Preventable Baby Loss

Caroline Johnson Excerpts

Wednesday 4th September 2024 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I congratulate the hon. Member for Ashfield (Lee Anderson) on securing the debate; the stories he read were very emotive.

Many people witnessing birth for the first time describe the experience as the miracle of birth. It is indeed the most wonderous occasion. I have been honoured to be present at the birth of many hundreds of babies in my work as an NHS doctor. Unfortunately, birth is an unpredictable process, and the hon. Member for North Shropshire (Helen Morgan) is right that we should focus not on natural birth but on the outcome of a healthy mother and child.

Birth does not always go smoothly. Generally, and increasingly as I became a more senior doctor, I attended only the very high-risk deliveries—those when things go wrong. In a job focused on saving lives, the opportunity to do so at birth is perhaps the most rewarding, but sadly, despite the best efforts of the whole team—midwives, obstetricians, paediatricians and allied professionals—some babies die, and that leaves a hole in the families that, as others have said, does not go away.

I spoke in the baby loss debate in 2022 as the responsible Minister, and I am reminded today of the words of Hayley Storrs, which were read by the hon. Member for Leeds East (Richard Burgon):

“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.”—[Official Report, 25 October 2022; Vol. 721, c. 65WH.]

That very moving account has stuck with me. It reminds us that this pain endures, so we must do all we can to prevent it.

I pay tribute to my NHS colleagues who strive every single day to ensure that pregnancy and birth lead to the happy, healthy outcome that we all want. Politicians and the Government must do all we can to support that. We must hold the NHS to account when it fails to uphold the very highest standards.

I also pay tribute to the many great charities, such as Sands, Tommy’s and Bliss, which have been mentioned by others, that do such great work in this area. I was proud to run the London marathon with a constituent earlier this year to raise money for Bliss, and I am grateful for the support it provided to him.

We must focus relentlessly and systematically—starting at pre-conception, as the hon. Member for Sheffield Hallam (Olivia Blake) said—on every single factor that can cause or increase the risk of baby death. That includes reducing teenage pregnancy, smoking and obesity; ensuring that there is chronic illness optimisation, so that if someone has diabetes, it is optimally managed before they conceive; making medication changes if needed, so that someone is not taking teratogenic drugs at the onset of pregnancy; and ensuring that women are aware that folic acid should be taken before and during the early parts of pregnancy. Before the general election, the Government consulted on the fortification of flour with folic acid to reduce the number of babies who suffer from a shortage of folic acid during pregnancy. Can the Minister confirm whether this Government will go ahead with the proposed legislation to fortify bread products?

Additionally, the Chancellor has said that she will stop all non-essential communications. Many of the messages we are talking about are public health messages that need public communication strategies. Can the Minister confirm that this essential form of communication is not affected by the Chancellor’s restrictions on communication costs?

NHS England introduced the saving babies’ lives care bundle, which currently focuses on six areas: smoking; the assessment of foetal growth during pregnancy; awareness among parents and families that a reduction in foetal movements can be a significant warning sign; expertise training for cardiotocography monitoring during labour and pregnancy; the reduction of premature birth; and the management of diabetes to ensure that people have optimal control. The NHS had a plan to update the bundle to introduce maternal early-warning schools and tracking tools. Can the Minister confirm whether it is on track to deliver that? Can she also confirm that the saving babies’ lives care bundle will be updated this year and at regular intervals, as evidence improves on how we can best reduce the number of baby deaths?

Two years ago, as Minister, I delivered a statement to the House on behalf of the Government regarding the outcome of Bill Kirkup’s independent review of maternity services in East Kent. His report was very sobering. Those tragic events revealed failings—failings seen previously elsewhere, which should and must not be repeated. In response to the review, the Government set up a group chaired by Maria Caulfield, then the Minister for Women’s Health, to oversee the work being done to improve maternity services nationwide, including by implementing the recommendations in Dr Kirkup’s report. Can the Minister confirm that the group’s work will continue under the new Government? If so, can she confirm who will lead it?

Can the Minister confirm that she will support the work of the healthcare safety investigations branch, which investigates all cases of stillbirth and life-changing injury, to see what lessons can be learned and how care can be improved?

Other have talked about the Sands and Tommy’s “Saving Babies’ Lives” report, and particularly about workforce issues. The previous Government invested heavily in increasing workforce numbers, building five new medical schools. That takes time, but it will ultimately increase the number of obstetricians and paediatricians. The number of midwives also increased. There were 23,361 full-time equivalent midwives in NHS trusts and other core organisations in 2023, which is an increase of 19% since 2010. Births fell in England and Wales during a similar period. In the spring Budget, the Government committed £35 million to improving babies’ care, £9 million of which was related to preventing brain injury. The remainder related mostly to funding 160 additional posts in midwifery and neonatal care. Can the Minister confirm that that investment will proceed in order to support the care of pregnant women and babies?

In summary, it is almost 10 years since the Government launched the maternity safety ambition. While that goal has not yet been achieved, from 2010 to 2022, the stillbirth rate fell by a fifth, the rate of maternal mortality fell by a fifth, and the rates of neonatal mortality for those babies born after 24 weeks fell by 36%. Those statistics are a good achievement, representing many hundreds of families who will now enjoy watching with love as their children grow, thrive and develop. We must build on that now to ensure that many more families—all families—have the same opportunity.