, Cousens S, Jassir FB National, regional and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. The Lancet Global Health. 2016; 4:(2)

Confidential Enquiry into Stillbirths and Deaths in Infancy. 4th Annual Report.London: Maternal and Child Health Consortium; 1997

Downe S, Finlayson K, Walsh D, Lavender T. ‘Weighing up and balancing out’: a meta-synthesis of barriers to antenatal care for marginalised women in high income countries. BJOG. 2009; 116:(4)

Dyer E, Chudleigh T. Peer review of third trimester abdominal circumference measurements. Ultrasound BMUS. 2020; 29:(2)

Henrichs J, Verfaille V, Jellema P, Viester L, Pajkrt E, Wilschut J. Effectiveness of routine third trimester ultrasonography to reduce adverse perinatal outcomes in low risk pregnancy (the IRIS study). BMJ. 2019; 367

NHS Digital. NHS maternity statistics, England - 2020-21. 2021. (accessed 23 September 2021)

NHS England. NHS Mandate 2013-14. 2014. (accessed 23 September 2021)

NHS England. Saving Babies' Lives: a care bundle for reducing stillbirth. 2016. (accessed 23 September 2021)

NHS England. Implementing Better Births: Continuity of Carer. 2017. (accessed 24 September 2021)

NHS England. Saving Babies' Lives: a care bundle for reducing perinatal mortality. 2019. (accessed 23 September 2021)

National Institute for Health and Care Excellence. Inducing Labour. 2008. (accessed 23 September 2021)

Office for National Statistics. Births in England and Wales in 2013. 2014. (accessed 23 September 2021)

Office for National Statistics. Births in England and Wales in 2016. 2017. (accessed 23 September 2021)

Rolnik DL, Wright D, Poon LCY ASPRE trial: performance screening for preterm pre-eclampsia. Ultrasound in Obstetrics and Gynaecology. 2017; 50:(4)

Scala C, Bhide A, Familiari A Number of episodes of reduced fetal movement at term: association with adverse perinatal outcome. American Journal of Obstetrics and Gynaecology. 2015; 213:(5)

Evaluating the implementation of Saving Babies' Lives care bundle in NHS Trusts in England: stillbirth rates, service outcomes and costs. 2018. (accessed 23 September 2021)

Midwife scan clinic: response to increased demand for third trimester ultrasound

02 February 2022
13 min read
Volume 30 · Issue 2


In response to the high UK stillbirth rate, the Saving Babies' Lives care bundles of 2016 and 2019 recommended increased focus on reduced fetal movements and fetal growth restriction. Adopting the recommendations precipitated a sharp increase in third trimester scans, causing existing ultrasound services to be overwhelmed. A midwife scan clinic, established at Kingston Hospital NHS Trust in 2019, has been found to manage this increased scan demand efficiently and effectively. Midwife-sonographers triage scan requests, perform the scans and provide post-scan management in a one-stop-shop scenario. Evaluation of the service found that it has reduced multiple appointments, streamlined women's experience, provided continuity of care and proved cost-effective. Unexpected positive outcomes also occurred for breech presentation at term and for women under the care of the safeguarding team. Combining midwifery and ultrasound skills in a midwife scan clinic is a quality improvement initiative that facilitates the increasingly central role that ultrasound plays in fetal surveillance.

Third trimester scan demand across the UK grew by 27.9% between 2016 and 2018, (Widdows et al, 2018). Reflecting this national trend, the Kingston Hospital NHS Trust maternity unit saw a 32% increase from 2015-2018 (Figure 1). The likely reason for this rise in third trimester scan demand relates to the recommendations of the Saving Babies' Lives care bundle, version 1 (NHS England, 2016). This was produced in response to the UK stillbirth rate being higher than other comparable European nations, at 4.7 per thousand births (Office for National Statistics, 2014). The report's recommendations arose from the NHS England Mandate Objective to halve the stillbirth rate by 2030 (NHS England, 2014) by focusing on four key elements of maternity care. Two of these had a direct impact on the demand for third trimester scans: increased fetal surveillance for fetal growth restriction and increased awareness of reduced fetal movements.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month