The Felicity Reynolds Oral Prize presentations are a highlight of the OAA’s Annual Scientific Meeting. Each year, the highest-scoring abstracts are brought to life by their authors, showcasing new research and innovative ideas in obstetric anaesthesia. For many recipients, winning the Felicity Reynolds Prize marks the beginning of a much larger journey for their projects.
In the second part of this series, 2024 Felicity Reynolds Prize winner Dr Esther Godfrey shares the journey of The SuPPORT Project, from inception to fruition, and where the work is heading next.
Project inspiration: Esther and Juno’s story
I had a very straightforward pregnancy with my first child, but my daughter Juno developed a fetal tachycardia in labour due to E. coli chorioamnionitis and sepsis. I progressed through labour with an epidural, but needed a category 2 caesarean birth under an epidural top-up anaesthetic. I expected our daughter to be born crying, to be checked over by the paediatric doctors and then to be back in our arms and maybe need some intravenous antibiotics after birth. I did not expect her to be born as poorly as she was.
At 7pm on 14 March 2017, my life turned upside down. Juno was born not breathing, floppy, and blue. My anaesthetic team stayed by my side, calm and compassionate, explaining that the neonatal doctor and midwife were helping Juno breathe and later intubating her. I could not see the resuscitaire - it was behind me. So, it was my anaesthetist that I relied on to give me assurances that our daughter was having the care that she needed.
Despite multiple organ support in the neonatal intensive care unit, Juno was too septic to survive. She died in our arms at two days old, from E. coli septicaemia.
I am immensely proud that Juno has become the inspiration for The SuPPORT Project. I hope that her legacy will provide other parents with an evidence-based approach to high-quality communication during one of the most traumatic and vulnerable times of their lives.
What really is high-quality communication during neonatal resuscitation?
When I returned from maternity leave, Dr Nicola Harris, obstetric anaesthetist and co-founder of The SuPPORT Project, asked about my personal experience of communication in theatre. She had been approached by anaesthetic residents and ODPs who felt uncertain about how to communicate with mothers and birth partners when a baby is born unwell and requires interventions or resuscitation.
I reflected on my own experience of communication, which had been very mixed. Some interactions lacked thought, consideration and left scars. Some individuals had offered such incredible moments of support and they are forever remembered for their kindness.
Anaesthetists and ODPs are often the professionals best placed to speak with parents at this critical time, yet there was no existing guidance or specific training on how to communicate during neonatal resuscitation in obstetric theatres.
So, in 2020, I asked Dr Nicola Harris and Dr Thomas Kitchen to join me in founding The SuPPORT Project.
The SuPPORT Project: Supporting Parents and Professionals through NeOnatal Resuscitation in Theatre
The SuPPORT Project aims to enhance communication and understanding during neonatal resuscitation in the operating theatre. Its key objectives are to:
- Explore communication between the anaesthetic team, mothers/birthing people, and their birthing partners.
- Raise awareness of the importance of clear, compassionate, and effective communication with families during neonatal resuscitation.
- Develop guidance and pragmatic tools to support healthcare professionals in providing high-quality communication during this critical time.
Guidance could not be formulated for such challenging circumstances without learning what mothers and birthing people, and fathers and birth partners want during neonatal resuscitation and by investigating the lived experiences, challenges and barriers met by anaesthetic team members. Only by learning from those directly involved could we determine what constitutes ‘best practice’.
Our team undertook a scoping exercise to explore parental experiences, alongside a qualitative exploration of lived experiences from the anaesthetic team. Project learning from the research conducted has been used alongside input from The SuPPORT Project multi-disciplinary team to develop a clinical communication tool and specific guidance. This is under final review and will be made available for public use in the near future.
In 2020, The SuPPORT Project successfully secured an innovation grant through the OAA and we were honoured to present our work at the OAA ASM 2024, winning first prize in the Felicity Reynolds session.
Sharing our work
Since our work was presented at the OAA’s ASM, we have recorded a podcast for the Royal College of Anaesthetists’ NovPod (Season 2, Episode 13), which has had 1,200 listeners across 61 countries. We have also presented our work nationally and internationally, including at the World Congress of Obstetrics & Gynaecology 2025 and the British Intrapartum Society Conference 2024. Next year, we’ll be presenting at the Scottish Maternal Critical Care Symposium. We are thrilled to have such an enthusiastic response from multi-disciplinary team members keen to champion SuPPORT in their local units across the UK and beyond. Our work was also published in International Journal of Obstetric Anaesthesia in June of this year: https://www.sciencedirect.com/science/article/pii/S0959289X25002948
Next Steps: Education & Implementation
The SuPPORT Project infographic tool is currently in the process of being finalised. It aims to support clear, compassionate communication during neonatal resuscitation, informed by parental feedback. This A4 guide is designed to sit at every anaesthetic machine in obstetric theatres across the UK.
We are now in discussion with national agencies on UK-wide implementation and educational strategy. Our goal is to embed guidance into multi-disciplinary training and improve confidence in communication with birthing people and their partners at critical moments. The future is bright for The SuPPORT Project - it continues to grow, with incredible engagement and meaningful progress.
The SuPPORT Project MDT:
- Dr Esther Godfrey – Expert parent / Anaesthetics and Intensive Care Medicine Registrar
- Dr Nicola Harris – Consultant Obstetric Anaesthetist
- Dr Thomas Kitchen – Consultant Anaesthetist
- Dr Amy Shacaluga – Consultant in Obstetrics and Gynaecology
- Dr Susan Channon - Centre for Trials Research Cardiff University
- Maryanne Bray – Midwifery
- Dr Jennifer Calvert – Consultant neonatologist
- Dr Catriona Matthews - Neonatal principle psychologist
