(2 years, 2 months ago)
Westminster HallRead Hansard Text Read Debate Ministerial Extracts
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Jill Mortimer (Hartlepool) (Con)
I beg to move,
That this House has considered baby loss and safe staffing in maternity care.
I am honoured to begin this important Baby Loss Awareness Week debate about safe staffing in maternity care, which is imperative. I speak today as the co-chair of the all-party parliamentary group on maternity, but also as the mother of three children. I also speak today because of my three very different pregnancy and birthing experiences, which for me highlight the impact of different staffing approaches on pregnant women.
I lost my first baby in the very early weeks of pregnancy, and I was told by a very kindly midwife that sometimes you have to lose a baby to ripen the womb. This made me feel dreadful. I fought very hard not to grieve openly for that loss, because I felt guilty that I should not. Forgive me: I am full of cold and dosed up, so I will get very emotional.
My first experience of birth 30 years ago was, as it is for many first-time mothers, a long and painful labour. I was persuaded to have an epidural; I think the words were, “You need Slick; he’s very good. Call for Slick.” When it is your first baby, you do not know how labour should feel. You think, “It’s worse for me than everybody else, because I am in so much pain.” So I took the epidural. I was then left for long periods without being checked. There were not many staff on the labour ward that night, and I was in a room on my own with my husband. I was told that when I got nearer they would remove the epidural, because I would need to push.
Sadly, but thankfully, it was only when, unbeknown to me, my son was crowning and in distress that the midwife happened to look in for a check. I had to have an emergency episiotomy and an emergency forceps delivery, which resulted in me having a really severe post-partum haemorrhage, and I nearly died. I remember looking at my new baby in the arms of his father and thinking, “They’re safe; I can go now,” and then I blacked out.
My second son was an extremely large baby, at almost 11 lb, but this was not picked up and he basically got stuck—
Jill Mortimer
He was a whopper; he still is a whopper. It caused long-term damage to my pelvis but, worse, he has had to battle his entire life with learning difficulties caused by a lack of oxygen at his birth. He was a floppy, quiet baby, and at 18 months he was diagnosed with, among other things, hypertonia. All his development was delayed, and he did not walk or speak until he was nearly two. I worked with him, and I am so proud that he kept battling on learning how to learn. Today, at 27 years old, he is training to be a nurse. [Hon. Members: “Hear, hear!”]
It was only during my third pregnancy that I experienced continuity of care, which was wonderful. The ability to build a relationship with my midwife, who stayed with me throughout my pregnancy, labour and beyond, was invaluable. I did not have to go through my story with new people all the time and had someone I came to know and trust by my side. I was lucky enough to experience that and wish more women had that chance.
Despite the benefits of continuity of care, I look back on the pregnancy and birth of my daughter with mixed emotions, because there should have been two of them. Very early in that pregnancy I again started to bleed. I bled with my first son and ended up spending a week in hospital, with people saying to me, “Don’t worry, it’s very early on; you’ll have another baby.” I lay still for a week, I did not breathe, and I kept him. But this time I started to bleed again, and I miscarried my daughter’s twin. I did not know how to feel or how to grieve, while having to put all my efforts into sustaining my pregnancy, fearful every day that I would lose the baby I still carried. I was lucky that my beautiful daughter was born safe and healthy, but that loss never goes away. With each milestone, I reflect on how they should be celebrating together. There should be two of them.
Guy Opperman (Hexham) (Con)
Grab a breath for a second. First, I congratulate my hon. Friend on bringing forward this vital debate. The House is joined with her in supporting the cause that she is espousing. Does she agree with me—this is something that I certainly have suffered from—that the concept of the take-home child is something we all need to come to terms with? I have had three children, but I have been able to take only one home. For my hon. Friend, it is unquestionably the case that she loves and adores her daughter, but never forgets those who came along with her but did not make it in the end. Is that a fair description of the situation?
Jill Mortimer
You have done. Yes, that loss never goes away. I still feel guilty, because it was so early; I did not go through what people such as my hon. Friend have gone through.
Kim Leadbeater (Batley and Spen) (Lab)
I thank the hon. Lady for sharing her deeply personal and emotional story. I want to place on the record my thanks to Alex Walmsley in my constituency, who recently won a BBC Radio Leeds “Make a Difference” award for founding Sands United West Yorkshire, a football team that provides peer support for men affected by baby loss. We often tend to focus on the women, but it is really important that we talk about the fathers who have suffered that loss as well. Does the hon. Lady agree that keeping open local maternity units, such as the Brontë birth centre in my constituency at Dewsbury and District Hospital, is essential to maintaining safe and quick access to maternity services for our communities?
Jill Mortimer
I agree that local maternity services— I have the Rowan suite in Hartlepool—are invaluable, because the midwives know their community. They know the women—they are often friends with the mother or an aunt—and that gives them the feeling that people are listening all the time. It is also important that we get midwives trained in bereavement care. I wonder how that kind of care and intervention may have impacted my experience and helped me to cope with emotions of guilt and loss while still allowing myself to feel joy for the life that I had brought into the world in my daughter.
Sadly, experiences 25 years on from mine have not got any better. I am proud to be here today to speak on behalf of my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory)—my friend and colleague—who, as co-chair of the all-party parliamentary group on baby loss, has told us all of her own recent terrible experience of baby loss. We have just had the publication of the Kent report, which details 200 incidents at hospitals in Margate and Ashford. Baby loss still happens all too often. We simply need more midwives so that they can feel confident that they are providing the very best care they can to all mothers. As noted in the Ockenden report, it is not just about safer staffing levels: it is about quality care. We need more trained bereavement specialist midwives.
Sir Roger Gale (North Thanet) (Con)
I had not intended to intervene, because I have to leave the debate, but my hon. Friend mentioned the Queen Elizabeth The Queen Mother Hospital; as the constituency MP, may I place on the record my concern, and the fact that we are pursuing with vigour—and I mean with vigour—every angle to ensure that what happened there never happens again?
Jill Mortimer
I thank my right hon. Friend for his intervention. I am reassured that everybody involved in that case is working hard to put things right.
I am regularly in contact with the wonderful staff at the Rowan suite in Hartlepool. They, too, advocate for the importance of bereavement care for grieving parents. The reality is that bereavement specialists have on average just two hours of working time to dedicate to each baby death. That is simply not enough. I have heard from bereavement midwives who are left having to choose which parents they go to. There are simply not enough of those midwives to go round. Parents who were so full of hope hours earlier are left alone, suffering the rollercoaster of grief that fills the inevitable void from losing a pregnancy or a baby. Expert, kind and understanding support is vital at that terrible time.
I have also met representatives of Sands, one of the many great charities that work in this important area. They have told me that cases of stillbirth in England and Wales rose in 2021 for the first time in seven years. That reflects the experiences of mothers who contacted Mumsnet to say that during covid most of their maternity appointments were cancelled. Mumsnet contacted me to share those mothers’ stories. One mother said that her previous history and notes were ignored and that a previous condition she had suffered from escalated and caused unnecessary complications. She felt that was due to bad organisation, shortages, funding cuts and bad management during covid, which left the delivery unit at her local hospital dangerously understaffed on the night her daughter was born.
I have three asks of my hon. Friend the Minister. Covid is largely behind us, but maternity staff are still exhausted from that time, and 13 babies are stillborn or die shortly after birth every day. Will the Minister please tell us what steps the Government are taking to ensure the 2025 ambition announced by the Health Secretary in 2017 to halve stillbirth and neonatal death rates?
The joint meetings of the APPGs on maternity and baby loss have listened to evidence and stories from multiple women and agencies, and we have commissioned a report with Sands and the Royal College of Midwives. We want to ask the Minister whether she will commit to increasing investment in maternity services and fulfilling the shortfall of 2,000 midwives and 500 consultant gynaecologists and obstetricians. We need more and, sadly, it is becoming harder to retain staff because they are burnt out from the effects of staffing shortages. It is a vicious cycle.
David Linden (Glasgow East) (SNP)
I pay tribute to the way in which the hon. Lady has opened and framed this debate. I speak as chair of the all-party parliamentary group on premature and sick babies and I absolutely agree with the points she is making. Will she go slightly further and ask the Government to consider amending the shortage occupation list so that we can attract more people to come here and fill those roles? We all know a massive timebomb is coming down the line in terms of the neonatal workforce and those on maternity wards.
Jill Mortimer
I thank the hon. Gentleman for his intervention. Sadly, that is not a matter for me as I am not a Minister; it will be for the Minister to reply to that.
Will the Minister look at training more bereavement midwives? Sands has developed the national bereavement care pathway, which provides the framework and tools to ensure that all health professionals are adequately equipped to provide the standard of bereavement care so sorely needed during the immediate aftermath of pregnancy or baby loss. That would prevent women like me, 30 years on, from hearing those same lines; health professionals would understand that, kind as they are meant, they do not help in the long term.
Alicia Kearns (Rutland and Melton) (Con)
I thank my very good friend for her work on this issue. On the point about discrepancy, in my constituency a baby died—it was negligence—and the mother was sent home with four leaflets and never contacted again by the hospital. By contrast, my very best friend lost her baby at nine months in January—as Members can see, we all grieve when we lose someone that close to us—and she had phenomenal care from Tommy’s. Will my hon. Friend press the Minister to do all she can to ensure that there are national guidelines against which the NHS is held to account, monitored and graded for how it provides bereavement care?
Jill Mortimer
I thank my hon. Friend; she must not apologise because obviously this issue is very close to us all. We feel very deeply for all mothers who lose. That is one thing that I wish to ask the Minister to do: will she ask the Government to mandate the national bereavement care pathway so that it is nationwide? Although 105 trusts are already formally committed to rolling it out, they need the additional funding to fully implement all the standards of the NBCP. It is no good just taking part of it; we need it all in place and all midwives need to have that training. What steps is the Minister taking to ensure that all trusts can implement this vital support service?
Those are the three big asks. I know they are big, that times are not great and that there are not funds, but this is such a vital policy area and so much long-term pain could be caused. I thank Members for their time.
Several hon. Members rose—
Philip Davies (in the Chair)
Order. Given the number of Members who wish to speak, I have to impose an immediate four-minute time limit. We need to get to the Front Benchers no later than 10.30.
Helen Morgan (North Shropshire) (LD)
It is a pleasure to serve under your chairmanship, Mr Davies. I thank the hon. Member for Hartlepool (Jill Mortimer) for securing this important debate and for speaking so movingly about her experience.
I draw Members’ attention to the fact that I am the vice-chair of the APPG on baby loss and a member of the APPG on maternity. I joined those APPGs shortly after my election last December because in Shropshire the issue of avoidable baby loss is extremely raw. Although neither of the Shrewsbury and Telford NHS Trust hospitals are located in my constituency, the vast majority of families in North Shropshire welcome their new arrivals in one of those maternity wards.
I did not have my baby in Shropshire as I lived in Buckinghamshire at the time. When he arrived in 2009 by emergency caesarean, making his feelings about the indignity of the situation known to everyone in the theatre at an enormously high volume, I never once worried that either of us were likely to be unsafe. The idea that things might go tragically wrong did not even cross my mind. Although the birth of my baby did not go to plan, I felt brilliantly cared for at all times. When I moved to Shropshire four years later, I realised that, tragically, that is not always the case. Friends with experiences similar to mine told of near misses, blue babies being resuscitated and long stays in special care baby units. A close friend told me she did not realise until many years later that flashbacks to the trauma of the birth were not normal.
We now know, thanks to the bravery of many families and the detailed review of Donna Ockenden and her team, that there were serious and systemic failings at Shrewsbury and Telford over a long period of time. The tragic stories include those of constituents and personal friends. I know of many other women who did not come forward, either because their baby did not suffer any long-term consequences or they did not want to revisit painful tragedies. It sometimes seems that everyone of my age in Shropshire knows a family who lost a baby.
The causes are multiple and this is not the time to discuss them, but safe staffing was fundamental in that tragedy. In the executive summary to the report, Donna Ockenden states:
“It is absolutely clear that there is an urgent need for a robust and funded maternity-wide workforce plan, starting right now, without delay and continuing over multiple years.”
Margaret Ferrier (Rutherglen and Hamilton West) (Ind)
The APPG’s report on staffing shortages found that hospital staff feel that post-natal care has suffered the most from cuts, with most aftercare being devolved to healthcare workers who do not hold the same level of qualification as a midwife. That will impact on the health of mother and baby—for example, if they do not have access to breastfeeding support because resources are stretched too thin. Does the hon. Member agree that post-natal care needs urgent attention?
Helen Morgan
I agree. Many of us have experience of less than brilliant post-natal care, and the staff shortages are well documented. The Health and Social Care Committee report recommendation that £200 million to £350 million a year is required to be invested immediately in maternity services speaks to that issue. On Wednesday 30 March, the then Health Secretary, the right hon. Member for Bromsgrove (Sajid Javid), confirmed that £222 million had already been committed but was not guaranteed for the future, although he would keep it under review. That was two Health Secretaries ago.
On 1 September, the next Health Secretary argued that, given how stretched the NHS was, services such as maternity might no longer be a priority. I seek reassurance from the Minister that that is not the case. Maternity services have been treated as a Cinderella service for years and we have been left with shocking scandal after shocking scandal, with thousands of families devastated by poor care at a time when they were supposed to be at their happiest. I am at a loss to understand the deprioritising of maternity services—the one service that every one of us will need at least once in our lives.
The workforce gap of 2,000 midwives and 500 new consultants has been referred to, but it is estimated that nearly 700 midwives have left the profession in the past year, and eight out of 10 report that they do not have enough staff on their shift to provide a safe service. Will the Minister commit to increasing funding to meet the £200 million to £350 million-a-year recommendation, for a specified period of time, and to developing a fully costed, multi-year workforce plan?
The safe staffing report produced by the baby loss and maternity APPGs, on which I serve, has already been referred to. I draw particular attention to the need for more bereavement midwives. The pressure and increased likelihood of failure, and the sheer exhaustion that overworked maternity staff feel, must be a cause of some of the other issues we have seen at Shrewsbury and Telford NHS Trust, and at the other trusts that face challenges.
Shropshire is not the only area of the country to have suffered a crisis in its maternity services, with Morecambe Bay, East Kent and Nottingham all facing serious issues. Far too many families have faced tragedy. I ask the Minister to ensure that their experiences are not in vain, and that the Government will act on unsafe staffing.
Guy Opperman (Hexham) (Con)
I thank my hon. Friend the Member for Hartlepool (Jill Mortimer) for bringing forward this debate. This is my first Westminster Hall speech in seven and half years; it is an honour and a privilege to speak on such an important matter.
I have had three children, but was able to take only one home from hospital. Teddy and Rafe came and went in the summer of 2020—briefly—and were loved all too shortly. I welcome the work led by the teams at Oxford and Leicester to ensure that there is clear advice to support health professionals in assessing and documenting signs of life in extremely difficult pre-term births. That is what I want to focus on.
I should put on the record, as I am sure many will, the amazing charities such as Sands and others who work in this sphere and who have helped me get over the trauma, loss and bereavement, as have the Northumbria NHS trust in my constituency and St Thomas’s, where my children were born. I thank my constituent, Sarah Richardson, and all the teams at Hexham Queen’s Hall and Hexham Abbey for their support for baby loss awareness.
Consistency across the NHS is key. People will lose children; that is a fact of life. Pregnancy is, as we all discover, more complicated than we imagined it would be—even in 2022. There is work to be done on the improvement of midwives and maternity staffing levels, but the key for me is a consistent approach across all NHS trusts up and down the country. Why does that matter? Because there should not be a postcode lottery in which a parent in trust A is treated differently from a parent in trust B, and poor souls go on the internet and find out that in trust A they would have been treated in one way, but in trust B in another way.
We all have to accept that mistakes are made and that giving birth is a fragile process, but we should expect the NHS and our Government to promote consistency of approach in dealing with the individual issues that mums and dads have.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
Does the hon. Member agree with me that the principle that he correctly outlines should also apply to the nations of the United Kingdom, and that equality of service should apply right across Great Britain?
Guy Opperman
It is a perfectly fair point that there is a difference of approach in the different countries of the great United Kingdom, and I utterly agree that if someone lives in the United Kingdom, they should have a consistency of approach. There should be a coming together of the various professional boards to drive forward consistent standards. I will give one specific example.
Guy Opperman
My hon. Friend will take my time, but I will give way very briefly.
Alicia Kearns
Before it even gets to treatment, a big problem is the way we assess the safety of a pregnancy, which is the same as it was in the 1960s. It has not changed. There is a new AI programme—the Tommy’s app—that could be rolled out across the entire country to ensure that technology is used to assess the vulnerability of pregnancies. Does my hon. Friend agree that that sort of tool is what we need rolled out to ensure consistency of diagnosis and safety in pregnancy, and not just treatment?
Guy Opperman
I endorse what my hon. Friend says. It helps doctors. Doctors and midwives are not the villains here; they all try very, very hard. It is easy for politicians to say, “This trust is not doing the right thing,” or, “This team is not doing the right thing,” but that is genuinely unfair. We have to shy away from being so critical.
This is about trying to provide the cover and approach so that clinicians are better able to deal with particular scenarios and situations. That is genuinely possible. There is good evidence that, on occasion, parents have been told that their child was stillborn when it should have been determined to be a neonatal death. That has consequences, because, as some will know, coroners can investigate neonatal deaths but not stillbirths. There is some evidence—only some; this is very much anecdotal and I do not want to start hares running—that a trust seeking to improve its figures would say that more births were stillbirths rather than neonatal deaths.
We have to be honest about the process and start from a position of generosity of spirit towards the doctors and clinicians who all try their hardest. If nothing else emerges out of today, driving forward a consistency of standards on how deaths are treated is vital.
I have one final comment. My second child came and went in one very long day at St Thomas’s, over the road from this place. The fact that his was a neonatal death meant that the trust attempted to save his life for a period of time and we were able to spend time with him, which is something that I will always treasure.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
It is a pleasure to serve under your chairmanship, Mr Davies. I recognise that health is devolved to the Scottish Government but, with your permission, I will give a cautionary tale.
Some years ago, we enjoyed a consultant-led maternity service based in Caithness General Hospital in Wick, but NHS Highland decided to downgrade it. The consequence is that pregnant mothers now have to travel 104 miles from Wick to Inverness to give birth to their children, which has caused a huge outcry in my constituency. Thinking about the north of Scotland, Members can imagine what it is like to be in an ambulance or a private car in the winter when the weather changes, which it very often does between Caithness and Sutherland, and people get caught in snowdrifts. Despite repeated demands, the Scottish Government have never conducted a safety audit of the huge change in the service. It is a massive issue in my constituency.
More recently, the NHS decided to similarly downgrade the maternity service based in a town with which the Minister and I are equally familiar—Dr Gray’s Hospital in Elgin. There was a huge outcry about that, and this time the Scottish Government said, “Okay, we’ll review the decision.” My first point is that wherever someone lives in Britain, what is good for the goose is good for the gander.
I will close—I will make it easier for you, Mr Davies, by keeping this a short speech—with two unfortunate tales. In 2019, a mother from Caithness expecting twins was being transported on the long journey to Inverness. As I say, it is 104 miles, as opposed to the distance between Elgin and Inverness, which is 38 miles, and I do not know why they are doing it for Elgin and not for the highlands. In Golspie in Sutherland, she gave birth to her first twin and then had to travel 52 miles to Inverness to give birth to the second twin. Miraculously, both children survived, as did the mother, but if that is not harrowing for an expectant mother, I do not know what is.
In the last few days, we have heard the terrible tale of a couple having to leave from the far north in their own car after the mother’s waters had broken. It was a three-hour journey. Recently, the Public Services Ombudsman ruled that her child suffered brain damage as a result. Can you imagine? Consequently, NHS Highland has been ordered to apologise. In my book, I do not think an apology is good enough. It is a cautionary tale. I recognise that health is devolved, but I feel very strongly that no mother, father, child or unborn baby should suffer increased risk simply because of where they live in our United Kingdom.
Tim Loughton (East Worthing and Shoreham) (Con)
I could not, and I certainly do not, seek to compete with the personal testimonies of my hon. Friends the Members for Hartlepool (Jill Mortimer) and for Hexham (Guy Opperman). As Members know, I have been around for a while in this place. We sit through many harrowing and poignant debates, but none has been more emotional and more emotive than those that we have traditionally had to commemorate Baby Loss Awareness Week, and today is another example of that. I pay particular tribute to my hon. Friend the Member for Hartlepool for securing the debate, and to our colleagues for bravely coming forward with their personal testimonies, which make this problem so real. Understanding it is so important for our constituents.
I was lucky with my three children. I did not have to go through the traumas that we have heard about, but so many people do. Despite all the terrible news that we have heard recently, it is worth noting that maternity services in this country are still safe and that the infant mortality rate has fallen to a historic low. However, we are still 19th out of 28 European countries for mortality rates. The ethnic and regional variations in this country are still a disgrace, and those infant mortality rates do not take account of stillbirths. There are 13 stillbirths a day. No doubt lockdown has made the situation worse.
I want to focus briefly on stillbirth. Stillbirth is 15 times more common than cot death. I concentrate on it, because I have been campaigning on it for many years. My Civil Partnerships, Marriages, Deaths (Registration etc) Act 2019 became law in February 2019. Two of its clauses have taken effect; two have not, and those two are to do with stillbirth. I should not have to discuss this today, because those clauses should have taken effect. My Act gave powers to the Secretary of State for Justice to amend the Coroners and Justice Act 2009 so that coroners had the power to investigate stillbirths. They do not have those powers, because coroners can only investigate the body of a deceased person and a stillbirth is not designated as a deceased person. That is a technical, historical situation.
My hon. Friend the Member for Hexham talked about some infant deaths being described as stillbirths. Given those occurrences, rare though they may be, we have heard stories and The Daily Telegraph ran a campaign recently showing that this issue is still a problem. Given the scandals of East Kent, Shrewsbury and Telford, and Morecambe Bay, we need more than ever the reassurance that the coroner has the ability, if he or she chooses, in a limited number of cases, to investigate whether a stillbirth was a result of mismanagement or incompetence or whatever. Parents need that reassurance, and we could all learn from such cases. This measure must come into force, three and a half years after the legislation that enabled it to do so.
My Act included another clause, which was about recognising stillbirths that take place before 24 weeks but are not designated as ever happening. A panel was set up to look at that back in 2018. I was a member of that panel. It has still not reported; no conclusions have come forward. The Act made it necessary for those conclusions to come forward. Could we at last get on with this important legislation? We all agreed that it was necessary and it was passed unanimously through this Parliament.
Angela Crawley (Lanark and Hamilton East) (SNP)
It is a pleasure to serve under your chairmanship, Mr Davies. I thank the hon. Member for Hartlepool (Jill Mortimer) for bringing this important debate to Westminster Hall and for bravely sharing her experience. I also thank the hon. Member for Hexham (Guy Opperman). Sharing these experiences is what makes this House real to people. I know it is difficult to do so.
Today, I want to concentrate not on healthcare, which is devolved in Scotland, but on the professionals. Through my work in the APPG and on the Miscarriage Leave Bill, many have written to me to express their concerns and fears about returning to work after their own personal experiences of pregnancy loss. A swathe of healthcare professionals working in healthcare settings each and every day experience pregnancy loss themselves, and then return to work quite soon after to help to deliver another couple’s baby. It must truly be one of the most traumatic and devastating experiences to have to return to work after pregnancy loss, for anyone, but it must be especially devastating for these healthcare professionals.
Much of this debate is about safe staffing, and rightly so, because there is no more vulnerable time for any parent than through the pregnancy and at the birth of their own child. It is a time of fear and apprehension; a time when people ultimately place all of their trust and faith in healthcare professionals. I cannot imagine how triggering it must be for those healthcare professionals who have to return to work each and every day, and experience their own trauma time and again while supporting other parents to have their happy ever after. For some, that is not possible, which just reopens the trauma for those healthcare professionals.
The loss of a baby at any stage can be truly devastating for anyone, in any profession. That is why I have pushed repeatedly in the House for a basic minimum of three paid days leave for any individual who experiences pregnancy loss. Many people in this House have bravely shared their experiences. I do not particularly wish to go into each individual experience, but sharing experiences is so important because it reminds people that we are individuals, that we are human, and that we ourselves have an understanding of the pain and grief that come with pregnancy loss.
The Minister will no doubt tell me that there is provision for parents who experience pregnancy loss before 24 weeks in the form of sick leave, unpaid leave and other vehicles, but the fact is that there is no statutory provision. Last week, I met with the Chartered Institute of Personnel and Development, which informed me that, thankfully, there are whole sectors and industries that are introducing pregnancy loss policies. Sadly, however, no healthcare professions were among the list of organisations that are introducing such policies.
It is imperative that, regardless of sector or industry, when someone experiences pregnancy loss—there is no provision in law before 24 weeks—they are at least recognised and supported on their return to the workplace. The sad fact is that, for healthcare professionals, that is not the case. A third of employers say that they do not have a formal policy, and the CIPD notes that most smaller businesses feel that a formal policy is a luxury that they cannot afford. Without statutory provision, and without implementation in the healthcare profession itself, the reality is that day in, day out, more individuals will experience pregnancy loss and will have to return to work without the recognition of that loss. That is simply too much; it is simply a tragedy.
Philip Davies (in the Chair)
Order. I am sorry to cut the hon. Lady off during her speech.
Saqib Bhatti (Meriden) (Con)
It is a pleasure to serve under your chairmanship, Mr Davies. I thank my hon. Friend the Member for Hartlepool (Jill Mortimer) for securing the debate, and for her emotional and eloquent speech. She is an asset to the House. I also pay tribute to my hon. Friend the Member for Hexham (Guy Opperman), who spoke passionately about his story, of which I was aware; whether intentionally or not, he highlighted the need for support also for the fathers who go through baby loss. I thank him for his bravery. It is always humbling and a privilege to follow so many emotional contributions. We remember all the babies who were sadly taken too soon. They will always be loved, and never be forgotten.
Every year, stillbirths, neonatal deaths and miscarriages devastate about 3,500 parents. In the west midlands, where I am based, there are about 5.3 deaths per 1,000 live births. Among people from black, Asian and minority ethnic communities, that figure is 6.4 deaths per every 1,000. The theme of this year’s Baby Loss Awareness Week is stepping stones, which focuses on parents’ difficult journey to recovery. It is important to provide focused support, and the Government have taken some action through the Parental Bereavement (Leave and Pay) Act 2018 and the extra £127 million for the NHS. However, my hon. Friend the Member for Hartlepool made an appropriate call for further support. I am particularly taken by the idea of a national pathway, which would provide consistency and avoid a postcode lottery. That certainly merits further discussion.
I pay tribute to charities such as Sands, the Lullaby Trust, Abbie’s Fund and Tommy’s, which clearly do an immense amount of work. However, I pay specific tribute to the Lily Mae Foundation, which is based in my constituency. Just a week and a half ago, it celebrated its 10-year anniversary. Ryan and Amy Jackson lost Lily Mae on 7 February 2010, but they took that tragedy and loss and turned it into something good for people who go through similar experiences. The charity supports parents. It has distributed over 4,000 memory boxes and organises the Balsall Common fun run. Amy also provides one-to-one support. The charity has already supported over 1,000 parents. It also organises an annual skydive, which I have now committed to doing next year. I have not yet told my Whips, but I assure them that it is very much in my interest that I land safely and avoid a by-election at all costs. Will the Minister join me? I put that request on the record.
I am conscious of time, so I have some simple requests of the Minister. I ask her to recognise the support for charities such as Lily Mae, and the invaluable role they play in supporting parents and alleviating pressures on the national health service. I ask her to consider what further support can be given to those organisations.
I am keen to advocate for support for the roll-out of bereavement suites. Before I came to this place, while I was president of the chamber of commerce, I saw a bereavement suite in Birmingham Children’s Hospital. Magnolia House plays an immense role in providing a safe space for parents to process news or spend time with their children in their final hours. A lot of thought goes into it, from the wallpaper to the cups those parents hold.
Finally, I pay tribute to all the fantastic midwives, obstetricians, gynaecologists and grief counsellors for the immense work they do. They do an amazing job. I simply thank them.
Olivia Blake (Sheffield, Hallam) (Lab)
It is a pleasure to serve under your chairship today, Mr Davies. I thank the hon. Member for Hartlepool (Jill Mortimer) for securing today’s important debate and speaking with such bravery. I also thank colleagues from the APPG for producing such an illuminating report, which looks beyond the stats and figures, and shines a much-needed light on the impact of staffing shortages in maternity settings.
Earlier this year, I met midwives in my own constituency, and what they had to say was deeply upsetting. They told me that they were in crisis, could not cope with the conditions, and felt burnt out, underpaid, undervalued and ignored. However, at the top of their list of concerns were the repercussions that that environment had on their ability to do their job. They described the constant stress of feeling unable to provide the quality of care they wanted to and that patients deserve, and spoke about the pressure they felt to take on extra shifts, knowing that if they did not, they would be leaving colleagues to suffer or, in the worst cases, patients in crisis.
Margaret Greenwood (Wirral West) (Lab)
My hon. Friend is making an important point, which is reflected in some of the conversations that I have had with people working in maternity services. I am sure she will be aware that we have lost 500 midwives from the NHS in England over the last year. Does she agree that it is important that the Government come forward, as a matter of urgency, with a plan to address this staffing shortage crisis?
Olivia Blake
I completely agree. The picture is the same up and down the country. Last year, the Royal College of Midwives warned of an “exodus”, as more than half of midwives surveyed said they would consider quitting their jobs. The result is that two thirds of midwives are unsatisfied with the quality of care that they are able to deliver. That is a bleak picture.
The solutions are quite simple: a proper workforce plan, pay that midwives can live off, conditions that do not drive them to burn out, and increased training opportunities for both new midwives and nurses wanting to convert to midwifery. Midwives across the country are calling for change, so I look forward to hearing the Minister’s response to the report. For the sake of midwives in my constituency and patients across the country, I hope she will commit to taking on board the recommendations.
Two years ago, during a Westminster Hall debate on baby loss, I was inspired by the brave Members around me to speak publicly for the first time about my own experience of miscarriage. I am glad to see the progress that has been made since then, and I put on record my huge appreciation to the campaigners and individuals who have worked tirelessly to achieve that, from Tommy’s and Sands to the campaigner Myleene Klass, who I have been working with. However, for the one in five women who will experience a miscarriage, not enough has changed. The support they receive is still not consistent nationally. Women must still experience three miscarriages in a row before they can access support and tests to find out what is causing the loss, and national miscarriage figures are still not recorded.
Just last week, I spoke to a constituent who has experienced three miscarriages. The experience has had huge repercussions on her mental health, but she has not been able to access NHS mental health support. Now that she has had three miscarriages, she can finally have the simple tests carried out, but she should not have had to wait.
Last year, the then Minister responsible for women’s health, the right hon. Member for Mid Bedfordshire (Ms Dorries), committed to addressing the issue. During an Adjournment debate on 17 June, she stated that the Department would include two of the three Tommy’s recommendations from The Lancet series, “Miscarriage matters”, in the women’s health strategy: to
“ensure that designated miscarriage services are available 24/7 to all”
and
“take steps to record every miscarriage in England.”
The Minister said that the implementation of the last recommendation—to end the three-miscarriage rule and bring in a graded model of care—was not in the remit of the strategy and would instead be left up to the Royal College of Obstetricians and Gynaecologists. I am pleased that the college has consulted on a graded model and adopted it into its guidance, although leadership is still missing from Government to ensure the resources to properly end the three-miscarriage rule. These are welcome steps, but unfortunately the other two were missing from the women’s health strategy.
I received more promises from the previous Minister, the hon. Member for Lewes (Maria Caulfield), that the recommendations would be included in the upcoming pregnancy review, but that review has not been published for years, as we have heard from other hon. Members. With the new Minister in charge, we are yet to receive any confirmation of when the review will be published and our calls will be met. In the light of that, will the Minister commit to including all three Lancet recommendations in the pregnancy loss review and to meeting with myself and campaigners at the earliest convenience to discuss that review? This cannot be something we speak about once a year and then dump in the “too hard to deal with” pile. These are vital and simple steps that we must take to improve miscarriage care for every woman who has or will experience a miscarriage. We cannot wait any longer; we need a new model of care for miscarriage.
David Rutley (Macclesfield) (Con)
Thank you for the chance to say a few words during this important debate, Mr Davies. There have been hugely moving contributions and testimonies from my hon. Friends the Members for Hartlepool (Jill Mortimer) and for Hexham (Guy Opperman)—he and I have been friends for many years, and we are with him in his loss and with all others experiencing such real sadness. We are fortunate in Macclesfield to have support groups, such as Smile Group, that provide help for people having difficulties during or after pregnancy and, no doubt, we have groups that help people during baby loss as well.
We have heard moving and important contributions about the importance of greater consistency in standards, which I completely support. Maternity services are highly valued in our communities. In Macclesfield, our maternity unit was temporarily closed during the pandemic over two and half years ago. It is one of just a few maternity units that is still temporarily closed, and it is greatly missed by parents, and mums and dads who are expecting babies. I am working closely with the East Cheshire NHS Trust and the Cheshire and Merseyside integrated care board to ensure that the unit reopens in line with Government policy—it is Government policy to reopen temporarily closed units—and with the trust’s ambitions in April next year. The unit is vital, as it provides reassurance to parents and the full range of maternity services, including support for baby loss, locally in our community. I would welcome the Minister’s support for the reopening of this much-loved maternity unit.
In closing, let me say again how grateful I am for these contributions across this Chamber. The debate has helped to highlight a vital issue that we need to talk more about and provide more support for.
Bell Ribeiro-Addy (Streatham) (Lab)
It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the hon. Member for Hartlepool (Jill Mortimer) on securing this important debate.
The loss of a baby at any stage of pregnancy or after birth can be an incredibly painful experience for any parent. I pay tribute to everyone who has and will share their experience of baby loss in this Chamber. It takes a lot to relive that trauma, but I have heard that it means so much to everyone listening when we speak about such issues in this House. Sadly, when baby loss happens, people are often told, “It is one of those things” or “It just happens”. I remember being told in my grief that I was not the first woman that this happened to and that it was one of those things. It is heartbreaking that women continue to be gaslit in this way when we know that negative pregnancy and birthing experiences can drastically or even fatally change outcomes. We have to accept that it is not always “one of those things” and work to come up with solutions to end it.
I want to touch on two things. The first is a report conducted by Five X More—the black maternal health awareness campaign. It conducted the largest nationwide study of black women’s experiences of maternity services in the UK, and the results make for some shocking reading. The report will be presented to Parliament next Tuesday, and will be followed by a lobbying event by the campaign—where it will reiterate the call on the Government to set a target to address disparities and close the gap in mortality rates—to which all hon. Members have been invited. I put that request to set a target to the Minister again today.
The report encompasses the views of more than 1,300 black and black mixed-heritage women and their maternity experiences, including a number of black women who have experienced baby loss. As some will know, black women are four times more likely to die during pregnancy, labour or post partum; Asian women are twice as likely; and women of mixed heritage three times more likely. Black women are 40% more likely to experience a miscarriage, and black babies have a 50% increased risk of neonatal death and a 121% increased risk of stillbirth.
The Five X More report highlights all the negative interactions that women experience with healthcare professionals: feeling discriminated against in their care; receiving a poor standard of care, putting their safety at risk; and being denied pain relief. After experiencing negative maternity outcomes, 61% of the women surveyed reported that they were not even offered additional support to deal with the outcome of their pregnancy—something that, as we have heard today, is widespread. It is vital that we acknowledge these racial biases when we discuss maternity care.
To make maternity care safe for all patients, it is vital that the level of staffing and the treatment of staff is looked at. For every 30 midwives trained in this country, 29 are lost—what an indictment of the state of maternity services in this country. That is one of the reasons I am proud to support March with Midwives and the awareness it is trying to raise of the dire conditions midwives are facing. Midwives are overstretched, under strain and working in situations they know are unsafe, but pushing ahead anyway at a risk to their physical and mental health. They do not do it for the big bucks, but the least we can do is pay them decently—something that we know we are not doing.
All we ask from the Minister today is to address the pay conditions and shortages that midwives are facing. Everybody in this room owes their life or the life of one of their loved ones to a midwife. They deserve better, as do the women and babies they aim to care for.
Jim Shannon (Strangford) (DUP)
I thank the hon. Member for Hartlepool (Jill Mortimer) for setting the scene so very well and the hon. Member for Hexham (Guy Opperman) his contribution. It is always good to hear about personal experiences in speeches, as it shows us all what some people have gone through. My mother has had four miscarriages, while my sister has had two; Naomi, who works in my office, has had one. Although I cannot say that I have personally experienced miscarriage in a real sense, I understand it through the losses of my mother, my sister and my assistant. It is something that very much touches all our hearts.
My heart aches knowing that one in four pregnancies ends in miscarriage, one in 80 pregnancies is ectopic and 13 babies are stillborn each day. For some, those figures may be just stats, but, in reality, every one is a personal story. We have heard some of those stories today.
I have been contacted by countless organisations and constituents about maternity staffing and training. In 2021, the Government announced an investment of £95 million to increase staffing, while a subsequent £51 million is being made available until 2024. I was shocked, although not really surprised, to be told by the charity Sands that that is still not enough to ensure that services across the UK are safely staffed.
Three weeks ago, I had the opportunity to meet Karen Murray and Jayne Cardwell of the Royal College of Midwives and the South Eastern Health and Social Care Trust. I know that the Minister is not responsible for health in Northern Ireland, but I want to give that perspective to the debate, if I can. Midwives in Northern Ireland are experiencing the very same things as here on the mainland, as hon. Members present have spoken to. Karen Murray and Jayne Cardwell brought to light just how dire the situation is in Northern Ireland. We have witnessed recent reports of scandals in Morecambe Bay, where the deaths of 45 babies could have been prevented if adequate maternity care was provided. I stand here blessed and grateful that we have not experienced something similar in Northern Ireland. The representatives I met said that
“it is by the grace of God”
that we have not experienced similar scandals.
The Royal College of Midwives has issued a blueprint for Northern Ireland that paves the way for sustainable, efficient and safe maternity services for women in Northern Ireland. It is a blueprint that could be carried out across the whole UK. The RCM has made it clear that there must be an allocation of money to maternity services that is ringfenced for the full implementation of safety initiatives. There are serious systematic failings—the RCM’s words—that are putting the safety of mothers and newborns at risk. We need more midwives and more specialist bereavement care, especially having heard the stories from hon. Members today. Those are some of the things we need to look after. We also need better supervised neonatal units and consistent financial commitments from our Governments, both regionally and in Westminster, to deliver this.
Organisations such as Bliss, Sands and the RCM have made many recommendations on how we can improve the situation with our maternity services. First, the maternity strategy is in serious need of updating. We must see more midwives and those qualified in specialist care to ensure that even people in the most intricate circumstances are looked after. The Royal College of Midwives says its staff feel the pain of the people they work with; that came across clearly in the meetings I had with the organisation. All our healthcare professionals need better financial, emotional and mental health support as they recover from the devastating impact of the pandemic.
I urge the Minister to engage with our regional Minister, Robin Swann, to ensure that there is never again a repeat of the recent scandals and reports we have heard across the UK. Everyone involved in the political sphere wants to improve the situation, and we can all unite to ensure that our constituents are protected and safe through their maternity journey. Let today be the start of the journey for better maternity care.
Philip Davies (in the Chair)
Before we get to the Front Benchers, last but by no means least I call Richard Burgon.
Richard Burgon (Leeds East) (Lab)
It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the hon. Member for Hartlepool (Jill Mortimer) on securing the debate, and on the candour and bravery with which she spoke from personal experience. I will use the limited time available to me to share the experience of my constituents, Hayley Storrs and Reece Watson, who wrote to me as follows:
“My name is Hayley Storrs & my partners name is Reece Watson. I’m 33 years old & live in Leeds. I work for NHS England as a Care Manager & my partner as an Electrical Engineer.
In October 2021, after a low risk pregnancy our first baby Ollie James Watson, passed away following a placenta abruption at 40 weeks & 5 days gestation. After suffering a haemorrhage at home, we were kept waiting at Calderdale Hospital in an understaffed Maternity Assessment unit, with bleeding & in active labour for over 1 hour before being seen by a midwife.
My son had already passed away inside my tummy & I wasn’t aware. Following his death & traumatic labour where I suffered a post partum haemorrhage, we received no bereavement support from the trust aside from a postcard on his 1st birthday.
The labour ward was short staffed when Ollie was born & I was left alone on numerous occasions with internal bleeding & no pain relief due to staff shortages. We have since learned that had a simple doppler scan been undertaken at any time during my pregnancy Ollie could have been saved. As a result of our experience, I suffered from PTSD, Birth Trauma, depression & severe anxiety, which still impact my day to day life.
Sands were an incredible support to me during the darkest days of my grief, when I wasn’t sure I would survive without Ollie. They provided information, comfort, support & a listening ear when I needed it the most. I attended a local support group which helped me connect with other women in similar situations to ours & made me feel less alone.
What people fail to understand when someone loses a child, it is that you have lost a lifetime. First days at school, first steps, graduations, what their favourite story would have been, birthdays, Christmases. Instead we walk out of a hospital with empty arms & into a world of grief & loss we are not equipped to navigate. My son deserved better than a memory box of scan photos, he deserved to live.
Please listen to us when we say that enough is enough, ask yourselves the question what will it take for change to happen? How many more babies like ours will die before something is done? How many more bereaved parents will it take to campaign for better, safer maternity care for you to take notice? How many more government enquiries will it take for someone to stand up & say ‘we see you, we hear you & we stand with you’?
In loving memory of Ollie James Watson, and all of the babies who never made it home. You will never be forgotten.”
Those are the words of Hayley Storrs, Ollie’s mum, from the constituency of Leeds East. I share them because to put on record Hayley’s and Rhys’s experience. Although I have not experienced baby loss myself, I think it is important that hon. Members who have personal experience share their experiences, that other Members share our constituents’ experiences, as I have done, and that we all come together on a cross-party basis really to address the issue.
This incredibly important debate has shown what can be done when we come together. I congratulate every Member who has spoken bravely about their personal experience, particularly the hon. Member for Hartlepool, who secured the debate and opened it in such an illuminating, informative and brave way.
Patricia Gibson (North Ayrshire and Arran) (SNP)
I am pleased to participate this year in what has become a tradition of debating baby loss. I thank the hon. Member for Hartlepool (Jill Mortimer) for opening the debate; I participate as someone who suffered a stillbirth at full term and who almost died in the process.
Over the last year or so, I have gone to more funerals than I have in the rest of my 54 years of life so far. When we gather to bury our dead at funerals, we talk about them: we talk about what they were like, their foibles and their character, using anecdotes told with affection and laughter. They are mourned and remembered for the person they were. But with stillbirth, there are no such stories. Over time, you simply learn to live with a loss that changes you forever. At the funeral, all there is is a life unlived. There are no amusing anecdotes, there are no character foibles to remember, and there is no personality yet formed upon which to base memories. There is only the madness of grief for a life whose promise and potential have been unfilled and unrealised—a much longed-for and much wanted child, born fully grown and often otherwise perfectly healthy, dead before it can take its first breath. “Born sleeping” is so apt because such babies look exactly like that—a perfectly fully grown, normal baby, but one who is just so unnaturally quiet, appearing fast asleep, with a room all ready at home, prepared and waiting for their arrival. Your very stake in your future is gone.
I want to talk about pre-eclampsia, because it is the cause of so many stillbirths every year. To make an impact on stillbirths, we really need to learn and understand more about this condition. Its most deadly form is HELLP—haemolysis, elevated liver enzymes and low platelets—syndrome. What is interesting is that pre-eclampsia is associated with very serious long-term health risks for women who develop it during pregnancy. They are at long-term risk of chronic hypertension, ischaemic heart disease, cerebrovascular disease, kidney disease, diabetes mellitus, thromboembolism, hypothyroidism and even impaired memory. Who is monitoring the long-term health of women who have suffered pre-eclampsia? Why are the longer-term risks not specifically monitored? Women in those risk categories are not even told that they face those risks and they are simply unaware of the long-term health challenges they may face once they are discharged from hospital. How can that be right?
People talk, quite rightly, about stillbirths being a product of health inequality, but we also know that too often they happen as a result of systematic errors in care. Sometimes, the most basic red flags are simply overlooked, or at worst, ignored. We only have to see the recent, and frankly horrific, independent reports—the latest of which came out only last week regarding maternity care in East Kent, Nottingham, Shrewsbury, Telford and, to my deep regret, the Greater Glasgow and Clyde health board. In my experience, far from seeking to review procedures and learn lessons, that board simply lawyered up to seek to intimate me—and who knows how many other bereaved parents—into silence. It failed to silence me, but I have absolutely no reason whatever to believe that it has learned anything from the systematic errors that led to the death of an otherwise perfectly healthy, 8 lb 5 oz baby. Staffing was not the issue; it was systematic failures, negligence and incompetence that killed my baby and almost killed me.
In all these cases—some publicised recently—bereaved parents all say they encounter the same thing: cover-ups, ranks closing and few, if any, answers—only the isolation and bewilderment of emptiness. I have no confidence that this situation will change, which is why independent reviews are necessary. Health boards and health trusts seem simply unable or unwilling to admit errors without being forced to do so, and that is unacceptable and inexcusable. Despite the warm words, I have seen no evidence that that situation will change.
The bereavement care pathway, which many have mentioned today, is a very positive thing. If parents are to be listened to, their questions must be answered without fear of serious mistakes being uncovered. If there are serious mistakes to be found, they should be found; all else is cosmetic and, quite frankly, patronisingly pointless.
We have made some progress since the first debate I secured about stillbirth in 2016. There is now much greater willingness to talk about the babies whose lives are snuffed out before they can begin. The more that bereaved parents feel able to talk about stillbirth, the less isolated they will feel, but the isolation is real and debilitating, and its impacts are long lasting.
This year’s Baby Loss Awareness Week theme was stepping stones—depicting the path that people must take after losing a baby and the various stages of that journey. The fact is that, for those of us who have to carry out the grotesquely unnatural act of burying a fully grown baby, the path of grief does not end. Grief stays with you for the rest of your life; you simply somehow find a way to live with it.
It really is time that we stopped hearing about serious failings in maternity care that lead to stillbirths. How many times have we had reports? How many times have we had reviews? How many times have we had investigations? What health trust or health board does not know in this day and age what is required to deliver babies safely and support mums through their pregnancy?
Sadly, we know that the latest failures found in East Kent will not be the last. I honestly despair, and I know that all those who have been through a stillbirth also continue to despair, each time we hear of yet more systematic failures. Of course staffing is an issue, but it is not the whole story. For those babies already gone, it is too late, but Governments across the UK must do more to do better; otherwise, more babies will be born asleep.
Feryal Clark (Enfield North) (Lab)
It is a pleasure to serve under your chairmanship, Mr Davies.
May I start by thanking the hon. Member for Hartlepool (Jill Mortimer) for securing this important debate? I also thank all Members for their deeply emotional, moving and important contributions to the debate, especially those who shared their personal experiences and the experiences of their constituents. By talking about these issues so openly, we work to remove the stigma that sometimes surrounds them. This debate and Baby Loss Awareness Week are vital for voices to be heard, and I praise the work of the over 100 charities that co-ordinate and support Baby Loss Awareness Week every year, particularly Sands.
Across the UK, thousands of parents experience the pain of baby loss every year. As we heard, one in four pregnancies ends in miscarriage, one in eight pregnancies is ectopic and 13 babies are stillborn or die shortly after birth every day. Just last week, we saw the publication of the report into the failings of East Kent maternity services, where up to 45 babies could have survived had they received better care—45 lives that were needlessly cut short and 45 families who were made to suffer the most devastating heartache. I am heartbroken for the families who suffer the loss of a baby. Those who suffer such tragedy must receive the physical and emotional support they need and so deserve. Yet, as we have heard this morning, so often they do not receive it.
My constituent Katie suffered a miscarriage in 2017, when she was 13 weeks pregnant. Immediately after receiving the news, she was told to go to another hospital, and her pregnancy folder was replaced with two sheets of paper entitled, “Your options after miscarriage”. She said that she was not treated with compassion by staff at the next hospital. After her operation, there was no follow-up, no aftercare and no information about what to do next. On returning to work, she discovered that her pay had been cut, as her employer did not class pregnancy loss before 24 weeks as a reason to receive sick pay. Katie was lucky enough to find herself pregnant again, but at every appointment she had to go through the details of her miscarriage time and time again. I worry that the trauma Katie went through is shared by many women across the country.
There is a pattern of avoidable harm in maternity units across our country. There were nearly 2,000 reported cases of avoidable harm at Shrewsbury and Telford Hospital NHS Trust. Half of maternity units in England are failing to meet safety standards. Pregnant women were turned away from maternity wards more than 400 times just last year.
Then there are the inequalities highlighted in the debate. I pay tribute to groups such as Five X More that do so much to highlight those disparities, and I thank my hon. Friend the Member for Streatham (Bell Ribeiro-Addy) for mentioning the important work they do. Stillbirth rates for black babies are twice as high as for white babies, and neonatal death rates are 45% higher. In the UK, black women are four times more likely to die in pregnancy or childbirth. A recent review by the NHS Race and Health Observatory found evidence of women from ethnic minority backgrounds experiencing
“stereotyping, disrespect, discrimination and cultural insensitivity”
when using maternity and neonatal healthcare services. Although I welcome some of the measures the Government have taken to address these problems, it is clear that so much more is still to be done.
As with the Government’s response to the investigation into East Kent maternity services last week, the women’s health strategy that was released about two months ago commits only to considering the recommendations of the pregnancy loss review expected later this year and the Lancet series on miscarriages. Considering further recommendations is not enough to reach the Government’s target of halving childbirth and neonatal deaths by 2025 and to provide the care that women need.
Underpinning all this across the NHS is the question of workforce, as we have heard from almost every Member this morning. More midwives are leaving the profession than are joining it. NHS England estimates that nearly 700 midwives have left in the past year—stressed, burned out and overworked. There is now a shortage of more than 2,000 midwives just in England. In a recent survey by Sands, almost one in 10 NHS trusts in England stated that they had no bereavement specialists in their maternity services—no services for parents who lose a child.
I thank all the members of the all-party parliamentary groups on baby loss and on maternity for the report they did on safe staffing in maternity services. It found that bereaved families are affected by staffing shortages, as stretched staff do not have the time to offer compassionate care, to understand what families’ needs are or to refer families to relevant services. We just do not have the staff to provide the good and safe care needed to prevent the avoidable loss of babies. Eight out of 10 midwives reported that they did not have enough staff on their shift to provide a safe service. Even the Chancellor agrees; last week, as co-chair of the all-party parliamentary group on baby loss, he signed the report, which describes maternity and neonatal services as
“understaffed, overstretched and letting down women, families and maternity staff”.
He went on to call for safe levels of staffing. So, as I asked in the main Chamber last week, will the Minister deliver on the Chancellor’s promise? Women, families and their babies deserve to be given the best standard of care to ensure the best possible outcomes. It is high time that the Government delivered that.
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Caroline Johnson)
First, I thank all the Members who have taken the time to attend the debate and those who have spoken so openly about their own, and their constituents’, experiences and concerns. I particularly thank my hon. Friend the Member for Hartlepool (Jill Mortimer) for securing the debate and enabling us to have this important conversation.
Let me take this opportunity to recognise the work of everyone who has been involved in Baby Loss Awareness Week. It is important that we make it easier to speak about pregnancy loss and enable people to have open conversations about their experiences, which in turn can help those who have experienced the tragic loss of a baby. I also take this opportunity to commend the work of the charities that provide excellent support to families experiencing baby loss, including all the members of the Baby Loss Awareness Alliance and the Lily Mae Foundation, which was mentioned by my hon. Friend the Member for Meriden (Saqib Bhatti).
As we take time to reflect, I want to acknowledge how difficult the loss of a baby is. Everyone’s grief will be different. It is a personal, individual process, which people will try to navigate in many different ways. Although it can be challenging to reflect on such tragic losses, this week provides an opportunity for people to remember, reflect, share and seek support and comfort from other people.
This is the seventh year in a row that a debate has been held to mark Baby Loss Awareness Week. I am honoured to take part as the new Parliamentary Under-Secretary of State at the Department of Health and Social Care and to work with everyone to continue making a difference in an area as vital as maternity and neonatal safety.
The independent review into maternity and neonatal services at East Kent Hospitals University NHS Foundation Trust, as mentioned by my right hon. Friend the Member for North Thanet (Sir Roger Gale), was published last Wednesday. I take this opportunity to extend my condolences to the families who suffered due to the care they received and express my gratitude to the individuals who were instrumental in establishing the review and to the inquiry team for carrying out the review to such a high standard. The Government and I take the findings and recommendations of that report extremely seriously, and I am committed to preventing families from experiencing the same pain in the future.
Our maternity safety ambition, as mentioned by my hon. Friend the Member for Hartlepool, is to achieve half the 2010 rates of stillbirths, neonatal and maternal deaths, and brain injuries in babies occurring soon after birth. Since 2010, the rate of stillbirths has reduced by 19.3%, the rate of neonatal mortality for babies born over 24 weeks gestational age has reduced by 36% and maternal mortality has reduced by 17%. However, it is important to note that there was an increase in the rate of stillbirths between 2020 and 2021. This increase occurred at the same time as the covid pandemic, and detailed work is going on to establish why that was the case. I reassure hon. Members that we remain committed to our maternity safety ambition.
Every woman giving birth has the right to a safe birth, and the Government and NHS England are committed to providing women with personalised and individual maternity care. The role of NHS staff in maternity services is critical to safe care for families, and I recognise all the great, hard work by teams across the country and thank them for it.
Members on both sides of the Chamber have talked about funding and workforce. NHS England has invested £127 million in bolstering the maternity workforce even further and in programmes to strengthen leadership and retention and provide capital for neonatal maternity care. We will keep that funding under review. That investment is on top of the £95 million investment made last year in the establishment of 1,200 more midwifery posts and 100 more consultant obstetrician posts. There are increasing numbers of midwifery and obs and gynae trainees.
I am grateful to the APPGs on maternity and on baby loss for producing their report into the maternity workforce, and I acknowledge the important themes in it. The hon. Member for Enfield North (Feryal Clark) raised the issue of retention. NHS England has established a nursing and midwifery retention programme, supporting organisations to assess themselves against a bundle of interventions aligned to the NHS people promise and it will use the outcomes to develop high-quality local retention improvement plans. In addition, in 2022-23 we made £50,000 available for each maternity unit in England to enhance retention and pastoral support activities.
Dr Johnson
I will not, because I have a lot of questions to get through in a really short time.
Many hon. Members talked about bereavement. In the difficult scenario of baby loss, we understand that bereavement care for women and families is critical. We continue to engage closely with the bereavement sector to assess what is needed to ensure that bereaved families and individuals receive the support that they need. This year we have provided £2.26 million of national funding to support trusts, expand the number of staff trained in bereavement care and directly support trusts to increase the number of days of specialist bereavement provision that families can access.
In the women’s health strategy, which hon. Members mentioned, published earlier this year, we discussed the introduction of pregnancy loss certificates for England. This will allow a non-statutory, voluntary scheme to enable parents who have experienced a pre-24 weeks pregnancy loss to record and receive a certificate to provide recognition of their baby’s potential life. The certificate will not be a legal document, but it will be an important acknowledgement of a life lost, and we hope that it will provide comfort and support by validating a loss.
We understand the impact of pregnancy and childbirth on mental health, especially for those affected by the loss of a baby, and we are committed to expanding and transforming our mental health services so that people can receive the support that they need when they need it.
As part of the NHS long-term plan, we are looking to improve the access to and quality of perinatal mental health care for mothers and their partners. Mental health services around England are being expanded to include new mental health hubs for new, expectant, or bereaved mothers. These will offer physical health checks and psychological therapy in one building.
Guy Opperman
I accept that my hon. Friend has many things to cover today. As a former Minister, may I advise her that she might want to be encouraged to write to everyone with detailed answers from civil servants to the points raised?
Does my hon. Friend agree on one key point—that the collation of data and the consistency of approach must be nationwide? While we have many wonderful trusts, that has to be driven by the NHS, for which she is a Minister.
Dr Johnson
I absolutely agree with my hon. Friend.
Going back to the issue of perinatal mental health, we have previously funded Sands, the stillbirth and neonatal death charity, to work with other baby loss charities and the royal colleges to produce and support the roll-out of a national bereavement care pathway to reduce the variation in the quality of bereavement care provided by the NHS and ensure that, wherever a woman and family are being cared for, they get a high standard of care. The pathway covers a range of circumstances of baby loss, including miscarriage. As of April this year, 78% of trusts in England had committed to adopting the nine national bereavement care pathway standards.
The hon. Member for North Ayrshire and Arran (Patricia Gibson) talked about pre-eclampsia. NHS England is establishing maternal medicine clinics. These are specialist networks across the UK, which will manage pre-conception, antenatal, post-natal and medical issues in women, and reduce long-term morbidity, thereby improving outcomes for those women who have co-existing medical conditions.
My hon. Friend the Member for Macclesfield (David Rutley) spoke about the maternity unit in his constituency. I know that he is a doughty campaigner for that unit. I will write to him with further information on progress in that area.
The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) talked about the Scottish health service and how it is performing in relation to maternity care. It is, of course, a devolved issue in Scotland, but I was moved to hear about what is happening in areas of the north of Scotland near Elgin. I would encourage the devolved Scottish Administration to consider carefully what is going on there and to see what they can do to improve care. It seems unacceptable for women to travel 102 miles to give birth.
The NHS in England has a medical education reform programme, co-sponsored by NHS England and Health Education England, to direct investment for specialty training for population needs back towards smaller and rural hospitals. That programme entered its implementation phase in August 2022.
Hon. Friends mentioned The Lancet recommendations. While the pregnancy loss review will be published shortly, I am not in a position today to commit to what it is going to say, but we will consider it carefully.
Feryal Clark
I understand that the Minister is not in a position to comment on that review, but now that she has had the opportunity to review the recommendations from the East Kent investigation by Dr Kirkup, is she in a position to say whether the Government will accept those recommendations, or when the Government will announce whether they are going to accept them? They will have a nationwide impact.
Dr Johnson
I thank the hon. Lady for her question. We were both horrified by the East Kent report, which made for extremely difficult reading. We are carefully considering the review. The hon. Lady will appreciate that we are having a change of Prime Minister today and possibly a change of Minister too, so it is difficult for me to make any commitments at this stage, beyond that the Government will consider the matter carefully and further information will be provided in due course.
Let me conclude by making three broad points. First, we appreciate how difficult and distressing baby loss can be at any point in pregnancy and childbirth. I highlight again the importance of sharing experiences and coping mechanisms that may guide other families through their own bereavement. It is important to continue this conversation past this year’s campaign and, again, I thank my hon. Friends who shared deeply personal experiences.
Secondly, I touched on the important range of targeted programmes we are developing to better support families with their bereavement and ensure all families have access to the care they need and deserve, such as pregnancy loss certificates and the national bereavement care pathway. We understand how difficult baby loss can be, and families deserve compassionate and personalised care from their local health professionals.
Thirdly, we are committed to our maternity safety ambition to halve the 2010 rates of stillbirth, neonatal and maternal death, and brain injuries in babies occurring during or soon after birth. NHS England will consider the actions from both the Ockenden report and the East Kent report and map a coherent delivery plan for maternity that will be delivered through the maternity taskforce programme. We have also established a joint working group led by the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists to help deliver the plan as effectively as possible. I thank hon. Members for taking time to be here today and I thank everyone who took part in Baby Loss Awareness Week.
Jill Mortimer
I sincerely thank all colleagues who have taken part in the debate, particularly those who have shared their own devastating personal stories. As the hon. Member for Leeds East (Richard Burgon) said, there is clearly cross-party support for addressing this important issue; I do not think anyone in the Chamber wants to quote from any more reports. Will the Minister kindly take what she has heard today to the Prime Minister and ask that it be made a priority?
Question put and agreed to.
Resolved,
That this House has considered baby loss and safe staffing in maternity care.