Baby Loss Awareness Week

Maria Caulfield Excerpts

Thursday 23rd September 2021 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

I thank all Members of the House who have taken part in the debate this afternoon. The shadow Minister, the hon. Member for Tooting (Dr Allin-Khan), is right to say that this is an issue that unites us all and puts politics aside. The loss of a baby is never easy to discuss, whether it is the loss of your own baby or a baby known to you, or the experience of a constituent, it is a hugely emotional and sensitive area, and time is often not the great healer it is made out to be. This debate has raised some difficult but important issues.

I also thank the co-chairs of the all-party parliamentary group on baby loss: my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory), who spoke extremely bravely about her experience of losing baby Lily; and my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who also helped to secure this debate. The response and strength of feeling shows how many lives have been affected and touched by this issue. There have been so many moving contributions, and I cannot name them all, but they included those from the hon. Member for Pontypridd (Alex Davies-Jones), my hon. Friend the Member for Bracknell (James Sunderland) and the hon. Member for North Ayrshire and Arran (Patricia Gibson), who talked about baby Kenneth.

This is the sixth year that a debate has been held to mark Baby Loss Awareness Week, and I am honoured to take part as the new Minister for primary care and patient safety and to work with all hon. and right hon. Members across the House to make a difference in an area as vital and important as maternal and neonatal safety. It is perhaps fitting that the debate is happening so soon after I have taken on this role, as it has sharply focused my mind on the huge amount of work there is to do in improving the outcomes for families and babies.

The Government’s maternity ambition is to halve the 2010 rates of stillbirth, neonatal and maternal deaths and brain injuries in babies occurring during or soon after birth by 2025. The ambition also includes reducing the rate of pre-term births from 8% to 6%, and we are making progress on that. Since 2010, there has been a reduction of 25% in stillbirth rates and a 29% reduction in neonatal mortality rates for babies born after 24 weeks gestation. There is, however, progress to be made on reducing maternal mortality rates, brain injury rates and pre-term birth rates, because progress has been slower than any of us would have hoped. There are pilot schemes in place, however, including those introduced under the brain injury reduction programme, which saw £9.4 million-worth of investment during the spending review last year going towards reducing the incidence of birth-related brain injuries. The pilots will produce cutting-edge training and expert guidance, and I hope to report back to the House on their impact.

My hon. Friend the Member for Truro and Falmouth raised some incredibly important points, and I want to touch on a few of them. Financial investment can of course make a difference in improving maternity services. NHS England announced earlier this year an additional £95 million of recurrent funding for maternity services to support the recruitment of 1,200 midwives and 100 consultant obstetricians and the implementation of the actions arising from the Ockenden report. NHS England and NHS Improvement are also providing an additional £52 million to fast-track a long-term plan commitment for all women to be able to access their maternity notes and information via a smartphone or other device by 2024.

Money is not the only solution, however. One key way to improve outcomes is to look at what has gone wrong in the past, and the perinatal mortality review tool is important in that regard. The Health Departments in England, Wales and Scotland collectively fund the perinatal mortality review tool so that the deaths of all babies between 22 weeks gestation and four weeks old are reviewed to provide answers to bereaved parents about how their baby died and so that the NHS can learn lessons and improve care. All bereaved parents now have the option to be involved in a high-quality review of the death of their baby and, according to the last perinatal mortality review tool annual report last year, 84% of review cases in England, 86% of cases in Wales and 87% of cases in Scotland included parents in their final reports. It is by learning from parents and listening to their concerns that we will ultimately improve services for families and save lives.

The shadow Minister and my hon. Friend the Member for Truro and Falmouth raised the issue of tackling inequalities in perinatal outcomes for women from black, Asian and other minority ethnic groups. There are huge disparities in outcome across different communities. Earlier this month, NHS England and NHS Improvement published an equity and equality strategy, supported by a £6.8 million investment, to address the causes of inequalities in health outcomes, experience and access. It provides guidance for local maternity systems and focuses on black, Asian and minority ethnic groups, who currently experience poor maternal health outcomes. This is a priority area for me, and I take the point raised by my hon. Friend the Member for Truro and Falmouth about the importance of continuity of care.

In helping to support bereaved families following the tragic loss of a baby, I am delighted to hear that we have now reached the milestone of every NHS trust in England having expressed an interest with Sands in joining the national bereavement care pathway programme, and 65% of trusts are now members. We will continue to take a cross-Government approach to assessing what more needs to be done to support bereaved families.

I will discuss with my ministerial colleagues the point raised by the hon. Member for Lanark and Hamilton East (Angela Crawley), in particular, on leave for those who have experienced a miscarriage before 24 weeks.

Important points have been made about mandating a pathway and funding to ensure that every hospital has an appropriate bereavement suite and specialist staff and training. I will feed back to the House on our progress on that, as I recognise that we need to move swiftly.

My hon. Friend the Member for Truro and Falmouth, like many other hon. Members, commented on mental health support for bereaved fathers, parents, families and siblings. We heard from my right hon. Friend the Member for South West Surrey about the impact that the loss of baby Sarah had on his whole family. Losing a baby can have a massive impact on the whole family, and this Government are committed to expanding and transforming mental health services in England so that people, including those affected by the loss of a baby, get the help and support they need. My hon. Friend the Member for Guildford (Angela Richardson) could not have been more eloquent about the experience of not getting it right.

We have a long-term commitment that a further 24,000 women will be able to access specialist perinatal mental healthcare by 2023, building on the additional 30,000 women who can access such services this year.

[Dame Andrea Leadsom]

Does my hon. Friend agree that, along with all the things she is talking about, we need a joined-up set of start of life services, such as the Government are already working so hard to implement in their “Best start for life” work? If we could provide continuity of care and wraparound support for families, so many of the health disparities and terrible outcomes would be avoided.

--- Later in debate ---

[Maria Caulfield]

My right hon. Friend is right that there has to be a whole family, cross-departmental approach, which I hope we can take forward.

The partners of expectant new mothers also face the stigma that many hon. Members have mentioned this afternoon, and I hope we can improve the situation by offering a range of help, such as peer support, behavioural couples therapy sessions and other family and parental interventions. I will focus on that.

This year, unlike in our previous debates on Baby Loss Awareness Week, we have to consider covid. This year, more than most, has been particularly difficult for those facing the loss of a baby. The covid pandemic means measures have been put in place to protect healthcare workers, patients and the general public, and it has been particularly difficult for those who have suffered baby loss during this period.

Specifically on preventing maternal death and morbidity due to covid, recent findings from a national perinatal study show that of 742 women admitted to hospital since vaccination data has been collected, four had received a single vaccine dose and none had received both doses. This means that more than 99% of pregnant women admitted to hospital with symptomatic covid-19 are unvaccinated, and one message I want to get across today is that it is hugely important that mothers and their families are vaccinated to improve their safety.

[Sarah Owen]

We have been pushing the Joint Committee on Vaccination and Immunisation to make sure that pregnant women are a priority group. Will the Minister give a commitment today that pregnant women will be a priority group in any booster programme?

[Maria Caulfield]

I take the hon. Lady’s point. There was a lot of misinformation earlier in the year that made pregnant women reluctant to come forward, and there is a lot of work we can do to improve that communication.

[Jess Phillips (Birmingham, Yardley) (Lab)]

I wish to raise a specific point about covid that I learned of from an obstetric consultant: the number of preemie births dramatically dropped during covid because women were at home. It was a doctor from Reading who told me this. He had to be dispatched somewhere else in the NHS because his services in dealing with premature babies were no longer needed as the number had dropped so greatly because women were at home. Will that form part of the strategy, to make sure that in terms of baby loss we are looking after women throughout their pregnancies?

[Maria Caulfield]

The hon. Lady makes an excellent point. We need to be guided by clinical evidence and practice, and we will look back and reflect on some of the lessons that can be learned from the period of covid.

Many hon. Members mentioned the staff who look after women and families who have lost a baby. It is incredibly important that we support those staff, because the impact is huge. May I put on the record my thanks to every one of those maternity staff who look after women and families, because the toll on them is sometimes greatly underestimated? It is assumed that because they go into that speciality they can cope with this, but it is extremely difficult for them. Like my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken), may I too welcome Jane Scott and her colleague, one of the midwives from St Mary’s Hospital, who have set up the UK National Bereavement Midwife Forum? I would be delighted to visit them and learn from their experience, because we are committed to supporting staff and making sure that they are able to undertake the special work that they do.

In conclusion, there are multiple and complex issues associated with baby loss and we need to do more not only to support families through such a difficult experience, but to reduce the numbers of people experiencing baby loss in the first place. Crucially, as I said in my opening remarks, we have made some good progress on our national maternity safety plans. We have seen a 25% reduction in the stillbirth rate since 2010 and a 29% reduction in the neonatal mortality rate for babies over 24 weeks’ gestation. That means hundreds more mothers and families are going home with a live and healthy baby each year, but, as this debate has ably demonstrated, there is still much more to be done. I hope to return to the Chamber next year during Baby Loss Awareness Week to be able to show the further progress we have made on this important issue.