Stillbirth Certification

Chris Heaton-Harris Excerpts

Wednesday 31st October 2012 Westminster Hall

[Chris Heaton-Harris (Daventry) (Con)]

It is a pleasure to serve under your chairmanship for the first time, Mr Owen. I hope that you will be as gentle with me as are the other Chairmen whom I have served under in Westminster Hall. I thank the House for giving me the opportunity to talk about stillbirth certification.

On 18 May 2011, I led a Westminster Hall debate on the sensitive and emotive subject of stillbirth. I explained back then that I had wanted to raise the subject ever since a couple of my best friends had a stillborn child. The way in which they and other parents of stillborn children are treated is simply not good enough for a modern developed country.

Seventeen babies are stillborn or die shortly after birth every single day in the United Kingdom, and the stillbirth rate has not changed in a decade. That number is way too high. I have been told that approximately 30% of stillbirths remain completely unexplained and that lots of different factors play into the deaths of the remaining 70%. I know that the Minister who will reply to the debate is concerned that the UK is slipping down the league table of developed nations in this regard. According to a study published last year in The Lancet, the UK has one of the worst records for stillbirths, ranking 33rd out of 35 high-income nations. Although it is important to acknowledge that all women are vulnerable, we need to work out why women in our nation may be at a higher risk of stillbirth and what we can do to change that fact.

There are some troubling regional differences in the percentage rates of stillbirth across the United Kingdom. How can we explain the 33% difference between the incidence of stillbirth in the south-west, which has the lowest rates, and the east midlands, of which my constituency is a part, which has the highest?

I have had discussions with people who point out that in recent years, Britain has become one of the unhealthiest nations in Europe. We are the most obese nation in Europe and we have the heaviest drinkers. As life expectancy has increased, more British women are also waiting until later in life to become first-time mothers. All those could be contributing factors to the horrid statistic that I read out earlier.

I could not let this occasion go by without asking the Minister what research is being done into the reasons behind our high stillbirth rate. Why is there so much regional variation? More than anything, I want the Minister to assure me and those in the Chamber that the Government have an ongoing commitment to reduce the number of stillborn children throughout the United Kingdom, to talk about this subject more and to spread best practice. What will the Minister do to ensure the spread of best practice? There are many hospitals across the United Kingdom that have fantastic practice in this area, but, equally, there are those where best practice is desperately needed. Eventually, I hope that fewer parents will suffer this terrible fate. I was personally delighted by the announcement by the Department of Health, on 16 May, of the Government’s maternity pledges, which include the pledge to provide more NHS support to women who have suffered a stillbirth.

I do not intend to go over much of the territory that we covered in the debate last year, but wish instead to concentrate on one particular area—the certification of stillborn children. Without a doubt the passing of the Still-Birth (Definition) Act 1992 was a breakthrough and had huge significance for parents. From the passing of that Act, a baby who was born dead at or after 24 completed weeks of pregnancy was recognised in law as an individual. It required that the baby’s death be registered in person by one or both parents at a register office within six weeks of the baby’s birth and it stated that a stillbirth certificate be issued.

Since I raised this subject in May 2011, I have been contacted by hundreds of families who have suffered the terrible anguish of stillbirth. Many of them have shared their stories with me, and I am in awe of how some of those parents have dealt with the worst of all possible situations.

A number of themes have started to fall together around the whole subject of stillbirth. Indeed, many parents had issues that were individual in their nature. If they had complaints about their treatment, they tended to sort them out for themselves. However, there was one very distinguishable theme that came out of my many conversations and e-mails—how to help parents grieve and eventually to move on. I believe that something simple can and should be done in that regard.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing this matter to Westminster Hall. It is something that affects many people across all the constituencies in the United Kingdom. Does he agree that as things stand, the parents are not able to get the closure that they so desperately need? Although nothing can ease the pain, even to acknowledge that there was life in the first place would give a sense of closure to the family. It is a small thing but it could be of great comfort to a grieving family.

[Chris Heaton-Harris]

Yes, I do agree, and I shall come on to that point in the next couple of minutes. Certainly, that applies to a number of the parents to whom I have been speaking. Although no one will ever be able to give them back their baby, they almost feel as though the state is cheating them. It is as if their baby was never in existence. Having a birth and death certificate might help them get over that point in their grief so that they can move on.

[Jim Shannon]

The issue for parents is coming to terms with the emotional trauma that they have been through. Having a certificate will mean a terrible lot to those people, and that is what we are trying to achieve.

[Chris Heaton-Harris]

That is my intention in raising this debate today. However, this is about not just the certification element, which I hope the Minister will answer, but the need for more awareness of all the issues around stillbirth and neo-natal care.

Having the flexibility for parents to be able to choose to have a birth and death certificate for babies born after 24 completed weeks of pregnancy but showing no signs of life, would massively help a large number of parents in their grief and show that the state recognises that they had a wonderful child. As some parents would be distressed at the possibility of having to go down that route, I wonder whether we could have a more flexible system whereby parents have the choice of a formal birth certificate, a stillbirth certificate issued by the hospital or—if they so choose—nothing. In modern society, we have the ability and sensibility to deal with the matter of certification, which is important to most of the parents to whom I have spoken because it is a simple process of formally naming their deceased baby.

Over the course of my time in this place, I have raised the matter of stillbirth certification a number of times. However, on each occasion I have received a similar reply from the Department of Health. One reply said:

“The registration of stillbirths and live births serve different purposes.”

It helps Departments collect statistical data and

“enables us to monitor the causes of stillbirth.”

Another reply said:

“Different state benefits are available to parents depending on whether a child was live-born or stillborn, so it is important to be able to distinguish one certificate from another.”

I completely understand the need for the state and the Department to be able to collect these important data for use in research. In fact, I am keen to encourage the Department to do more. However, I simply cannot understand why in 2012, with all the modern technology that we have at our disposal, we cannot, in a sophisticated way, collect all the data that are required and issue birth and death certificates when they are requested by parents.

[Jonathan Lord (Woking) (Con)]

I am grateful to my hon. Friend for giving way and I commend him for pursuing this issue in Westminster Hall when I know that there is another debate very close to his heart going on in the main Chamber. Does he have any information that he could share with us about how other countries do things, which might help to nudge the Department of Health in the right direction on this matter?

[Chris Heaton-Harris]

There is actually quite a lot of information out there. There is a very good charity called Sands, which has brought me lots of examples of best practice from across Europe, and indeed from different states in the USA. I am not saying that those methods would all work if they were brought into the NHS. However, by looking at the research that has been going on in Denmark and in Australia, and at the best practice in France and in some states in the US, we might be able to form much better practice in the UK to spread throughout the NHS. There are examples of good practice out there, and although I cannot cite them “fact for fact” off the top of my head right now, the charity Sands has all that information on its website. Sands is a very good resource for information.

I want to go back to the issue of what the state can do when it comes to stillbirth certification. I am quite sure that a sensible and easy solution can be found that allows these certificates to be issued and at the same time enables the state to have all the right information that it might require about any situation around each stillbirth.

Knowing that this debate was coming up, I asked some parents to try to help me to express why this new flexibility—if we are able to have it—would help them. A mum in my local area called Michelle told me this:

“My son was 9 days past his due date when he died at the end of my labour in May 2011; he weighed 7 pounds and 7 ounces, had wavy fair hair and was perfect. I can still feel the weight of him in my arms and how soft his skin felt. To be told your child has died is the worst pain a parent can feel but to be told they will not be recognised as a person in their own right but a statistic is heart-breaking. My son looked like any other baby, I went through a labour like any other mother but I didn’t have the happy ending. Going to the registry office to register his death was made harder knowing that the parents waiting with us would be registering their baby’s birth yet we would only be allowed to register our son’s death, not given the dignity of having a birth certificate. I feel I am being punished for not having a child that was lucky enough to take a first breath or to hear his first cry. A birth certificate is incredibly important to me and unless you have lost a child who has had the misfortune of being labelled as stillborn it is difficult to understand the need for this recognition. I have been lucky enough to go on to have a daughter, I love both my son and daughter equally yet they are not treated equally in the eyes of the law.”

She went on to say:

“This cruel law needs to be changed, what sense does it make to only register the death when the baby has to be born first regardless if he will take a first breath.”

I know from previous conversations that I have had with the Minister that he completely understands all the issues that I have raised here today, and I very much look forward to hearing his comments. All I ask is that he returns to his Department, reflects on today’s debate and considers whether it is actually not too difficult to build into the system the flexibility that I and a large number of parents from across the country would like to see. It would mean a great deal to a lot of people, Michelle included.