Monash researchers find Safer Baby Bundle reduces stillbirths
Researchers from Monash University, the Hudson Institute of Medical Research and Monash Health have conducted the first evaluation of the Safer Baby Bundle’s impact in Victoria, with results showing that the initiative was associated with a reduction in stillbirths.
The Safer Baby Bundle initiative is a set of evidence-based clinical guidelines and educational resources developed by the NHMRC Centre of Research Excellence in Stillbirth for clinicians and pregnant women to help prevent the tragedy of stillbirth.
Across three linked studies published in The Australian and New Zealand Journal of Obstetrics and Gynaecology, Dr Keeth Mayakaduwage and Associate Professor Miranda Davies-Tuck examined whether the Safer Baby Bundle reduced stillbirth and perinatal mortality, changed the causes of perinatal death, and whether its benefits were experienced equitably across population groups.
Dr Keeth Mayakaduwage, the primary author of the evaluation, is an adjunct lecturer in the Department of Obstetrics & Gynaecology at the School of Clinical Sciences at Monash Health and an obstetrics and gynaecology (O&G) resident medical officer at Monash Health. He undertook this work as part of his Honours project at the Hudson Institute of Medical Research, supervised by senior author Associate Professor Davies-Tuck, Research Group Head of Epidemiology and Clinical Trials at the Hudson Institute of Medical Research, and other NHMRC Centre of Research Excellence in Stillbirth investigators.
Reduction in perinatal mortality
In Australia, more than six babies are stillborn every day and a further two die within the first 28 days of life. In 2022, there were over 3,000 perinatal deaths, representing around one percent of all births.
Dr Mayakaduwage believes the findings provide critical evidence to guide safe, effective and equitable national implementation. “We found that implementation of the Safer Baby Bundle in participating Victorian maternity services was associated with a reduction in stillbirth and a statistically significant reduction in overall perinatal mortality, without an increase in unintended harms such as caesarean section, induction of labour, preterm birth or neonatal intensive care admission,” Dr Mayakaduwage said.
“Stillbirths due to unexplained causes and specific perinatal conditions declined in Safer Baby Bundle sites, suggesting improvements in antenatal detection and management of fetal risk,” he said. “However, these benefits were not observed across all population groups, with no improvement seen among several migrant groups and an increase in perinatal mortality among Indigenous women during the study period.”
A/Prof Davies-Tuck said, “These findings are significant because they demonstrate that stillbirth reduction is achievable at scale, while also highlighting that universal programs may not benefit all populations equally if they are not culturally tailored.”
Australia is one of the safest countries in which to give birth, but progress in reducing stillbirth has been slow and uneven, underscoring the need for effective, evidence-based national prevention programs.
“Certain demographic groups, including migrant and Indigenous populations, experience disproportionately higher risks of stillbirth, reinforcing the need for culturally safe and targeted prevention strategies,” A/Prof Davies-Tuck said.
Now adapted for indigenous communities
The Centre of Research Excellence in Stillbirth has now adapted the Safer Baby Bundle for Indigenous women and for migrant and refugee communities in Australia. A/Prof Davies-Tuck led the cultural adaptation for migrant and refugee communities, through a co-design process developed in partnership with these communities.
“Families need maternity care that identifies babies at risk earlier, responds appropriately to warning signs, and does so without exposing mothers and babies to unnecessary intervention,” she said. “Stillbirth is devastating, yet many cases are potentially preventable with timely, evidence-based antenatal care.”
Professor Euan Wallace AM, Dean, Sub-Faculty of Clinical and Molecular Medicine at Monash University, and recently appointed Chief Research and Innovation Officer at Monash Health and is a co-author on the series. “This research shows that a structured, system-wide approach can reduce preventable deaths while maintaining safety for mothers and newborns. Importantly, it also identifies populations who did not experience these benefits,” he said.
Dr Mayakaduwage noted that this evaluation was conducted prior to the rollout of the culturally adapted bundles, and ongoing evaluations will be critical to determine whether these adaptations improve outcomes and equity for these groups.
He also acknowledged Safer Care Victoria and the Consultative Council on Obstetric and Paediatric Mortality and Morbidity for their leadership in rolling out the Safer Baby Bundle across Victoria. Developed by the Centre of Research Excellence in Stillbirth, the bundle forms part of the National Stillbirth Action and Implementation Plan.
About Monash University
Monash University is Australia’s largest university with more than 80,000 students. In the 60 years since its foundation, it has developed a reputation for world-leading high-impact research, quality teaching, and inspiring innovation.
With four campuses in Australia and a presence in Malaysia, China, India, Indonesia and Italy, it is one of the most internationalised Australian universities.
As a leading international medical research university with the largest medical faculty in Australia and integration with leading Australian teaching hospitals, we consistently rank in the top 50 universities worldwide for clinical, pre-clinical and health sciences.
For more news, visit Medicine, Nursing and Health Sciences or Monash University.
MEDIA ENQUIRIES