Skip to content Back to top

Each Baby Counts: Learn and Support

Each Baby Counts: Learn and Support, is a national improvement programme developed by the Royal College of Obstetricians and Gynaecologists and Royal College of Midwives. It aims to reduce the number of babies who die or are left severely disabled because of incidents occurring during term labour.

Reports from maternity units across the country found that escalation was often a major contributor to incidents. Each Baby Counts: Learn and Support was set up to improve working practice and escalation, by focusing on behaviours, culture, and psychological safety.

The aims:

  • To reduce delays in escalation by improving the response to escalation and action taken.
  • To standardise the use of safety critical language.
  • To reduce feelings of hierarchy, creating a supportive environment which empowers staff of all levels to speak up when they identify deterioration or a potential mistake.
  • To promote a culture of respect, kindness, and civility amongst staff members, normalising positive feedback and saying thank you to each other.
  • To improve the ways in which we listen to women.

We are implementing Each Baby Counts: Learn and Support in maternity units across Greater Manchester and Eastern Cheshire.

Each Baby Counts: Learn and Support Toolkit

Visit the Royal College of Obstetricians and Gynaecologists website to access the toolkit.

Download here Download here

Each Baby Counts: Learn and Support local resources

Click below to access ‘print ready’ versions of our local posters and business cards.

Download resources Download resources

Team of the shift is designed to make escalation easier so we can keep women and babies safe, support each other as a team and improve psychological safety.

At the start of the shift, ask yourself…

  • Do I know everyone on shift today?
  • Do I know who I am going to escalate concerns to?
  • Have I said thank you to a colleague?
  • Have we celebrated our successes together?
  • Have I checked if my colleagues are okay?
  • Is there a shared vision for the shift?

 The aims are to:

  • Give Escalation the respect and time it deserves.
  • Set the scene for the day.
  • Identify the team leaders, including those who will be escalated to.
  • Flatten hierarchies by giving everyone a voice and encouraging first name introductions.
  • Support staff by creating psychological safety, encouraging them to raise concerns and speak up.
  • Identify learning needs for trainees and students.
  • Create a positive workplace culture by thanking staff and celebrating successes.
  • Eliminate cultures of criticism.
  • Promote a sense of teamwork, mutual respect, and create a shared mental model of the team’s workload, priorities, and potential challenges that shift.

AID is designed to improve communication.

If you are escalating start your conversation by stating what you need. Do you want advice? To inform? to do something?

Then give your ‘situation, background, assessment and recommendation’ (SBAR), this enables the receiver to mentally prepare for the right response.

If you are being escalated to and unsure what is required, you can ask “What do you need from me?”

If treatment is not needed, thank the person who escalated their concerns and use this as a teaching moment.

Have a conversation about why are they concerned and explain why you don’t feel treatment is currently required. Agree when another escalation would be required. Discuss what you expect to happen if the patient deteriorates and offer reassurance that you will attend again if required.

If treatment is needed, thank the person for escalating their concerns and treat the deterioration.

If there is still a difference of opinion following ‘Teach or Treat’ then a third opinion should be sought

Contact us

If you have any questions about Each Baby Counts: Learn and Support please contact

Launch Recite Me assistive technology