Registration of Stillbirths

Tim Loughton Excerpts

Tuesday 14th January 2014 Commons Chamber

[Tim Loughton (East Worthing and Shoreham) (Con)]

I beg to move,

That leave be given to bring in a Bill to amend the Births and Deaths Registration Act 1953 to provide that parents may register the death of a child stillborn before the threshold of 24 weeks gestation.

My wife and I are very fortunate to have three teenage children. All were born healthily and without complications. We, like other hon. Members, are lucky, but other parents —I suggest that there are more than many would realise—have not been so fortunate. Some experience loss through miscarriage, often repeatedly; some give birth routinely but experience the pain of losing a child within days, weeks or months; and some go through all the trials and tribulations and highs and lows of pregnancy only to give birth to a stillborn child. It is to try to help those parents that I am introducing this Bill.

Perinatal mortality rates—stillbirths and neonatal deaths of babies within 28 days of being born—remain worryingly high in the UK. In 2012, 7.4 deaths per 1,000 live births were recorded. That was little changed on the year before, although an improvement of about a third from 30 years ago. That is better than some of our European counterparts, but worse than most. It is also nothing like the progress that has been made on preventing cot deaths, which, after much high-profile attention and the “Back to Sleep” campaign in the 1990s, have fallen dramatically by two thirds in less than 20 years.

Other countries, such as Holland and Norway, have reduced their mortality rates much more dramatically, yet, in the UK, we continue to see wide variations geographically and demographically. For example, the stillbirth rate in the south-west of England is 4.7 per 1,000 live births; in the north-east, it is 5.8, a 23% difference. There are big differences between age groups and mums from different ethnic backgrounds.

The simple fact is that 3,558 babies were stillborn in England and Wales alone in 2012. One in 200 pregnancies ends in stillbirth after 24 weeks—it is 15 times more common than cot death. That equates to nearly 10 babies every day. That is 10 mothers who have lost a child after completing more than half the term of a pregnancy. They then have to go through the pain of childbirth to see a baby who will not grow up. In 2011, the figure was 3,811 babies, and in 2003, it was 3,612. The situation has not improved in the last decade.

I am not the first hon. Member to raise the issue in the House. I pay tribute to my hon. Friend the Member for Daventry (Chris Heaton-Harris), who has worked tirelessly through debates, and through his work with constituents and Sands, the excellent stillbirth and neonatal death charity. I also recognise the work that Health Ministers and the Department of Health have done with the Royal College of Obstetricians and Gynaecologists, and with the Royal College of Midwives, to promote better research into causes, develop a stillbirth prevention programme and examine variations in clinical practice.

I am using this opportunity to reiterate the challenges we still face over perinatal mortality rates, but the situation is worse, hence the focus of my Bill. A stillbirth is classified as such only if the gestation period is 24 weeks or more. One day less, and that stillbirth becomes a non-viable delivery, or is more commonly referred to as a mid-trimester miscarriage. There are no central records of exactly how many babies are born in that way, so they do not form part of the perinatal mortality figures.

Without wishing in any way to downplay the importance and pain of a miscarriage, particularly for new parents struggling to have their first child, the experiences are different. That was brought home to me most starkly by the story of a constituent of mine, Hayley, who came to see me before Christmas, campaigning for a change in the law.

Last year, Hayley was pregnant. For nearly 20 weeks, she carried the child of her partner Frazer. She felt the baby kicking. She went through all the other ups and downs of a first-time pregnancy. Sadly, after around 19 weeks, something went wrong, and Hayley and Frazer’s baby died unborn. It was not a miscarriage, and the following week Hayley had to go through the pain of giving birth to a baby that she knew was no longer alive. She had to take powerful drugs to induce the pregnancy. She experienced contractions. She went into Worthing hospital and had pain relief. The following day in June, she gave birth to her baby, Samuel. She held Samuel in her arms. She and her partner took photographs, had his hand and footprints taken and said their goodbyes.

Fortunately, Hayley was given good support by the clinical staff at Worthing hospital and had bereavement guidance later. She has an understanding employer in West Sussex county council. She was also fortunate to find a sympathetic funeral director. The funeral took place two weeks later.

To all intents and purposes, Hayley went through all the experiences of pregnancy and the pain of childbirth endured by any other mother, but they were coupled in this case with the unimaginable grief of a parent who has lost a child before they could ever get to know him. She did not just go through a stillbirth: she had a still baby; she became a mum. The crucial difference is that Hayley’s and Frazer’s baby is not recognised in the eyes of the state because he was born before 24 weeks’ gestation. If he had survived until 24 weeks and one day, he would have been recognised and the death properly registered in a register of stillbirths, forming part of the statistics I referred to earlier. More than just adding to the statistics though, that would have been the acknowledgement of an actual, individual baby. To add further insult to injury, Hayley had to hand back her maternity exemption certificate straight afterwards.

That stark difference surely cannot be right; it adds insult to the unimaginable pain that the parents have already had to suffer. Until the passing of the Still-Birth (Definition) Act 1992, which amended the Births and Deaths Registration Act 1953, the threshold was 28 weeks, so prior to that even more babies went unrecognised in official records. That change followed a clear consensus in the medical profession on the age at which a baby is considered viable. Since then, in fact, there have been cases of babies born before 24 weeks who have, incredibly, survived.

It is true that there is an informal procedure for hospitals to issue so-called commemorative certificates for foetuses that are not classified as stillbirths. They provide parents with a certificate that records their pregnancy loss before 24 weeks. Sands has produced a template of a certificate of birth and encourages all hospitals to adopt it. However, it is unofficial and counts for little in the eyes of the state.

Late last year, Hayley became pregnant again, but sadly suffered a miscarriage after five weeks. Coming hard on the heels of the stillbirth, this was a further huge blow for her and her partner. The effect was no less tragic than the earlier stillbirth, but the experience was a very different one. Yet the stillbirth and the miscarriage are treated as just the same in the eyes of the law, and it is this inequity that I want to put right.

My Bill would provide for the official registration of stillborn babies below 24 weeks’ gestation. It would not be based on a crude time threshold of what is deemed a viable foetus, but on the experience of giving birth. Hayley and Frazer’s baby would be recognised as having existed; Samuel’s death would have been registered. That would go some way to providing some comfort to parents such as Hayley and Frazer at an unimaginably painful time. It would provide some form of closure and allow them to move on more easily. It would also provide more data to aid the analysis of why such stillbirths happen and, hopefully, of what can be done to jump-start a resumption in falling numbers from the last decade’s plateau. For those who say that the physical act of registering a dead child alongside those registering a healthy birth could open up wounds and exacerbate the grief of the parents, I am sure that a more discrete and empathetic procedure could easily be devised.

The Bill has nothing to do with changing the law on abortion. It does not propose to change the status quo with regard to entitlement to maternity benefits and bereavement entitlement, although I think official recognition would make it easier to secure appropriate empathy and flexibility from employers. The Government have already made changes, rightly, to maternity allowance guidance to ensure mothers whose babies are stillborn after 24 weeks receive benefits they are legally entitled to, and the process has been made easier.

My Bill proposes a modest measure that requires minimal changes to legislation and little cost to the state, but for mums like Hayley, and her partner, and thousands of others struggling to have children, it has the potential to make a huge difference in helping them to handle the grief of a loss that most of us could not imagine. It is the right thing to do, it is the right thing for this House to do, and I commend it to hon. Members.

Question put and agreed to.

Ordered,

That Tim Loughton, Chris Heaton-Harris, Mr Gary Streeter, Paul Burstow, Tracey Crouch, Sarah Teather, Mr Frank Field, Andrea Leadsom, Mrs Caroline Spelman, Pauline Latham and Jim Shannon present the Bill.

Tim Loughton accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 28 February, and to be printed (Bill 153).