CompletedInterventional

Effectiveness of a maternity improvement programme to reduce excess bleeding and need for transfusion after childbirth: the Obstetric Bleeding Study UK (OBS UK)

Losing too much blood after childbirth affects around 50,000 women in the UK each year. It can lead to emergency blood transfusions, intensive care stays, and emotional trauma like post-traumatic stress. The OBS UK study is testing a new way of caring for mothers in 36 NHS maternity hospitals. This care plan involves checking bleeding risk before birth, carefully measuring blood loss at every birth, calling senior doctors quickly if heavy bleeding starts, and doing fast bedside tests to check blood clotting. Researchers are using standard NHS birth records from around 189,000 women to see if this care package lowers the need for blood transfusions and makes birth safer. Some women and their birth partners will also be invited to share their experiences in interviews to help researchers understand the emotional and practical impact of birth-related bleeding.

At a glance

Status

Completed

Sponsor

Cardiff University

Enrolment target

189,000

Start

01 Feb 2024

Estimated completion

31 Jul 2026

Obstetric bleeding

What is this study about?

Heavy bleeding after childbirth, known to doctors as postpartum haemorrhage, is the most common serious complication of having a baby. Every year in the UK, roughly 50,000 women lose a litre or more of blood during or shortly after giving birth. This can be a terrifying experience that requires emergency treatment, blood transfusions, or admission to an intensive care unit. For many mothers, it can also lead to long-lasting emotional distress and post-traumatic stress.

To tackle this problem, doctors and midwives in Wales created a step-by-step care plan. Under usual guidelines, staff often estimate blood loss by sight and only start measuring once bleeding is already heavy. The new care plan changes this by checking each woman's bleeding risk early, accurately measuring blood loss for every birth by weighing pads and swabs, bringing in senior medical staff quickly, and running fast bedside blood tests to check how well the blood can clot.

The OBS UK study is now testing this approach across 36 large NHS hospital maternity units. Hospitals will start with their usual care and then gradually adopt the new care package. By comparing results before and after the change, the research team wants to prove whether this approach reduces severe bleeding, cuts down the need for transfusions, and provides good value for the NHS.

Key takeaways

Tests an improved hospital care plan designed to spot and treat heavy bleeding after birth more quickly.
Takes place across 36 large NHS maternity units involving around 189,000 births.
Uses accurate measurements of blood loss and fast bedside tests rather than guesswork.
Most mothers do not need to attend extra visits, as data comes from routine hospital records.
Optional interviews will look at how heavy bleeding affects mental health and family finances.

Who may be eligible?

This study focuses on whole hospital maternity units rather than individual volunteers signing up. If you give birth at one of the 36 participating NHS hospitals during the study window, your routine birth records will automatically be included in the main research analysis.

To take part in the main study, a maternity unit must be a busy NHS hospital delivering more than 2,000 babies each year, with hospital leaders who have agreed to train their staff and put the new guidelines into practice.

A smaller group of women and their birth partners may also be invited to join optional interview studies. These sub-studies are for women aged 16 and over who experienced heavy bleeding (more than one litre of blood loss), as well as some women who had normal blood loss, to help researchers understand their physical recovery and emotional wellbeing.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

You are giving birth at one of the 36 participating NHS maternity hospitals.
Your birth takes place during the study period (between May 2023 and January 2027).
You have not registered an opt-out for your routine NHS health records to be used in research.
You are aged 16 or over if you choose to take part in an optional interview sub-study.

Answer every question to see your result.

What does participation involve?

For most women giving birth at a participating hospital, taking part does not involve any extra hospital visits, new medications, or personal appointments. Your clinical team will simply care for you using the study's updated safety steps, and information from your standard hospital records will be securely gathered.

If you are invited to join one of the optional sub-studies about your mental health or family costs, a researcher will contact you to explain what is involved. This usually means taking part in an interview or filling out a survey about your birth experience and how you felt afterwards. You can choose whether to take part in these interviews, and taking part will not change the medical care you receive.

The entire research project is scheduled to run from May 2023 to January 2027.

Potential risks and benefits

The main benefit of this study is that hospital staff will have better tools and training to detect and manage bleeding quickly, which may reduce the chance of needing a blood transfusion or intensive care. Because the care package uses established safety practices rather than experimental drugs, there are no extra physical risks involved. If you choose to take part in an interview, talking about a difficult birth may bring up painful memories, but support is available if you find it distressing. You always have the right to opt out of your health records being used or decline interview invitations at any time without your NHS care being affected.

Locations (37)

Kings College Hospital
Approximate
London, England
James Cook University Hospital
Approximate
Middlesbrough, England
Southampton General Hospital
Approximate
Southampton, England
Hampshire Hospitals NHS Foundation Trust
City only
Basingstoke, England
Barts Health NHS Trust
City only
London, England
Royal Blackburn Hospital
Unverified
Blackburn, England
The Rotherham NHS Foundation Trust
Unverified
Rotherham, England
Queen Alexandras Hospital
Unverified
Portsmouth, England
Royal Surrey County Hospital NHS Foundation Trust
Unverified
Guildford, England
NHS Grampian
Unverified
Aberdeen, Scotland
Worcestershire Royal Hospital
Unverified
Worcester, England
Ninewells Hospital
Unverified
Dundee, Scotland

Common questions

Do I need to take an experimental drug to be part of this study?

No. The study does not test any new or experimental drugs. It focuses on better hospital teamwork, accurate measurement of blood loss, and faster response times.

How does the team measure blood loss accurately?

Instead of staff estimating how much blood was lost by looking, pads, sheets, and swabs are weighed so doctors and midwives know the exact amount of bleeding right away.

Can I opt out of having my information included?

Yes. You have the right to opt out of your routine NHS health data being shared for research. You can speak to your midwife or use the NHS national data opt-out service.

Will taking part change my personal birth plan?

No. The study does not interfere with your personal birth preferences, choices for pain relief, or infant feeding decisions. It simply adds safety checks to protect against heavy bleeding.

What happens if I am asked to do an interview?

Interviews are completely optional. If invited, you can decide whether you feel comfortable talking about your birth experience. You can pause or stop the interview at any point.

How to find out more

Sarah Bell

OBSUK@cardiff.ac.uk +44 2920 743107 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.