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The GAP Care Pathway is aligned with and complementary to the Fetal Growth element of the NHS Saving Babies Lives' Care Bundle v3.
It is available here: GAP Guidance
See also our FAQ pages
To access the E-Learning portal please use the following link: GAP-Elearning
Data entered on GROW 2.0 is available to all users for monitoring and benchmarking.
See introductory video and interactive app with simulated data for individual trust and national averages.To view your Trusts data and benchmark against national data please login to GROW 2.0 and use 'Dashboard' icon on the landing page.
GAP training: dates of forthcoming workshops are listed here.
SFH - Standardised fundal height measurement video.
GROW 2.0: Upgrade to electronic chart and recording system
Recent abstracts presented by the Perinatal Institute:
RCOG June 2025: https://perinatal.org.uk/rcog_congress_2025_abstracts
BMFMS May 2025: https://perinatal.org.uk/bmfms_2025_abstracts
BMFMS April 2024: https://perinatal.org.uk/bmfms_2024_abstracts
RCOG June 2023: https://www.perinatal.org.uk/rcog_congress_2023_abstracts
| Customized growth charts for twin vs singleton pregnancies and their ability to identify small-for-gestational age associated risk of adverse perinatal outcome. Am J Obstet Gynecol. 2025 https://doi.org/10.1016/j.ajog.2025.07.044 |  |
| Induction of labour versus standard care to prevent shoulder dystocia in fetuses suspected to be large for gestational age in the UK (the Big Baby trial): a multicentre, open-label, randomised controlled trial. The Lancet, 2025 https://doi.org/10.1016/S0140-6736(25)00162-X |
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| Small-for-gestational age according to INTERGROWTH-21st fetal weight standard misses most pregnancies at risk of stillbirth identified by GROW. Ultrasound Obstet Gynecol. 2025 https://doi.org/10.1002/uog.29214 |
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| Accuracy of antenatal ultrasound in predicting large-for-gestational-age babies: population-based cohort study. Am J Obstet Gynecol. 2024;S0002-9378(24):00578–7. https://doi.org/10.1016/j.ajog.2024.04.052 |
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| Fetal size vs growth: comparative analysis of 3 models of growth velocity based on third trimester estimated fetal weights for identifying stillbirth risk. Am J Obstet Gynecol. 2023;S0002-9378(23):02188–9. https://doi.org/10.1016/j.ajog.2023.12.029 |
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| Stillbirth risk and SGA according to Hadlock, Intergrowth-21st, WHO and GROW fetal weight standards: analysis by maternal ethnicity and BMI. Am J Obstet Gynecol. 2023;229(5): 547.e1-547.e13. https://doi.org/10.1016/j.ajog.2023.05.026 |
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| Outcome-based comparative analysis of five fetal growth velocity models to define slow growth Ultrasound Obstet Gynecol. 2023;62(6):805-12. https://doi.org/10.1002/uog.26248 |
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| Evaluating the Growth Assessment Protocol for stillbirth prevention: progress and challenges J Perinatal Med. 2022;50(6): 737-47. https://doi.org/10.1515/jpm-2022-0209 |
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| Reduction of stillbirths in England from 2008 to 2017 according to uptake of the Growth Assessment Protocol: 10‐year population‐based cohort study Ultrasound Obstet Gynecol. 2021;57:401-8. https://doi.org/10.1002/uog.22187 |
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| Understanding and Preventing Stillbirth: A Global Task Special Issue of Journal of Perinatal Medicine, 2022. https://www.degruyterbrill.com/journal/key/jpme/50/6/html |
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| Prospective risk of stillbirth according to fetal size at term J Perinatal Med. 2022;50(6): 748-52. https://doi.org/10.1515/jpm-2022-0200 |
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| A fetal weight projection model to define growth velocity, and validation against pregnancy outcome in a cohort of serially scanned pregnancies Ultrasound Obstet Gynecol. 2022;60(1):86-95. https://doi.org/10.1002/uog.24860 |
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| Customized GROW vs INTERGROWTH-21st birthweight standards to identify small for gestational age associated perinatal outcomes at term Am J Obstet Gynecol MFM. 2022;4(2):100545. https://doi.org/10.1016/j.ajogmf.2021.100545 |
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| Customized growth charts: rationale, validation and clinical benefits Am J Obstet Gynecol. 2018;218(2S):S609-18. https://doi.org/10.1016/j.ajog.2017.12.011 |
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| Fetal growth surveillance – Current guidelines, practices and challenges Ultrasound. 2018;26(2):69-79. https://doi.org/10.1177/1742271X18760657 |
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| Customized vs INTERGROWTH-21st standards for the assessment of birthweight and stillbirth risk at term Am J Obstet Gynecol. 2018;218(2S):S692-9. https://doi.org/10.1016/j.ajog.2017.12.013 |
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| Preventing stillbirths through improved antenatal recognition of pregnancies at risk due to fetal growth restriction Public Health 2014; 128:698-702. http://dx.doi.org/10.1016/j.puhe.2014.06.022 |
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| Association between reduced stillbirth rates in England and regional uptake of accreditation training in customised fetal growth assessment BMJ Open 2013;3:e003942 https://doi.org/10.1136/bmjopen-2013-003942 |
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| The Growth Assessment Protocol: a national programme to improve patient safety in maternity care MIDIRS, 2013; 23:516-23. http://www.perinatal.org.uk/fetalgrowth/gap/Resources/GAP_article_MIDIRS_Dec_2013.pdf |
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| Tackling Stillbirth: simple and cheap techniques could save hundreds of babies a year The Times Leading Article 18.12.2013 |
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| Fetal growth screening by fundal height measurement Best Practice & Research Clin Obstet Gynaecol https://doi.org/10.1016/j.bpobgyn.2009.09.004 |
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ONS stillbirth rates in England
According to ONS figures, stillbirth rates in England have fallen consistently
for 9 years to their lowest point of 3.80/1000 in 2020. This represents a 29.0% reduction from the 2000-09 (10 year) average of 5.35, and equates to 1,022 babies saved per year.
Our 10 year, unit level analysis (doi.org/10.1002/uog.22187) showed
There was a flattening of the downward trend during the pandemic in 2020 and a sharp increase in 2021. Since then, stillbirth rates have remained at a level above the low-point reached before the pandemic.