Preterm Birth Committee Report

Baroness Goudie Excerpts

Friday 6th June 2025 Lords Chamber

[Baroness Goudie (Lab)]

My Lords, I thank the noble Lord, Lord Patel, and the members of the committee for this really important report, and for the time at which it has come, because the situation in this country for pregnant women, babies and preterm babies is a huge risk. This is the future of our country and the future of the world, and we do not treat the situation in the way it should be treated.

I will remind Members of a few points. The report is titled Reducing Risks and Improving Lives; to do that, we have to work much harder than we are working at the moment. Women’s health is at the worst position that it has ever been. I helped launch a report recently in the House of Lords—some Members were there—where we set out a manifesto for women’s health. The Minister was extremely helpful at that meeting and has helped us since.

As for the current landscape for preterm births in England, in 2022 some 7.9% of births in England were pre term, with 45% of babies born before 37 weeks. Those babies will need a lot of help and support not just in the very beginning but for the whole of their lives, certainly until they are through the whole of secondary school and into university. They also need to have proper checks as adults as well. When you are born and not fully developed, it affects the lungs, the brain—it affects everything. So, it is really important that we have a way in which people are checked regularly.

A number of preterm babies are born to mothers who have pre-eclampsia. Pre-eclampsia has a huge effect on the mother not only while she is pregnant but in the long-term, including heart conditions and other conditions. All mothers who have had pre-eclampsia should be seen by their doctors every 12 months, having heart checks as well. They are the future too—they are looking after children and keeping homes—so it is really important that we look at the state of mothers.

Preterm birth is the leading cause of neonatal morbidity in the UK. Outcomes for preterm infants remain uneven across the country. In most places, it is not registered when a child starts nursery or school; it should be, so that teachers have an understanding of what the issue may be if a child is not doing well, and how that can be helped.

There are disparities in the rates of preterm births. Preterm births disproportionately affect marginalised groups. Among black women, the rate is 8.5%; among Asian women, it is 8.3%; and among white women, it is 7.7%. These disparities are rooted in structural inequalities such as poverty and unequal access to proper healthcare for pregnant women. Women should be being seen regularly. They should know that they must keep these appointments, and if they do not, this must be followed through.

Further, we should have much more advertising and education for women and young girls about becoming pregnant, how you must be looked after and how you have to look after yourself. If something is not right when you are pregnant, you know yourself that it is not right. It should not be for the nurses to say, “Oh, go away and come back next week—it’s nothing”. They should let you come in and be checked. I know some people will be more nervous than others, but that would also save lives and prevent other awful things from happening.

There are poorer maternal health outcomes due to unconscious bias in healthcare settings. Addressing preterm birth requires confronting the underlying social determinants of health. We need much more understanding by social workers and counsellors. We also need more understanding of what is needed and for people not to be isolated. Sometimes, if someone has a problem—if they lose a baby or take a baby home that needs help—they are isolated and left on their own, sometimes in pretty terrible accommodation, and they do not see anybody. Again, we should be giving support. The Government should do that, because of the impact it has on families and the other children in the family.

Parents of preterm babies experience high levels of trauma, anxiety and uncertainty, and an increased risk of postnatal depression. That has a terrible effect on the marriage, on the other children and on how the baby is being looked after. Nearly 40% of mothers with preterm infants report clinical symptoms. There are challenges due to separation, impacting emotional and developmental outcomes. People leave them alone. The husband or partner does not always come home because they cannot always understand what is wrong. It is really important that we try and get these clear messages out that everybody needs to support each other.

There is also the financial strain of travelling, as the noble Lord, Lord Patel, mentioned, when babies are miles away from where their parents live. They are kept separately, and their parents are expected to come back and forth, where there is no accommodation for them in the hospital. They should be able to stay at the hospital, even if it is nearby. This is really bad. One has known what this is like—we have all had people we have had to support.

There is the loss of income, and parents get exhausted. They have to apply for extra entitlements, which take a long time to come and with which nobody is very helpful. They have to do it online, but they are not always capable or up to it because, emotionally, they are worried about what is happening to the baby and to themselves. This places additional emotional and administrative pressure on families.

As I said earlier, social isolation is a real problem. We really have to look at pregnancy in a completely different way than it has been looked at in the past. It is not just the case that you have a baby and then you will be fine. Today, we have to give much better care both to the baby and to the mother and father.