Baby Loss Awareness Week

Cherilyn Mackrory Excerpts

Thursday 23rd September 2021 Commons Chamber

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

I beg to move,

That this House has considered the matter of Baby Loss Awareness Week.

Ahead of Baby Loss Awareness Week 2021, which falls in recess this year, between 9 and 15 October, it was important to bring this debate to the House to highlight the fantastic strides that are being made in this area, to underline where more needs to be achieved, and for Members to reflect not only on their own personal experiences, but on those of our constituents.

Considering that one in 14 babies dies before, during or soon after birth, Baby Loss Awareness Week continues to be an essential focal point for bereaved families. I thank hon. and right hon. Members across the House—those who are here today and those who are unable to be here—for their solid and unwavering support for this most difficult of issues. I am grateful to those who have spared the time to speak and I pay particular thanks to the Backbench Business Committee for enabling this consideration to return to the Chamber, illustrating to bereaved families across the country how important their experiences are to representatives in this place.

On the run-up to this debate, I have been struck by the number of colleagues from all parts of the House who have spoken to me privately about their losses. Many are still simply unable to speak in public about their own experience, as it is still too difficult, even after many years.

As co-chair of the all-party group on baby loss, I have received wonderful support from: my co-chair, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who has utilised his knowledge and expertise to advance the cause; the many bereavement charities; and Ministers from the Department of Health and Social Care, particularly my right hon. Friend the Member for Mid Bedfordshire (Ms Dorries), who, as Minister, totally comprehended the issues and championed much progress in this area.

In that vein, I warmly welcome the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), to her place and look forward to continuing the excellent work already begun. In addition, I know that my hon. Friend the Member for Meriden (Saqib Bhatti) would have been here to speak had he not been promoted to the Health and Social Care Front-Bench team. He was marshalling the Balsall Common Fun Run and, on his behalf, I pay tribute to the Lily Mae Foundation for organising nearly 1,000 runners.

Last year was my first such experience in this role. I told the story of my loss—the diagnosis of severe spina bifida at the 20-week scan, and the choice, which is actually no choice at all, to terminate. I talked about the termination itself, the delivery, the cuddles and the kisses for my tiny daughter, Lily, and, finally, letting her go—you never really let them go, though, do you? I talked about how difficult it was to leave the hospital without my baby, about how it physically aches, and about how a part of my heart and soul had been left behind.

I wish to put on record my thanks again to the wonderful bereavement midwifery team at the Royal Cornwall Hospital in Truro. The kindness and compassion that they showed us in our darkest hours will never be forgotten. My work in this place, on this very subject, has given me a focus to channel my energy, but I will not lie that it is difficult at times. My grieving is now done quietly at home in stolen moments with her photograph—

[Nickie Aiken (Cities of London and Westminster) (Con)]

Does my hon. Friend agree that it is an amazing achievement for her to bring this debate today and that she will get cross-party support from all of us?

[Cherilyn Mackrory]

rose—

[Madam Deputy Speaker (Dame Rosie Winterton)]

If the hon. Lady wants to take a break, we can take another speaker and come back to her if that is what she would like.

[Cherilyn Mackrory]

Thank you, Madam Deputy Speaker, for your words and my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) for intervening.

Today, I wish to extend my sincere condolences to anyone who has experienced the loss of a baby. To anyone to whom this has happened, despite what they may see, I say that the sun will shine again. It does not feel like it now, but one day it just does. For me, the dark clouds of shock, anger, guilt and dreadful, dreadful sadness do eventually dissipate—

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

I pay huge tribute to my hon. Friend for her courage in coming to this place to share her views. I know that she is speaking for so many people who have such a tough time, whether through miscarriage or stillbirth. This was her terrible experience of a child who was not going to make it, but all of us here have her back. We all agree with her, and there are so many people here who would like nothing more than to see much more done in that critical period of maternity. All our thanks go to her for her bravery today.

[Cherilyn Mackrory]

I thank my right hon. Friend for her intervention and kind words.

I entered Parliament and suddenly had the opportunity to speak with many people who had experienced the loss of a baby. Unlike me, many have no idea why their baby had died. As well as prevention of baby loss, which I will come to later, my focus in this place is on the care for bereaved families. The all-party group was instrumental in the creation of the Government-backed national bereavement care pathway, which seeks to improve the quality and consistency of bereavement care received by parents in NHS trusts in England after pregnancy or baby loss.

There are different experiences from place to place. While the Department of Health and Social Care strongly urges the trusts to take part in the pathway, mandating it and its nine standards would lead to greater time, funding and resources being made available to healthcare professionals to deliver this. Poor bereavement care, from the moment of diagnosis and the breaking of bad news, exacerbates the profound pain felt by parents. Although approaches to bereavement care in the UK have greatly improved in recent years, inconsistency still remains, often resulting in a postcode lottery for parents.

As of last month, all NHS trusts in England have either expressed interest in, or formally committed to, implementing the pathway within their hospitals and their services. Trusts require additional funding, however, to fully implement the standards, especially to ensure that every hospital has an appropriate bereavement suite, specialist staff and training.

As I mentioned earlier, the care that we received in Cornwall on the weekend that we lost Lily was second to none. However, while I was able to access bereavement counselling through my work, my husband has never been offered anything. It is my opinion that supporting partners and the wider family are not being looked after in the way that we would hope. Because the mother births the child, dads and supporting partners often feel the need to be “strong”—to be there for them. People often ask how mum is, but may not ask how dad is. That is not healthy. What about the wider family? Grandparents are grieving for their lost grandchild and wondering how best to support. Siblings are wondering what has happened.

My daughter was only four when we lost Lily. She knew I was pregnant and we tried to explain what had happened in an age-appropriate way. She seemed to accept this as children do and did not mention it again—until a couple of weeks ago. Completely out of the blue and without warning, she said, “Mummy, when I was four, you were going to have a baby but then didn’t.” Crikey! Wham! What do you do? On the hoof, I needed to explain calmly to my now almost seven-year-old what had happened. I do not know whether I explained it in the right way, but she knows now that, if there are questions, we are always here. I do not want it to be a spectre on her childhood to wonder what happened to her mystery sister. It reminded me that a child’s mind can often make up what they do not know, and we need to make sure that siblings and the wider bereaved family are cared for long after the event.

[Angela Crawley (Lanark and Hamilton East) (SNP)]

I commend the hon. Member for her bravery in speaking about such a personal and intimate matter. She speaks about partners and the wider family. There has never been a more important point about ensuring that both affected parents are able to take leave. Does she support my Miscarriage Leave Bill, which will ensure that both parents can take paid leave during this traumatic time?

[Cherilyn Mackrory]

The hon. Member and I have spoken about this issue. Since that conversation, I have taken her Bill to the Employment Minister, so I hope that we will hear more about it later in the year.

Despite our making good progress, more needs to be done if the Government’s ambition to halve baby deaths by 2025 is to be met. If the current trajectory of reducing stillbirths is maintained, England may be off meeting that 2025 ambition. The Health and Social Care Committee report noted:

“The improvements in rates of stillbirths and neonatal deaths are good but are not shared equally among all women and babies. Babies from minority ethnic or socioeconomically deprived backgrounds continue to be at significantly greater risk of perinatal death than their white or less deprived peers.”

Babies should not be at higher risk simply because of their parents’ postcode, ethnicity or income. I will let my APPG co-chair and Chair of the Select Committee speak to the findings of the report. However, it appears that health inequalities in maternity outcomes have been known about for more than 70 years, yet there are still no evidence-based interventions taking place to reduce the risks.

Continuity of carer could significantly improve outcomes for women from ethnic minorities and those living in deprived areas. Way back in 2010, the Marmot review proposed a strategy to address the social determinants of health through six policy objectives, with the highest priority objective being to give every child the best start in life. Marmot noted that in utero environments affect adult health. Maternal health—including stress, diet, drug and alcohol abuse, and tobacco use during pregnancy—has a significant influence on foetal and early brain development. Midwives have a key role in promoting public health. Individual needs and concerns can be better addressed when midwives know the woman and her family, and continuity of carer is a key enabler of that. This public health work is of most benefit to vulnerable and at-risk families, who may require more time and tailored resources. Additional work is required to address the needs of these groups, because they are simply more at risk.

As well as improving clinical outcomes for mothers and babies, continuity of carer models can also result in cost savings compared with traditional models of care, because there are fewer premature babies, so fewer neonatal cot days are required; the incremental cost per pre-term child surviving to 18 years compared with a term survivor is estimated at nearly £23,000, and most of the additional costs are likely to occur in the early years of a child’s life; there are fewer obstetric interventions, with women 10% less likely to have an instrumental birth; and there are fewer epidurals and so on.

[Olivia Blake (Sheffield, Hallam) (Lab)]

Does the hon. Member share a concern that has been raised with me by midwives—that the term “continuity of carer” has been misinterpreted by some trusts, with multiple midwives seeing people in their early appointments to increase the chance that that person will see the same midwife in hospital?

[Cherilyn Mackrory]

Although it would be fantastic to have just one midwife, continuity of carer is actually more likely to mean two midwives or a very small team of midwives. The idea is that the patient can trust that small team, open up to them more and work with them for their own health and the health of their baby.

A continuity of carer model can assist with outside issues affecting a pregnancy, including by picking up on signs of domestic abuse. Sands, the bereavement charity, is calling for an additional Government-funded confidential inquiry into tackling inequalities in this area. Confidential inquiries have been crucial in driving down maternal and perinatal death rates in some groups. These in-depth reviews of all case notes conclude within a finite period and with solid recommendations. Previous confidential inquiries—for example, into term stillbirths and deaths in labour—have transformed our understanding of the changes needed to make care safer, and have contributed significantly to reducing deaths in some groups.

The additional risks faced by women from black and minority ethnic groups have been exacerbated by covid, and this highlights the urgent need to improve equity in maternity. The UK Obstetric Surveillance System study found that more than half of pregnant women admitted to hospital during the pandemic with a covid infection in pregnancy were from an ethnic background.

In June 2020, the chief midwifery officer, Jacqueline Dunkley-Bent, wrote to all NHS midwifery services highlighting the impact of covid-19, and the additional risks faced by women and babies from ethnic minorities. The letter called on the services to take four specific actions to minimise this additional risk: increase support of at-risk pregnant women, including by ensuring that clinicians have a lower threshold to review, admit and consider women from ethnic backgrounds; reach out and reassure women from ethnic backgrounds, with tailored communications; ensure that hospitals discuss vitamin supplements and nutrition in pregnancy, particularly vitamin D; and ensure that all providers record on maternity information systems the ethnicity of every woman, as well as other risk factors, such as living in a deprived postcode area, co-morbidities and so on.

The national maternity review’s 2016 report “Better Births” highlighted the increased risk of twins and multiple births. Tamba—now known as the Twins Trust—and the National Childbirth Trust told the report that there needs to be greater recognition of high-risk groups, such as those who have multiple births. Some 10% to 15% of such babies have an unexpected admission to a neonatal unit. The Multiple Births Foundation has said that risks and complications associated with multiple births are still poorly understood by the public and are underestimated by professionals. Multiple births have gone up and the mortality rate is higher among people who have those pregnancies. Again, more research is needed to understand better the risks posed by multiple births. Owing to the increase in fertility treatment and the increased maternal age, twins and multiple births are on the increase, so we must do better to ensure better outcomes.

I again thank colleagues who are here today, and those who have worked so hard in this sector to ensure that babies and their families have the very best outcomes. There is a lot of work still to do. I look forward to my engagement with the new Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), who I know will share our passion and use her vast experience to advance these causes.

We approach this year’s Baby Loss Awareness Week with events being held around the country and reflection in our hearts. The annual wave of light gives those of us who have suffered a loss the opportunity to light a candle in memory of our babies at the same time. It is a powerful signal, with thousands of people sharing messages and photos of their candles, showing just how many families are suffering with their own grief. This issue matters to every single Member of Parliament; it affects us all.

Let us use this opportunity to speak openly about our children, and to ensure that fewer and fewer families have to suffer this experience in the future. I am proud to lead a debate in this place that shows Parliament and parliamentarians at their very best. This important issue rises above party divisions, and, as we have seen today, the compassion of Members towards one another shines through.

--- Later in debate ---

[Cherilyn Mackrory]

I thank all right hon. and hon. Members who have spoken today for the support that we have given to one other and for the timely interventions. I will not go through all the speeches because I have only a short time to sum up, but I would like to extend my gratitude to my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) and accept her invitation to meet the team at St Mary’s Hospital in Paddington. I give special thanks to my right hon. Friend the Member for South West Surrey (Jeremy Hunt) for his candid testimony, which is both personal and full of bags of experience. I could not be more grateful for being able to co-chair the all-party group with him. With our new Minister on the Front Bench, this all-party group can continue to do great things and I very much hope we will be able to do so.

I also pay tribute to the hon. Member for North Ayrshire and Arran (Patricia Gibson), who religiously attends the all-party group and carries baby Kenneth in her heart. She spoke powerfully about the isolation of grief, and I can completely relate to that. I hope that events such as today’s debate bust that stigma and that people start talking to each other. Year after year, this is the toughest debate in Parliament to participate in, but it is oh so very important.

Pregnancy and baby loss has often been seen as a women’s issue, and it is a very powerful women’s issue—we have heard about the mental health side of things and we need to not let women down on that. More than that, however, it is a family issue and a community issue. We need to be looking out for each other and to make sure that families are looking out for each other, and that we all talk about these things. You name the children, you talk about that baby; it is not something that should be shied away from because we do not know what to say. Anything we say will be the right thing to say simply because we are talking about it.

I conclude by thanking all colleagues once again for their powerful testimony, and I look forward to continuing the very important work of the all-party group.