Strategies for Addressing Recurrent Pregnancy Loss (Virtual Symposium)-03-Stone

03-Stone_RainbowClinic

Pdf Summary

The document discusses the Rainbow Clinic model, an innovative approach to caring for women in subsequent pregnancies after stillbirth, which is defined as fetal death after 20 weeks or 350 grams, with global rates still high especially in low-income countries. Stillbirth risk factors include maternal age, race, obesity, preexisting conditions, and prior stillbirth history, which significantly increases recurrence risk and related complications.<br /><br />Research shows that specialized Pregnancy After Loss (PAL) services, like Rainbow Clinics, provide enhanced monitoring including more frequent antenatal visits, ultrasounds, and medical management such as increased aspirin use. These clinics emphasize continuity of care, sensitive communication acknowledging prior loss, and psychological support through dedicated coordinators and peer groups. Studies from centers like Birmingham’s have reported reduced rates of stillbirth recurrence, preterm births, and adverse perinatal outcomes following introduction of these clinics.<br /><br />The Rainbow Clinic at Mount Sinai, modeled after UK programs, offers multidisciplinary care involving maternal-fetal medicine specialists, mental health professionals, nutritionists, and personalized treatment plans based on individual risk factors such as placental pathology and maternal conditions. Starting in 2022, over 110 patients have been seen with positive feedback highlighting emotional support, flexible care, and reduced anxiety. Innovations include training staff across departments and ensuring consistent caregiver interactions.<br /><br />Ongoing large-scale research, notably Tommy’s National Rainbow Clinic Study in the UK, aims to evaluate clinical outcomes, patient well-being, and cost-effectiveness of this specialized care. Early evidence suggests these clinics not only improve pregnancy outcomes but also offer a strong social return on investment by addressing perinatal mental health.<br /><br />In summary, Rainbow Clinics integrate medical and psychological support to improve outcomes and experiences for women after stillbirth, with current efforts focused on expanding access, refining care protocols, and advancing research to reduce recurrent losses and associated distress.

Keywords

Rainbow Clinic

stillbirth

pregnancy after loss

maternal-fetal medicine

psychological support

antenatal care

perinatal outcomes

placental pathology

multidisciplinary care

perinatal mental health