Baby Loss Awareness Week

Olivia Blake Excerpts

Thursday 23rd September 2021 Commons Chamber

[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 ---

[Robert Largan (High Peak) (Con)]

It is a privilege to follow my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken). She spoke about her own personal experience and her rainbow baby. I do not think the term existed when I was born, but I am my mum’s rainbow baby, and it was lovely to hear my hon. Friend’s speech. I also congratulate my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) on her powerful and courageous speech, and on all the work she has been doing since she was elected.

Baby Loss Awareness Week gives us all an opportunity to think about families that have suffered that tragedy and what can be done to help. We have heard a number of very moving stories in this debate, and I cannot begin to imagine how painful that experience must be for bereaved parents. I appreciate how difficult it is for people to be open in public about the loss of a baby or a pregnancy. According to the Baby Loss Awareness Week alliance, one in four pregnancies ends in miscarriage, and 14 babies are stillborn or die shortly after birth every day. One of the most powerful things to help those who have experienced that loss is to do everything possible to stop the same thing from happening to other parents.

My constituency of High Peak is home to some inspiring and hardworking maternity teams and bereavement organisations, and I wish in particular to talk about one organisation, and about my constituent, Ciara Curran, who asked me to share her story. Ciara lost her baby daughter Sinead 11 years ago in April 2010 due to pre-term pre-labour rupture of the membranes, also known as PPROM. That condition is when the waters break before 37 weeks of pregnancy, and it puts mother and baby at risk of infection. After such a devastating loss, Ciara went on to set up an organisation called Little Heartbeats to help women who have lost a baby to PPROM, and to ensure that pregnant mothers receive the best possible care if diagnosed with that condition.

Little Heartbeats has worked with the Royal College of Obstetricians and Gynaecologists to produce clinical guidelines and patient information leaflets to help prevent the loss of babies from PPROM. It has also launched studies into the impact of PPROM, as well as possible treatments such as stem cell patches. In recognition of the work done by Ciara and her team, Little Heartbeats received the Butterfly Award for best support organisation in 2017, and it was shortlisted for The Sun’s NHS Who Cares Wins health awards this year. It is amazing to see someone who has dealt with such loss respond with tremendous courage and compassion.

However, we still need greater awareness and a clearer understanding of PPROM, helping us to better identify and treat it. I sincerely hope that the Health and Social Care Committee will look into how the condition can be better managed, and learn from the stories of women such as Ciara who have lost babies to PPROM. I have written to the Chair of that Committee, who is in his place today, on that point. He gave a remarkably powerful speech, and I sincerely hope the Minister listened carefully to it.

We need to make improvements to antenatal and maternity care more widely. That is why I am campaigning for an improved maternity unit and antenatal clinic for Tameside General Hospital, which serves my constituents in places such as Glossop, Hadfield, Charlesworth, Gamesley and Tintwistle. The Charlesworth building at Tameside Hospital houses the current maternity unit and antenatal clinic. Originally built in 1971, it has poor insulation and problems with overheating that affect sensitive clinical equipment, including incubators for new-born babies, and impact on the wellbeing of patients and staff alike. Capital investment is badly needed to improve the comfort of patients and staff by improving insulation and providing new welfare stations and waiting areas. That will also deliver better care for mothers and babies by ensuring that clinical equipment is not overworked. I very much hope that Ministers will carefully consider Tameside Hospital’s bid for that crucial project as part of the health infrastructure plan, which alongside the planned new urgent care centre at Tameside, the proposed emergency care campus at Stepping Hill Hospital, and the long-planned new health centre for Buxton, would make a significant difference to healthcare provision locally.

I thank all the doctors, nurses, midwives, researchers, and organisers who do so much to address this challenge. Ultimately, the NHS cannot deliver world-class care without the dedication and perseverance of its amazing staff. They deserve our thanks, but they also need our support. The Royal College of Midwives has said that maternity services are experiencing a shortage of 2,000 midwives. In a 2020 survey, seven out of 10 midwives said that they were considering leaving the profession. The pandemic has put huge amounts of pressure on NHS staff, and it is vital that midwifery benefits from the Government’s £36 billion package of support for the health and social care system. It is also important that bereaved parents can get specific support and better access to counselling. The Baby Loss Awareness Week alliance carried out a 2019 survey, revealing that 60% of parents who have experienced baby loss said that they needed specialist psychological support but could not get it with the NHS. We need to improve access to counselling and invest more in prenatal nurses, giving them the right training to help parents who experience baby loss. If we are going to meet the Government’s national maternity safety ambition to see baby deaths fall by 50% by 2025, then action is clearly needed.

[Olivia Blake]

I thank the hon. Member for highlighting counselling, which is such an important issue. Does he accept that the quadrupled risk of suicide among people who experience miscarriage should be taken into consideration in suicide prevention work?

[Robert Largan]

I am grateful to my constituency neighbour for her intervention, and I absolutely take that point. That definitely needs to be taken fully into consideration.

The House has been grappling with lots of lots of big, difficult issues these past months. We often have heated debates, and I am sure that we will have many more, for the foreseeable future. But there are times, like this, when parliamentarians can come together to try to find solutions to our shared challenges. Let us work together to help those who are going through the darkest of times and give them hope that things will get better.