Healthcare Support Services: Conception to Age Two

Cherilyn Mackrory Excerpts

Tuesday 15th December 2020 Westminster Hall

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

I thank my right hon. Friend the Member for South Northamptonshire (Andrea Leadsom) for securing this debate. I pay tribute to the work that she has done over the past 20 years and that of other right hon. and hon. Members. I am only just starting my journey in this House, and it is a pleasure to work with such experienced colleagues, but hopefully I can bring some real-life experience to the table, having only recently finished being at what my sister would call “the cliff face” of having a baby or a small child in the house.

I had two pregnancies. One ended with the joy of my eldest daughter, and one ended in tragedy with a loss. I am now the co-chair of the all-party parliamentary group on baby loss with my right hon. Friend the Member for South West Surrey (Jeremy Hunt). He is doing an inquiry with the Health Committee on maternity services. We have been able to listen and drill down on some of the risks to babies’ lives and some of the solutions. If we can improve the outcomes for stillbirth and neonatal death, we will automatically improve outcomes for at-risk children who survive. In theory, all families should benefit.

Many tools will need to be deployed in conjunction with how we reimagine supporting the first 1,001 days, and I look forward to reading the recommendations when they come forward. Today, I want to focus on just one tool: continuity of carer. As we have heard, nurturing relationships begin before birth. The foetal brain develops rapidly during pregnancy and is influenced by the physical environment of the mother’s womb and the environment beyond it. Babies can experience adversity in the womb. For example, where domestic abuse occurs, research shows that babies’ stress regulation systems adapt accordingly, leaving them more responsive to threat, and consequently more irritable and difficult to settle once they are born.

Research from NHS England shows that one in five mums and one in 10 dads experience mental health problems during pregnancy and after birth. As we have already heard, pregnancy can often be a trigger for domestic abuse, and between 15% and 30% of domestic violence cases start during that time. The impact of those adversities can have a profound effect on an infant, whose healthy social and emotional development depends on loving and consistent care.

Professor Jacqueline Dunkley-Bent, the chief midwifery officer for England, spoke to our APPG earlier this year, and I was struck by the work that midwives are already doing in this area and the results they are getting. Continuity of carer is relationship-based care that saves babies’ lives. Baby loss is reduced by 16%, and women are 19% less likely to lose their baby before 24 weeks. It also reduces pre-term birth. We are asking for women to have the same midwife or a small team of midwives. In March 2019, 10,500 women were on the continuity of carer pathway—17% of all women booked in. That will hopefully rise to 35% by March 2021, and black and Asian women, and those living in deprived neighbourhoods, are currently being targeted. I would like to see that rolled out.

I would like continuity of carer to be promoted to all families and replicated in the health visitor sector, because it is so important. Parents’ responses shape their experiences; if they have a trusted carer they can go to if they are in crisis or struggling, whether it is with domestic violence or coercion in a relationship—or post-natal depression, which many of us have felt—an awful lot of that stress will be expelled. They might even go to the trusted carer for things such as reduced movement. Yes, it is okay to go and talk to a healthcare professional, but many women think that they are bothering a midwife, especially if they do not know them. If they have continuity of carer, all those problems can potentially be solved by a quick phone call, because they will trust somebody at the end of the phone.

I conclude by saying that I look forward to the recommendations coming forward. It is my hope that this issue will be cross-party and long term and that we will have enough funding to put real change in place for all families to come.