Baby Loss

Victoria Atkins Excerpts

Thursday 13th October 2016 Commons Chamber

[Antoinette Sandbach]

October 15 is the international Wave of Light day, on which parents across the world will light candles in memory of their children. I believe that a lighthouse in Scotland will be lit up for the first time in many years in memory of lost children. I agree that if we talk about the issues and really drill down into the causes, we can start to change the figures in the UK. Key to that is raising the issues here in this place.

Our final ask to the Secretary of State for Health and the Minister is for a bereavement care pathway for parents. That needs to involve an integrated support service, including counselling for parents following the death of a child. I am grateful that, as a result of the work of the all-party parliamentary group on baby loss and information obtained through freedom of information requests, the Department of Health has commissioned Sands—the stillbirth and neonatal death charity—to start developing such a pathway. It is clear that it will require clinical commissioning groups, GPs, local NHS trusts and healthcare professionals to recognise the need for these services and to support such a pathway, working together with the third sector.

[Victoria Atkins (Louth and Horncastle) (Con)]

I join other Members in thanking my hon. Friend and my hon. Friend the Member for Colchester (Will Quince) for bringing this issue to the Chamber today. A mother and father living in my constituency had the nightmare of their baby boy passing away unexpectedly at home. The baby boy was rushed to the nearest hospital, which happened to be in a different region. The fact that the death was registered in a different region from the one in which my constituents live has caused them incredible problems, not least in accessing counselling and therapy. Does my hon. Friend agree that geographical and regional boundaries must not prevent grieving parents from getting the help that they need and deserve?

[Antoinette Sandbach]

I most certainly do. That is exactly the kind of bureaucratic barrier that needs to be broken down. My hon. Friend’s example powerfully demonstrates the need to have a proper bereavement care pathway in place in every region. It should not matter where someone lives; everyone who needs such support should be able to access it.

--- Later in debate ---

[Will Quince]

The hon. Gentleman raises an incredibly good point. In the run-up to birth, people can go to groups such as NCT and prenatal classes, so I totally agree. We have made friends who have gone through similar experiences. You feel that you can talk openly with them, because they have gone through very similar experiences and are feeling the same things as you. That is very powerful. There may be a role that charities and the NHS can play in putting parents—where they feel able—in touch with other parents who may want to talk about their experience.

I shall speak briefly about Government targets. I know that the Government sometimes get a hard time on the NHS, but they have accepted the premise of our argument. I remember first meeting my right hon. Friend the Member for Ipswich as Minister responsible for care quality—it was like pushing at an open door. We now have firm commitments to a reduction of 20% by the end of this Parliament and 50% by 2030. It is our job as an all-party parliamentary group to hold the Government’s feet to the fire and to make sure that they are working towards those targets and that we start to see results.

I could not let this debate go by without talking about some of the issues that charities have raised with me. I shall touch on prevention and then talk about bereavement. Research in this area is vital. As my hon. Friend the Member for Eddisbury said, around 50%—in fact, the figure is 46%—of stillbirths and 5% of neonatal deaths are unexplained. We need to look, for example, at ethnicity and ask why south Asian women are 60% more likely to have a stillbirth, and why black women are twice as likely to do so. Why is there a geographical disparity across the UK? I know that part of the answer is social inequality, but why is the figure 4.9% in some parts of the UK and 7.1% in others? That is around a 25% variation. It is not acceptable and we need to understand why it exists.

We need to look at multiple pregnancies, as the hon. Member for Livingston (Hannah Bardell) mentioned from the Scottish National party Front Bench, and at lower income families. We need to study our European counterparts and see why they are getting it so right and whether we can implement similar measures in the UK.

Some right hon. and hon. Members have mentioned public health and they are right to do so. Maternal age, nutrition and diet, drugs, alcohol and smoking are all relevant. We could achieve a 7% reduction if no woman smoked during pregnancy. That is a huge target to achieve and we could do a lot of work on smoking cessation, especially during pregnancy. Studies show that we could achieve a 12% reduction if no mothers were overweight or obese.

There is a huge piece of work that we could do on empowering women and mothers-to-be. Initiatives such as Count the Kicks are important. Nobody knows their body as well as a mother. If she feels that there is something wrong, there is a good chance that something is wrong. When she picks up the phone to the hospital or to her GP and her concern is dismissed with the words, “Don’t worry, it’s not important,” she needs to get it checked out. If there is nothing to worry about, great, but on the occasions when we do not get a concern checked out and then something terrible happens, we have to hold ourselves responsible.

There are various initiatives to empower women. Teddy’s Wish is currently sponsoring fantastic folders—as anybody who has had a baby will know, mothers-to-be get purple maternity notes which they carry around religiously just in case the baby comes early. The wonderful plastic folders that the maternity notes go in inform mothers—and fathers—what to look out for, what are the signs if something is not right, when to pick up the phone, when to go and see their GP and when to go to the hospital. Such innovation is exactly what is needed.

Investigation and reporting are important so that we learn the lessons of every stillbirth and neonatal death. Covering things up and dismissing them with comments such as, “That’s unexplained. These things happen. I’m terribly sorry,” are unacceptable. We have to learn from every case. I am pleased that the Government have put a significant amount of money into setting up a system of reporting to enable us to investigate and learn from every stillbirth and neonatal death.

The hon. Member for North Ayrshire and Arran (Patricia Gibson) rightly mentioned post-mortems. So many parents are not offered a post-mortem. One might wonder what parent would want that opportunity, but parents who lose children often want to know why. They want to understand how and why it happened and how they can make sure that it does not happen again. Offered the opportunity, many parents opt for a post-mortem because they know that that research can help others, but clinicians may not be asking the question—often with good intentions, because it is not an easy question to ask. We must ask the question if we are to get post-mortem rates up, which will feed into the research that will allow us to cut our stillbirth rate.

An hon. Member—I apologise, I cannot remember who it was—mentioned late-stage pregnancy scanning. In this country we do not scan past 20 weeks. We scan at 12 weeks and we scan routinely at 20 weeks, but there is no routine scanning past that. I find it bizarre that the abnormality scan takes place halfway through the pregnancy, but after that the mother-to-be is not seen again for a scan until she arrives at the hospital when she is in labour. Other countries across the world and particularly our counterparts in Europe do scans at 36 weeks or Doppler scans. There are huge improvements that we could make in that area.

I want to clarify one point in relation to prevention. The NHS is brilliant, and where we get it right in this country, we really get it right. The problem is the inconsistency across the NHS. I know that the Secretary of State and the Minister of State will agree when I say that we have some of the best care in the world, but it is important that that is replicated in every hospital and every maternity unit in the country, so that whatever hospital a woman goes into and whatever GP she sees, she will get the same level of care and consistent advice.

Even if we manage to achieve our target, even if we match our European counterparts and reduce our stillbirth and neonatal death rates by 50%, that will still mean between 1,500 and 2,500 parents going through that personal tragedy every year. That is why it is important that the APPG puts an equal emphasis on bereavement. I have talked about consistency of care across the NHS, and there should also be consistency of bereavement pathway and bereavement care across the NHS. It is important that we consider aspects such as training for staff. I know that Ministers have put huge amounts of funding into training as part of the plan to achieve a significant reduction in the stillbirth rate.

[Victoria Atkins]

I am extremely grateful, as I said, to my hon. Friend for his part in securing this debate. I mentioned my constituents who had the nightmare of losing their baby boy. I asked the mother to write to me to set out precisely what had happened. Perhaps one of the most harrowing parts of an already harrowing story was when she told me that at the hospital she and her husband were not allowed to stay with the little boy for long. They were pressured to leave and when she was leaving the baby boy, she wanted to go back to say her last goodbye. She was refused. She collapsed to the floor and the officials around her said that if she did not get up, she would have to leave in a wheelchair or a stretcher, as it was time to go. Does my hon. Friend agree that kindness costs nothing, and that there is a duty on everyone, whether in the NHS or in the police, to make sure that when they are dealing with parents in such a situation, kindness is very much part of the way that they behave?

[Will Quince]

Yes, and my hon. Friend raises a good point. I only wish that the disgraceful behaviour and story that she has just related was unique, but sadly it is not. Reports from across the country and personal testimonies that I have read, sadly, echo such experiences. That is exactly what we need to address, and it is why training in this area is so important. Midwives and clinicians should be trained to deal with bereavement, including what language to use and what not to say. I will not repeat some of the things that I have heard said to parents who are grieving.

In our case, a stillbirth did not come as a huge shock, but let us not forget that many parents have no idea that such an experience, of stillbirth or neonatal death, is coming. It is one of the most emotionally sensitive periods of their lives and they are at their most fragile. My hon. Friend is right: it costs nothing to act with kindness, empathy and compassion. I would like to think that we can reach a point where those themes run through every maternity unit in the country. I know that that is the case in the vast majority of maternity units, but where we have instances such as my hon. Friend describes, they have to be ironed out.

I know that I am pushing your patience with regard to time, Mr Deputy Speaker, but I think that the bereavement point is so important. We must have bereavement suites and bereavement-trained midwives in every hospital in the country, and we need gynaecology-trained counsellors in every maternity unit. We also need ongoing mental health support, because the time a bereaved parent leaves the hospital is the not the end of their grief; for many it is just the start. Indeed, future pregnancies can be the most traumatic periods, because from the day they find out they are pregnant to the day they have a crying baby in their arms, they are thinking, “Is this going to happen again?” What mental health support is available? In some parts of the country it is fantastic, but in others it simply is not.

I want to make two final points. One relates to relationship support. We know that between 80% and 90% of relationships break down after the loss of a child, and that has a huge social cost. That is why mental health support is so important. I also think—this is one of the reasons I co-chair the APPG—that the voice of fathers must be heard. Fathers feel that they have to act as a rock, but in many cases we were there too. In my view, there is no worse experience than seeing your wife give birth to a lifeless baby. It is something that never leaves you. Every single day I think about my son. I think about what he would have been like yesterday, on what would have been his second birthday. I imagine a small boy running around our house, causing havoc and winding up his sisters. It is not to be, but every single day we live with that grief. Fathers need support too, as indeed do the wider family.

I want to end on a positive note. This is a hugely exciting time for us, because the opportunity for change is enormous. The APPG has made enormous progress since publishing our vision document, and I encourage those Members who have not yet seen it to find a copy—it is available online and in paper copy. What we have achieved since February, working with magnificent charities across the country, and with individuals feeding in their personal experiences, has been absolutely incredible. This is just the beginning of the journey, because we have just set out our aspirations and our vision of what we want to achieve. I know that we are pushing at an open door, because the Government want to achieve these targets too.

I want to send one final message to every parent who is bereaved up and down this country: we care; we are going to keep talking about it; and we are not going to stop talking about it until we reduce the stillbirth rate and, most importantly, we have the best quality bereavement care in the world.