Baby Loss and Safe Staffing in Maternity Care

Feryal Clark Excerpts

Tuesday 25th October 2022 Westminster Hall

[Feryal Clark (Enfield North) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Davies.

May I start by thanking the hon. Member for Hartlepool (Jill Mortimer) for securing this important debate? I also thank all Members for their deeply emotional, moving and important contributions to the debate, especially those who shared their personal experiences and the experiences of their constituents. By talking about these issues so openly, we work to remove the stigma that sometimes surrounds them. This debate and Baby Loss Awareness Week are vital for voices to be heard, and I praise the work of the over 100 charities that co-ordinate and support Baby Loss Awareness Week every year, particularly Sands.

Across the UK, thousands of parents experience the pain of baby loss every year. As we heard, one in four pregnancies ends in miscarriage, one in eight pregnancies is ectopic and 13 babies are stillborn or die shortly after birth every day. Just last week, we saw the publication of the report into the failings of East Kent maternity services, where up to 45 babies could have survived had they received better care—45 lives that were needlessly cut short and 45 families who were made to suffer the most devastating heartache. I am heartbroken for the families who suffer the loss of a baby. Those who suffer such tragedy must receive the physical and emotional support they need and so deserve. Yet, as we have heard this morning, so often they do not receive it.

My constituent Katie suffered a miscarriage in 2017, when she was 13 weeks pregnant. Immediately after receiving the news, she was told to go to another hospital, and her pregnancy folder was replaced with two sheets of paper entitled, “Your options after miscarriage”. She said that she was not treated with compassion by staff at the next hospital. After her operation, there was no follow-up, no aftercare and no information about what to do next. On returning to work, she discovered that her pay had been cut, as her employer did not class pregnancy loss before 24 weeks as a reason to receive sick pay. Katie was lucky enough to find herself pregnant again, but at every appointment she had to go through the details of her miscarriage time and time again. I worry that the trauma Katie went through is shared by many women across the country.

There is a pattern of avoidable harm in maternity units across our country. There were nearly 2,000 reported cases of avoidable harm at Shrewsbury and Telford Hospital NHS Trust. Half of maternity units in England are failing to meet safety standards. Pregnant women were turned away from maternity wards more than 400 times just last year.

Then there are the inequalities highlighted in the debate. I pay tribute to groups such as Five X More that do so much to highlight those disparities, and I thank my hon. Friend the Member for Streatham (Bell Ribeiro-Addy) for mentioning the important work they do. Stillbirth rates for black babies are twice as high as for white babies, and neonatal death rates are 45% higher. In the UK, black women are four times more likely to die in pregnancy or childbirth. A recent review by the NHS Race and Health Observatory found evidence of women from ethnic minority backgrounds experiencing

“stereotyping, disrespect, discrimination and cultural insensitivity”

when using maternity and neonatal healthcare services. Although I welcome some of the measures the Government have taken to address these problems, it is clear that so much more is still to be done.

As with the Government’s response to the investigation into East Kent maternity services last week, the women’s health strategy that was released about two months ago commits only to considering the recommendations of the pregnancy loss review expected later this year and the Lancet series on miscarriages. Considering further recommendations is not enough to reach the Government’s target of halving childbirth and neonatal deaths by 2025 and to provide the care that women need.

Underpinning all this across the NHS is the question of workforce, as we have heard from almost every Member this morning. More midwives are leaving the profession than are joining it. NHS England estimates that nearly 700 midwives have left in the past year—stressed, burned out and overworked. There is now a shortage of more than 2,000 midwives just in England. In a recent survey by Sands, almost one in 10 NHS trusts in England stated that they had no bereavement specialists in their maternity services—no services for parents who lose a child.

I thank all the members of the all-party parliamentary groups on baby loss and on maternity for the report they did on safe staffing in maternity services. It found that bereaved families are affected by staffing shortages, as stretched staff do not have the time to offer compassionate care, to understand what families’ needs are or to refer families to relevant services. We just do not have the staff to provide the good and safe care needed to prevent the avoidable loss of babies. Eight out of 10 midwives reported that they did not have enough staff on their shift to provide a safe service. Even the Chancellor agrees; last week, as co-chair of the all-party parliamentary group on baby loss, he signed the report, which describes maternity and neonatal services as

“understaffed, overstretched and letting down women, families and maternity staff”.

He went on to call for safe levels of staffing. So, as I asked in the main Chamber last week, will the Minister deliver on the Chancellor’s promise? Women, families and their babies deserve to be given the best standard of care to ensure the best possible outcomes. It is high time that the Government delivered that.

--- Later in debate ---

[Dr Johnson]

I absolutely agree with my hon. Friend.

Going back to the issue of perinatal mental health, we have previously funded Sands, the stillbirth and neonatal death charity, to work with other baby loss charities and the royal colleges to produce and support the roll-out of a national bereavement care pathway to reduce the variation in the quality of bereavement care provided by the NHS and ensure that, wherever a woman and family are being cared for, they get a high standard of care. The pathway covers a range of circumstances of baby loss, including miscarriage. As of April this year, 78% of trusts in England had committed to adopting the nine national bereavement care pathway standards.

The hon. Member for North Ayrshire and Arran (Patricia Gibson) talked about pre-eclampsia. NHS England is establishing maternal medicine clinics. These are specialist networks across the UK, which will manage pre-conception, antenatal, post-natal and medical issues in women, and reduce long-term morbidity, thereby improving outcomes for those women who have co-existing medical conditions.

My hon. Friend the Member for Macclesfield (David Rutley) spoke about the maternity unit in his constituency. I know that he is a doughty campaigner for that unit. I will write to him with further information on progress in that area.

The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) talked about the Scottish health service and how it is performing in relation to maternity care. It is, of course, a devolved issue in Scotland, but I was moved to hear about what is happening in areas of the north of Scotland near Elgin. I would encourage the devolved Scottish Administration to consider carefully what is going on there and to see what they can do to improve care. It seems unacceptable for women to travel 102 miles to give birth.

The NHS in England has a medical education reform programme, co-sponsored by NHS England and Health Education England, to direct investment for specialty training for population needs back towards smaller and rural hospitals. That programme entered its implementation phase in August 2022.

Hon. Friends mentioned The Lancet recommendations. While the pregnancy loss review will be published shortly, I am not in a position today to commit to what it is going to say, but we will consider it carefully.

[Feryal Clark]

I understand that the Minister is not in a position to comment on that review, but now that she has had the opportunity to review the recommendations from the East Kent investigation by Dr Kirkup, is she in a position to say whether the Government will accept those recommendations, or when the Government will announce whether they are going to accept them? They will have a nationwide impact.

[Dr Johnson]

I thank the hon. Lady for her question. We were both horrified by the East Kent report, which made for extremely difficult reading. We are carefully considering the review. The hon. Lady will appreciate that we are having a change of Prime Minister today and possibly a change of Minister too, so it is difficult for me to make any commitments at this stage, beyond that the Government will consider the matter carefully and further information will be provided in due course.

Let me conclude by making three broad points. First, we appreciate how difficult and distressing baby loss can be at any point in pregnancy and childbirth. I highlight again the importance of sharing experiences and coping mechanisms that may guide other families through their own bereavement. It is important to continue this conversation past this year’s campaign and, again, I thank my hon. Friends who shared deeply personal experiences.

Secondly, I touched on the important range of targeted programmes we are developing to better support families with their bereavement and ensure all families have access to the care they need and deserve, such as pregnancy loss certificates and the national bereavement care pathway. We understand how difficult baby loss can be, and families deserve compassionate and personalised care from their local health professionals.

Thirdly, we are committed to our maternity safety ambition to halve the 2010 rates of stillbirth, neonatal and maternal death, and brain injuries in babies occurring during or soon after birth. NHS England will consider the actions from both the Ockenden report and the East Kent report and map a coherent delivery plan for maternity that will be delivered through the maternity taskforce programme. We have also established a joint working group led by the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists to help deliver the plan as effectively as possible. I thank hon. Members for taking time to be here today and I thank everyone who took part in Baby Loss Awareness Week.