Reducing Baby Loss

Patricia Gibson Excerpts

Tuesday 20th July 2021 Westminster Hall

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

It is a pleasure to follow the hon. Member for Strangford (Jim Shannon). As many others have done, I thank the hon. Member for Truro and Falmouth (Cherilyn Mackrory) for securing this important debate and for helping to ensure that the issue remains firmly and high up on the political agenda.

Although health in Scotland is a devolved matter, there is no diversion in our collective will across the UK to do all we can to reduce baby loss. In almost every debate on baby loss that I have spoken in—all of them, I think—I have said that in the past, too many women have reported that they felt concerned about their unborn babies because, “Something just doesn’t feel right.” They go on to report that they have been dismissed and have subsequently suffered a stillbirth. I have repeatedly made the fundamental point about stillbirth that women know their own bodies and that clinicians need to listen to them. If that were done routinely, some tragic baby losses could be avoided.

The devastating loss of a baby brings with it not just crushing grief for the bereaved parents and the wider family, but a real social cost. We know that 50% of marriages end in divorce, and that people are eight times more likely to divorce if they suffer the loss of a child in any circumstances. Of course, the cost of divorce to society is well documented, as are the social and personal costs for all those involved. We need to bear those things in mind.

It is truly devastating when the worst happens and a baby is lost. High-quality bereavement care is very important. I am pleased that, alongside the UK Government, the Scottish Government are funding Sands UK—the Stillbirth and Neonatal Death Charity—to develop national bereavement care pathways for different types of baby loss. I also have a sense that the culture in some quarters of dismissing pregnant women who report that something is not quite right is changing, and I really and truly hope that it is. People have talked a lot about figures today, but in recent years there has been some modest improvement in the stillbirth statistics, which is welcome. There is a long way for us to go, however, in understanding more about stillbirth and baby loss.

The Scottish Government have unveiled the women’s health plan to improve women’s health in the round. We have talked about how health inequalities inevitably affect outcome, so looking at women’s health in the round is important. That would, of course, include maternity, neonatal and postnatal care. “The Best Start: A Five Year Forward Plan for Maternity and Neonatal Care” recommends that all women in Scotland receive continuity of maternity and obstetric care. A number of hon. Members have spoken about that, particularly the hon. Member for Truro and Falmouth. That does help to improve outcomes for mother and baby.

Any focus on reducing baby lost must consider pre-eclampsia, which is the most common of the serious complications of pregnancy. If we knew even more about that condition, we could save around 1,000 babies from stillbirth each year. The challenge that pre-eclampsia poses is that in its early stages, it has no symptoms. I declare an interest: my baby son was stillborn on the very day that he was due to be delivered because of an extreme form of pre-eclampsia called HELLP—hemolysis, elevated liver enzymes and low platelets—syndrome. I will not recount the details of baby Kenneth’s death again; I have done it several times in previous debates. Kenneth would be coming up for his 12th birthday, and I am now just getting to the point where I can talk about it without automatically bursting into tears, so I suppose that is progress for me.

As the hon. Member for Truro and Falmouth pointed out, knowing why your baby has died is really important. Many bereaved parents find, just as I did, that the shutters come down when they ask the question why. It is very hard to get answers and they are much more likely to be fobbed off than to be given any explanation. I can testify to the impact of such treatment after your baby is stillborn, and it is beyond what any bereaved parents should have to suffer. If there is anything that can make a stillbirth worse, it is that treatment of being dismissed.

How can we honestly say that practitioners are seeking to improve how they do things and how they improve outcomes if, when mistakes happen—as they inevitably will at times—they too often appear to go unacknowledged? Sadly, I have no reason to believe that that culture has changed. In my case, all the signs of HELLP syndrome were there, but they were missed by a series of clinicians. That very nearly also led to my own death from a ruptured liver.

The Minister knows about the really interesting work going on with regard to pre-eclampsia called placental growth factor testing, which can point us towards improving the early detection and diagnosis of pre-eclampsia and will save babies’ lives. Offering this test to every mother has implications for lab capacity and other resources—resources are always more scarce than we would like—but it compensates by reducing the demand on maternity services in other ways. It offers the potential to reduce admission of expectant mums for suspected pre-eclampsia in lower risk women, as well as reducing unnecessary in-patient monitoring tests. In the next few years, I hope that we will be able to reduce a significant number of stillbirths caused by pre-eclampsia through the use of the PGLF testing for suspected cases.

However, I am deeply concerned—as everyone else will be—that some of the very modest progress made in recent years in tackling baby loss and stillbirth appears to have been reversed since the start of the pandemic. This phenomenon has been noted in a number of countries across the world. St George’s hospital in London highlighted a fourfold increase in stillbirths, and in Scotland, too, there has been an increase since the March 2020 lockdown. Although stillbirth rates were lower than they have historically been, even during the lockdown, it is still very alarming that there has been a rise. To have suffered a stillbirth during the pandemic while separated from the wider support of family and loved ones is truly heartbreaking, and has made it all the worse.

Experts are investigating the increase in stillbirths during lockdown, but we need to know the true cause. Was it because expectant mums were more reluctant to seek help? Was it caused directly by the effects of covid-19 on babies, or is there some other explanation? Regardless of the cause, this is a very worrying development. We are all waiting on the publication of research on that to see what can be learned to inform future care that is better and more responsive to women’s needs during covid, which we must remember is still with us.

I am delighted that we have had this debate today on this very important issue, and hope that wherever reductions in baby loss are made, the whole of the UK will share best practice and each part of the UK will learn from its other constituent parts, because expectant mothers and families awaiting a new arrival should all be entitled to the safest possible delivery of their baby.