Routine Pulse Oximetry Testing for Newborn Babies has been published by the British Association for Perinatal Medicine (BAPM) in partnership with expert stakeholders including the Royal College of Midwives’ fellow and Principal Educator for NHS Education for Scotland, Dr Tom McEwan.
The framework aligns with the RCM recommendations for decolonising practice which reasserts the NHS Race and Health Observatory’s (RHO) call for removing white normative standards within traditional newborn assessments that continue to be used regardless of their ineffective applicability to neonates with varying skin tones. The RCM support RHO’s recommendations for pulse oximetry testing as well as the routine use of transcutaneous bilirubinometer (TCBR) screening for jaundice assessment both in hospital and community settings.
The BAPM framework provides standardised guidance for routine pulse oximetry testing of all asymptomatic newborn babies of 34 weeks and above. Research shows that this supports timely investigation and treatment of unwell babies, while reducing unnecessary investigations in babies with delayed cardio-respiratory adaptation (ie healthy babies) and parent-baby separation. The framework includes clear care pathways for routine testing within 24 hours of birth and advice on provision in midwife-led settings including homebirths.
While many maternity units have already implemented routine pulse oximetry testing, variations and gaps in provision still exist across the UK and this contributes to health inequalities. This national, evidence-based framework therefore provides an invaluable resource for services that have struggled with or have yet to commence implementation.
Last year the NHS Race and Health Observatory (RHO) Review of Neonatal Assessment and Practice in Black, Asian and Minority Ethnic Newborns report highlighted that visual assessment of cyanosis in babies with skin tone variation leads to high numbers of false positives and false negatives, contributing to health disparities. Routine pulse oximetry for all newborns over 34 weeks reduces reliance on inequitable visual assessments and ensures midwives and maternity support workers/maternity care assistants are trained and familiarised with an evidence-based assessment tool. Routine implementation also normalises the use of pulse oximetry so that it becomes a go-to part of any assessment when there are concerns about wellbeing.
If the service you work within hasn’t yet adopted these assessment tools, then this is an urgent call to action for you to help lead this change. This is essential for delivering equitable, evidence-based care. We have known for too long that the health outcomes of newborns born to Black and Asian mothers are poorer than those born to white mothers. Addressing this is long overdue and you can make a difference now by implementing BAPM’s excellent and comprehensive Routine Pulse Oximetry framework. For more information you can join BAPM’s webinar on 9 December.
