I beg to move,
That this House
has considered the matter of Baby Loss Awareness Week.
Ahead of Baby Loss Awareness Week 2021, which falls in recess this year, between 9 and
Considering that one in 14 babies dies before, during or soon after birth, Baby Loss Awareness Week continues to be an essential focal point for bereaved families. I thank hon. and right hon. Members across the House—those who are here today and those who are unable to be here—for their solid and unwavering support for this most difficult of issues. I am grateful to those who have spared the time to speak and I pay particular thanks to the Backbench Business Committee for enabling this consideration to return to the Chamber, illustrating to bereaved families across the country how important their experiences are to representatives in this place.
On the run-up to this debate, I have been struck by the number of colleagues from all parts of the House who have spoken to me privately about their losses. Many are still simply unable to speak in public about their own experience, as it is still too difficult, even after many years.
As co-chair of the all-party group on baby loss, I have received wonderful support from: my co-chair, my right hon. Friend Jeremy Hunt, who has utilised his knowledge and expertise to advance the cause; the many bereavement charities; and Ministers from the Department of Health and Social Care, particularly my right hon. Friend Ms Dorries, who, as Minister, totally comprehended the issues and championed much progress in this area.
In that vein, I warmly welcome the Under-Secretary of State for Health and Social Care, my hon. Friend Maria Caulfield, to her place and look forward to continuing the excellent work already begun. In addition, I know that my hon. Friend Saqib Bhatti would have been here to speak had he not been promoted to the Health and Social Care Front-Bench team. He was marshalling the Balsall Common Fun Run and, on his behalf, I pay tribute to the Lily Mae Foundation for organising nearly 1,000 runners.
Last year was my first such experience in this role. I told the story of my loss—the diagnosis of severe spina bifida at the 20-week scan, and the choice, which is actually no choice at all, to terminate. I talked about the termination itself, the delivery, the cuddles and the kisses for my tiny daughter, Lily, and, finally, letting her go—you never really let them go, though, do you? I talked about how difficult it was to leave the hospital without my baby, about how it physically aches, and about how a part of my heart and soul had been left behind.
I wish to put on record my thanks again to the wonderful bereavement midwifery team at the Royal Cornwall Hospital in Truro. The kindness and compassion that they showed us in our darkest hours will never be forgotten. My work in this place, on this very subject, has given me a focus to channel my energy, but I will not lie that it is difficult at times. My grieving is now done quietly at home in stolen moments with her photograph—
Does my hon. Friend agree that it is an amazing achievement for her to bring this debate today and that she will get cross-party support from all of us?
Today, I wish to extend my sincere condolences to anyone who has experienced the loss of a baby. To anyone to whom this has happened, despite what they may see, I say that the sun will shine again. It does not feel like it now, but one day it just does. For me, the dark clouds of shock, anger, guilt and dreadful, dreadful sadness do eventually dissipate—
I pay huge tribute to my hon. Friend for her courage in coming to this place to share her views. I know that she is speaking for so many people who have such a tough time, whether through miscarriage or stillbirth. This was her terrible experience of a child who was not going to make it, but all of us here have her back. We all agree with her, and there are so many people here who would like nothing more than to see much more done in that critical period of maternity. All our thanks go to her for her bravery today.
I thank my right hon. Friend for her intervention and kind words.
I entered Parliament and suddenly had the opportunity to speak with many people who had experienced the loss of a baby. Unlike me, many have no idea why their baby had died. As well as prevention of baby loss, which I will come to later, my focus in this place is on the care for bereaved families. The all-party group was instrumental in the creation of the Government-backed national bereavement care pathway, which seeks to improve the quality and consistency of bereavement care received by parents in NHS trusts in England after pregnancy or baby loss.
There are different experiences from place to place. While the Department of Health and Social Care strongly urges the trusts to take part in the pathway, mandating it and its nine standards would lead to greater time, funding and resources being made available to healthcare professionals to deliver this. Poor bereavement care, from the moment of diagnosis and the breaking of bad news, exacerbates the profound pain felt by parents. Although approaches to bereavement care in the UK have greatly improved in recent years, inconsistency still remains, often resulting in a postcode lottery for parents.
As of last month, all NHS trusts in England have either expressed interest in, or formally committed to, implementing the pathway within their hospitals and their services. Trusts require additional funding, however, to fully implement the standards, especially to ensure that every hospital has an appropriate bereavement suite, specialist staff and training.
As I mentioned earlier, the care that we received in Cornwall on the weekend that we lost Lily was second to none. However, while I was able to access bereavement counselling through my work, my husband has never been offered anything. It is my opinion that supporting partners and the wider family are not being looked after in the way that we would hope. Because the mother births the child, dads and supporting partners often feel the need to be “strong”—to be there for them. People often ask how mum is, but may not ask how dad is. That is not healthy. What about the wider family? Grandparents are grieving for their lost grandchild and wondering how best to support. Siblings are wondering what has happened.
My daughter was only four when we lost Lily. She knew I was pregnant and we tried to explain what had happened in an age-appropriate way. She seemed to accept this as children do and did not mention it again—until a couple of weeks ago. Completely out of the blue and without warning, she said, “Mummy, when I was four, you were going to have a baby but then didn’t.” Crikey! Wham! What do you do? On the hoof, I needed to explain calmly to my now almost seven-year-old what had happened. I do not know whether I explained it in the right way, but she knows now that, if there are questions, we are always here. I do not want it to be a spectre on her childhood to wonder what happened to her mystery sister. It reminded me that a child’s mind can often make up what they do not know, and we need to make sure that siblings and the wider bereaved family are cared for long after the event.
I commend the hon. Member for her bravery in speaking about such a personal and intimate matter. She speaks about partners and the wider family. There has never been a more important point about ensuring that both affected parents are able to take leave. Does she support my Miscarriage Leave Bill, which will ensure that both parents can take paid leave during this traumatic time?
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.
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?
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 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.
I did not expect to be called to speak so early in the debate; thank you, Madam Deputy Speaker.
I again thank my friend, Cherilyn Mackrory, for her bravery and for sharing her experience on the Floor of the House. It matters to the people at home to know that we politicians are also human beings, and that we also feel grief and loss.
Whether a pregnancy was planned or a surprise, that moment of seeing two lines on a pregnancy test stick will stay with many parents for a lifetime. Equally, for many who are trying to conceive, a faint one line or “not pregnant” will stay with them also, each and every time they receive it. Pregnancy can be a joyous, happy celebration for many. Perhaps that is why we often choose not to speak of the sadness and heartbreak when a pregnancy loss happens. Tragically, one in four pregnancies will end in miscarriage. The experience of miscarriage, along with the grief and loss associated with the miscarriage or stillbirth, will resonate for one too many parents. Every pregnancy loss is different, and there is no right or wrong way to feel about it. Sadly, many patients feel stigma. They feel a sense of shame or a failure that they could not conceive or, even when they can, that the pregnancy does not result in a happy birth.
My hon. Friend is making an excellent speech that resonates with so many of us who have suffered baby loss. Will she commend, with me, the campaign run by my constituent Louise Caldwell? She is campaigning for a dedicated miscarriage unit after having to give birth to her child who was sadly lost, not in a miscarriage way, and suffering real compounded trauma from having to be in the maternity wing of the hospital while other parents were celebrating and she was bereaved and her whole family were devastated? Will she also congratulate the Scottish Government on taking forward an initiative to have dedicated miscarriage wings?
I thank my hon. Friend for raising that very valid point. I commend Louise for her bravery and for making sure that the Scottish Government will adopt a new policy to prevent people in future from having to undergo that experience of happiness in among the sadness at that very tragic moment.
Many partners will blame themselves and often feel helpless in this situation. Thanks to the work of my hon. Friends the Members for North Ayrshire and Arran (Patricia Gibson) and for Glasgow East (David Linden), only last year bereavement legislation was introduced that entitles parents who lose a baby after 24 weeks to two weeks’ paid bereavement leave. However, there is currently no provision in place for parents who lose a baby before 24 weeks. Too many parents—mothers, fathers, partners and any parents who are facing this tragic incident—are forced to take sick leave or unpaid leave. Understandably, many do not wish to disclose these private and intimate details to their employer, especially in the early stages of pregnancy.
Grief is not an illness. In and of itself, it is a process that parents must go through. There is simply no timeline for grief. Every parent, regardless of whether the loss happens after 24 weeks or before, should be given the time to grieve that loss without a financial penalty. That is why I have introduced a private Member’s Bill that would allow parents who experience a miscarriage before 24 weeks to seek a minimum of three days’ paid leave. Some companies have already gone further, offering leave for seven to 14 days—an example that I hope many more employers will replicate and that I absolutely welcome. This compassion and recognition of the loss and the grief that comes with a miscarriage, whether in policy or in statute, would allow parents to approach their employer and seek a legal right to paid leave.
This traumatic life event will inevitably affect both parents differently. There is a cost associated with such a loss, as many parents opt to take unpaid or sick leave, so there is already a financial penalty for people up and down the country. Often an employer has no idea what the nature of their employee’s sickness is, or the ramifications for their business. Therefore, having a policy on this issue, or the right to take paid leave in statute, should not add any further burden to them. Rather, it would allow the conversation to take place where both employee and employer can understand the situation and hopefully seek to support their employee in the best way that they can. Many parents have spoken of feeling isolated and alone, without the opportunity to share their loss with colleagues for fear of the shame and stigma that have been associated with such a loss. Introducing a minimum of three days’ paid leave would not only give parents a chance to grieve and process their loss but show everyone that miscarriage is no one’s fault and help to break that stigma.
It really is an honour to follow two such extremely powerful and persuasive speeches. I particularly thank my hon. Friend Cherilyn Mackrory for her courage in bringing Lily’s story to this House. It is actually a rather wonderful thing that she is giving such meaning to Lily’s life by talking about what happened so openly. The grief that she expressed so eloquently is shared by 1,700 families in our country every single year, so she is speaking for a lot of families up and down the country. Her words will resonate, so I thank her. It was not easy to do. But like many families who are bereaved, she has taken the decision to relive that grief over and over again to try to stop that tragedy being repeated, and I think we all salute her courage in doing so.
My hon. Friend said something that resonated particularly with me when she talked about the grief of fathers. I cannot claim to have experienced anything like the grief that she and her husband have experienced, but my father did, because my sister Sarah died when she was just six months old. I was there at the time. I was only two so I had no memory of it. During my father’s entire life—he died eight years ago—my mother used to tell us never to mention Sarah because he found it so hard. That reflects the comment of Angela Crawley that there is no timeline for grief.
Does the right hon. Gentleman believe, as I do, that fathers, like mothers and like any parent, have the right to have a grieving process and should have the right to paid leave in order to do so?
I thank the hon. Lady for giving me a moment to recover. She makes a very powerful argument. Without committing to supporting her proposal, I would hope that all employers would listen to her speech and offer that leave voluntarily on compassionate grounds, because that is the responsible and kind thing to do.
I want, in my brief comments, to talk about another group of people less often talked about who also feel this grief—the doctors, nurses and midwives responsible for a child’s care. Some people have used the phrase “second victim” to describe the agonising sadness people feel when they are responsible for a child’s care and that child dies. When I was Health Secretary, many times I asked people working in hospitals what the biggest tragedy and professional shock they had ever had was, and they would often say that it related to the death of a child. Even more acute is when that death was caused by an error. Those doctors, nurses, midwives and frontline professionals, who go into their profession with the highest and noblest of motives, have to live with the fact that perhaps because of an ordinary human mistake—the kind of mistake that all of us can make—something really terrible happened.
We as politicians, and those in nearly every other profession, make mistakes the whole time—a media appearance goes wrong, a speech goes down badly, we lose an election, or whatever it is—but the consequence is not someone dying. Frontline health professionals have the courage to go into a profession where they are taking that risk every day. When those tragedies happen, those frontline professionals want nothing more than to be completely open, transparent and honest about what happened so that we can learn from the mistake and put in place processes and systems so that it never happens again. But, in truth, we make it practically impossible for them to do that. They are terrified about losing their job, about the Care Quality Commission, about being struck off the medical or nursing register, about the reputation of their unit, about the reputation of their hospital, and about lawyers, who get involved very quickly.
When I was Health Secretary—I do not think this has changed even now—every week I signed off a multimillion-pound payment to a family whose child was disabled for life because of medical error that the NHS accepted. Most weeks it happened twice. Overall, the cost of that compensation for medical error in the NHS is £2.4 billion a year. Just under half of that relates to maternity. We have got to the obscene situation where we pay more in compensation to families when something has gone wrong than on the entire cost of every doctor and every nurse working in maternity units up and down the country. Why is that? It is because of a simple problem that the Health and Social Care Committee—I am delighted to see members of the Committee in their places on both sides of the House—is urgently asking the Government to address.
If, because of a mistake, a child is born disabled, the parents quite understandably want financial support to deal with the unexpected costs that the family will face for the whole of that child’s life. However, under the law, the only way to get that compensation is if a court agrees that there was clinical negligence. Quite understandably, parents will fight to get that compensation and, also understandably, the doctors, nurses and midwives become defensive if they are accused of clinical negligence. It does not have to be that way. We need a system where people are entitled to compensation as soon as it is accepted that a mistake was made without the necessity to prove clinical negligence.
The country with the highest safety standards and the lowest number of baby deaths in Europe is Sweden, which has about half our level of baby deaths. In Sweden, compensation is given more quickly just on the basis of a mistake being made, with the result not that they pay more but that they pay massively less, because they have half the number of tragedies that we have. Surely those of us who are passionate about patient safety will support that, and those who are—as we all are—worried about baby deaths will support that. Even people in the Treasury should understand that the way to reduce the obscene compensation bill is to make it easier for families in those terrible situations to claim compensation. If we had the same maternity safety levels as Sweden, 1,000 more babies would survive every single year. Just think of the heartache and the transformation in the lives of families up and down the country were we to do that.
I turn briefly to the other recommendations in the Select Committee’s report, published in July. One of the most important recommendations relates to staffing. When it comes to medical error, if there are not enough staff on a ward, the likelihood of mistakes will self-evidently be higher. Eight out of 10 midwives say that there are not enough midwives on their shifts, and Health Education England—the Government’s own body—says that there is a shortage of just over 1,900 midwives across the system. NHS Providers thinks that there is a shortage of about 500 doctors in maternity units and the Royal College of Anaesthetists says that there is a shortage across the system of about 1,000 anaesthetists. The cost of putting that right is between £200 million and £350 million a year. That is a significant amount. The Government deserve credit for already agreeing to put in £95 million a year, but that additional cost is as nothing compared to the £2.4 billion that we are paying in compensation every year. I hope that the Government will agree to put right that staffing shortfall. They have said this week that they are considering that.
Training is another vital issue. It is so important for doctors, nurses and midwives to have the time to learn from things that go wrong and to improve systems, but they can do that only if there is protected time for training in their busy schedules. I commend Baby Lifeline for the fantastic, proven training that it does, which has saved many lives. It is led by the inspirational Judy Ledger, who was inspired to do what she does by her tragedies. The report also talks about more screening and health inequalities, both of which were mentioned by my hon. Friend the Member for Truro and Falmouth.
I finish with two brief points. First, it would be wrong to say that this is an NHS problem. It is a tragedy that happens in all countries all over the world, and this year the World Health Organisation has made maternal and newborn loss the theme of World Patient Safety Day. The WHO says that, every day across the world, 7,000 babies die and the majority of those deaths are preventable.
Finally, we should remember the tremendous progress that has been made. In the last decade, the number of neonatal deaths is down by 25% and the number of stillbirths is down 30%. I commend Jacqueline Dunkley-Bent and Matthew Jolly in NHS England, who are leading the maternity safety transformation programme, and the many doctors, nurses and midwives who are supporting them. I also commend charities such as Sands and the Lullaby Trust as well as many others. Most of all, I commend the families who have campaigned through thick and thin, including James Titcombe, remembering his son Joshua; Derek Richford, remembering his grandson Harry; Carl Hendrickson, remembering his son Chester and his wife Nittaya; and Richard Stanton and Rhiannon Davies, remembering their daughter Kate. There are many others. Five babies die every single day. This is our moment to put it right.
It is a privilege to speak in the debate and to follow the incredibly moving and personal contributions of so many hon. Members. I thank in particular Cherilyn Mackrory for her bravery and strength. By speaking out and helping to remove the stigma around these conversations, she will have helped thousands of families in all our constituencies. That is Lily’s legacy.
I have previously spoken in this place about the loss that I felt not having a child because of infertility. There was the pain that I felt whenever I saw a woman pushing a pram, the guilt of jealousy at every celebratory pregnancy announcement on social media, and my declining every baby shower invite I received. There was the shame of knowing that my body had failed me, but I also know how incredibly privileged I am because I did get my happy ending.
My husband and I always knew that the road to pregnancy would be difficult. After a miracle round of privately funded IVF—we were denied NHS funding because I was a stepmum—we were delighted to be pregnant with our first child. I was, hand on heart, absolutely ecstatic about the prospect of motherhood. I always knew that I was desperate to be a mother and, despite our difficulties, I loved every moment of being pregnant. However, as is often the case, life was more than ready to cause chaos.
When my son arrived two weeks early after an emergency caesarean, he stopped breathing. My beautiful child, my longed-for child, was whisked away to a neonatal intensive care unit where he spent two weeks fighting for survival while my husband and I were utterly beside ourselves with anxiety. Both of us were completely broken at the thought of losing our little one. I know that feeling is shared by so many parents across the country. Indeed, it is a common interest shared by members of the all-party parliamentary group on premature and sick babies, of which I am a proud vice-chair. I encourage colleagues speaking in the debate to sign up. We are a small group led by my friend David Linden, with a focused interest in how to support parents of babies who pass away or who are born premature or sick.
With that in mind, I must thank the many charities who support families such as ours who have been campaigning to change things for the better for many years. Bliss and the Baby Loss Awareness Week Alliance are just two of the fantastic groups doing brilliant work. I am grateful for their support in preparing for the debate.
I very much welcome my hon. Friend’s speech. Will she join me in congratulating baby loss charity Forever Stars, based in Nottinghamshire, which successfully fundraised to provide improved facilities to support bereaved parents at both Nottingham’s hospitals, supports families with emotional support and practical advice and information, and this summer opened a remembrance garden at Highfields park?
I congratulate my hon. Friend’s local charity on its fantastic work.
Research from Bliss suggests that every year more than 100,000 babies in this country are born needing neonatal care. Many of them will be like mine and will spend many weeks—even months—in neonatal care. As we all know, some will sadly never go home at all. Shockingly, the statistics are particularly bad for women who live in deprived areas: such cases have an 80% higher risk of stillbirth and neonatal death compared with women living in the least deprived areas. That is a devastating figure, made worse by not having significantly reduced between 2016 and 2018. We should be making progress, but instead, parents are still faced with little support when going through what can only be described as one of the most difficult experiences that a human can ever face.
Of course, we all recognise that, sadly, the coronavirus pandemic has only made this situation even bleaker for bereaved parents. Neonatal units across the country have been impacted, and pandemic restrictions that see parents and babies even more separated than usual are still in place, sadly, in many units. Indeed, Bliss’s recent report from May this year showed that only 30% of NHS trusts that took part in its study were allowing full access for both parents to ensure they could be with their baby together whenever they wanted, sometimes in the final moments of their short lives. The picture has slightly improved since then, in that only about 10% of neonatal units now do not offer parents full access. But some parents are still routinely locked out of their baby’s care, and for those who do not make it, the current system is utterly failing them.
I would like to say that the situation is better for those whose babies do survive, but, sadly, that is not the case either. When my own child was fighting for his life, I was still recovering from an emergency C-section, and I really had to rely on my husband in every way possible. This was only possible because my husband had a flexible employer, who allowed him to pool his annual leave to secure more paid time off work. It should not be this way. While I was pleased to see the Government recently announce plans to introduce neonatal leave that will cover up to 12 weeks when a baby is receiving neonatal care, this policy simply does not go far enough. The changes are unlikely to come into force until 2023 at the earliest, leaving about 300,000 families with babies who will be spending time in neonatal care alone in the next three years forgotten about once again.
I will say, however, that I raise these points not to be political—I know that is a rarity in this place—but instead because these barriers are ones that really do impact people across the country. We are all here today to raise awareness of baby loss, and awareness is important, but what is more important is action. While I recognise that health is an issue devolved to our Welsh Labour Government, it is fair to say that the UK Government need to lead the way in introducing a statutory leave entitlement for those impacted by premature births, infant loss and infertility.
To conclude, I urge the Minister to work with her colleagues across Government Departments and the devolved nations to take bold action to support future generations and tomorrow’s parents. I look forward to hearing from her an update on what steps the Government are taking to support parents across the UK who experience the unimaginable loss of losing their baby.
I thank my dear friend, my hon. Friend Cherilyn Mackrory, for having the bravery we have seen here today, but also for how, throughout her time in this place, she has fought and campaigned very bravely for those who have experienced the loss that she has experienced. I think we see this place at its very best when we come together, put politics aside and discuss the issues that are so important and affect so many thousands of families across our country. I also pay tribute to the former Minister for patient safety, suicide prevention and mental health, my right hon. Friend Ms Dorries, who has certainly put campaigning for women’s health at the front of her Government’s priorities.
I, too, have experienced baby loss, and I remember it as if it was yesterday. It was my first pregnancy with my husband and, sadly, at eight weeks it did not continue. It is something that stays with me even today; this is the first time I have actually spoken about it publicly. However, I was very fortunate in that, within five months, I was pregnant again and I had my rainbow baby. Until Mrs Johnson, the Prime Minister’s wife, used that term I had never heard of a rainbow baby, but it is a fantastic term because it is about the positiveness that can come after the dreadful experience of losing a baby. My rainbow baby is now 17 years of age, in her last year of school and about to begin her life adventure.
It was not until I had my miscarriage that I realised that one in four pregnancies can be lost in this country, usually early—before 12 weeks. More than this, estimates from St Mary’s Hospital in Paddington in my constituency suggest that there are about a quarter of a million miscarriages every year in the UK, and about 11,000 emergency admissions for ectopic pregnancies, which always, sadly, result in pregnancy loss.
I think the theme of wellbeing for the forthcoming Baby Loss Awareness Week this year is so important. On this, I am very proud to highlight the work of the brilliant maternity wards at St Mary’s Hospital, which were the first in London to receive an outstanding rating from the Care Quality Commission. I invite the Minister to join me on a future visit to see their work at first hand, with, I hope, my hon. Friend the Member for Truro and Falmouth.
I note that patients from St Mary’s, which is part of the Imperial College Healthcare NHS Trust, have been taking part in a new study showing that one in six women experience long-term post-traumatic stress following baby loss.
I congratulate the hon. Member on having a rainbow baby, as I do myself. We know that the road to pregnancy is not always smooth, and the numbers she has just highlighted show how frequently this happens. Is it not now time that we reviewed the cruel requirement for three miscarriages or baby losses before medical intervention is offered to families?
I thank the hon. Member for her intervention, and I think it is clear from the debate today that there needs to be more support for women and their partners when they experience miscarriage. I will never forget, when I became pregnant with my daughter, how terrified I was of going for the 12-week scan, because my first experience had been one of baby loss and I had been told at that scan that the baby was not viable. I think I would have benefited from some counselling and some support when I was going for that scan for the second baby.
I thank the hon. Lady for the very powerful speech is making. I appreciate the very personal nature of what she is sharing, and it brings so much to this House that everyone is doing that. Would she join me in commending local organisations, such as Held In Our Hearts in my Livingston constituency, which has been operating for 40 years, that provide support with counselling services for those who have experienced baby loss, and does she agree that they are absolutely vital in supporting those who have suffered such loss?
I thank the hon. Member for her intervention, and she is absolutely right. We are blessed in this country with having so many outstanding charities and organisations that support women and their partners when they are experiencing baby loss.
The Imperial College Healthcare NHS Trust study has revealed some incredible findings. For example, after one month following a pregnancy loss, nearly a third of women suffer post-traumatic stress, while nearly one in four experiences moderate to severe anxiety and one in ten has moderate to severe depression. These women are going through such pain, and it is clear that they need more support. The scale is truly astonishing. Here I think due consideration should be paid not just to the women, but to the bereaved families. As we heard from my right hon. Friend Jeremy Hunt, this does affect the fathers involved. I remember, from my own experience, my husband going through such loss.
When I was researching for this debate, I reached out to an outstanding woman called Jane Scott, who is the senior bereavement midwife at the Imperial College Healthcare NHS Trust. She is here today I believe—I think in the Gallery above me—with her colleague Lauren Petrie. Midwives up and down this country do amazing work, but Jane in particular gave me powerful testimony before this debate. She explained that, before 2013, there was little or no provision in the labour ward she worked on at St Mary’s for parents who had experienced the death of a baby. Due to her tenacity, and to her basically battling the NHS trust, she was able to secure specialist services for bereaved parents. She told me that at the time she was battling,
“parental complaints were rife…Babies were going missing, funerals were going ahead without the parent’s knowledge, communication was poor which added longevity to the grieving process for parents…There was no provision for psychological support/counselling for parents.”
I was completely shocked when I read that, because to lose a baby, no matter how early in the pregnancy, and not to be able to have a funeral, is absolutely unacceptable.
With Jane’s hard work, and her setting up of bereavement services at St Mary’s, complaints from parents dropped by 90%. She said that the ward became almost unrecognisable, and much more of a positive place to be. Jane is a member of the all-party group on baby loss, and she continues to campaign to highlight the importance of understanding the effects of baby loss. She has now set up the national Bereavement Midwife Forum, which compares services, exchanges best practice, and provides support for midwives. There are now 250 members of the Bereavement Midwife Forum across the UK, and I pay tribute to Jane Scott and her fellow midwives for the outstanding work they provide.
From speaking to Jane, and others, I know that the Bereavement Midwife Forum firmly believes in, and is calling for, consideration for there to be one full-time bereavement midwife for every 3,000 deliveries in each trust. That is a reasonable request, and I would welcome any support that the Minister can provide to ensure that NHS trusts consider it. The forum is also calling for a standardisation of trauma counselling for bereavement midwives and bereaved parents. We must also ensure that there are band 8 regional bereavement midwives to oversee such services in each trust. Those are all sensible measures.
I wish to ensure that there is more support for midwives, particularly those who experience the dreadful death of a baby when looking after a mother—I cannot imagine how it must feel to be in that profession and experience that, and to work with a mother and a father who are going through such trauma. We must do more to support midwives, and doctors, who have that dreadful experience. Again, I thank my hon. Friend the Member for Truro and Falmouth for securing this debate. I am in awe of her. I also again pay tribute to all those midwives and doctors who work tirelessly day in, day out. To anyone who has experienced the bereavement of a lost baby I say this: you are not alone.
It is a privilege to follow my hon. Friend 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 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.
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?
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.
I will admit to being in two minds about speaking in this important debate. As a biological male, I cannot, of course, get pregnant. What do I know, really? Can I feel it? Do I have a right to be here? Do my experiences carry any legitimacy against the amazing stories that we have heard today? Of course the answer is yes, but there is a conflict. This is difficult territory for all of us, but not least for men. We need to destigmatise this conundrum. The fact that something is difficult does not mean that we should not do it or talk about it, so I really hope that I hold it together for the next five minutes or so.
For me, baby loss is about many things. It is about bereavement at the loss of any child, big or small. It is about the devastation that is left behind. It is about the hopes that are dashed, and the misery. It is about love. It is about the agony of miscarriage, however that child is conceived. It is about those trying for children—those who desperately want children. And it is about those going through in vitro fertilisation or intrauterine insemination, with the physical and emotional nightmare that that brings; people mortgage their house and their hopes, take out loans and bankrupt themselves, against the mirage of science. It is great when it works, but the agony of infertility is very real for so many people. This debate is also about those who might never have children and those who do not have children.
Back in April 2018, my young niece succumbed to a very serious illness. It was not long before her second birthday, and she would have been five today. I have not spoken about that publicly, and I do not really want to do so now, but I can tell the House that bereavement at the loss of a child is devastating, and I was not the parent. Grief works in so many ways; it is so difficult. Aside from the inherent loss of a beautiful and innocent child, it is about what is left behind. It is about birthdays, Christmases, the friends and boyfriends that never materialise, grandchildren and children, and it is also about the parents who grieve—and it lasts forever. Politically, this is actually very easy to deal with: we need to throw the kitchen sink at it. I note that the Minister is in her place. Money should be no object when it comes to this kind of thing.
My niece died just across the river in the fantastic Evelina Hospital. It is a brilliant facility, and I commend the staff who work there. What an amazing machine. It is so state of the art that it looks like a spaceship, and the people are just brilliant. I thank them and all the staff across the country doing that very difficult job. However, we must invest in more of these facilities. We have to give all our children the best possible care. It is only money, at the end of the day. There can be no greater prize than bringing a child into the world, or saving a life, or prolonging life, so let us give all our children the best possible chance.
We need to talk about this issue, as we are now, however difficult that might be. Of course, baby loss is also about losing a baby through miscarriage. These are not just embryos; they are people. They are lives. They are the embodiment of hopes and dreams for so many people. They are actually little versions of ourselves. Yes, nature can have a way of taking its own decisions, and that is fine, but miscarriage is devastating for all parents, grandparents, families and so many people who have direct involvement in it. I can only imagine the horror. My heart goes out in particular to women who have to give birth to a baby that once had a heartbeat. I cannot imagine how difficult that must be. We need to empathise and sympathise and just be there, to love and to feel for them.
For women who cannot get pregnant and who do not get pregnant, it is about the pain, the loss, the endless cycle of hope each month, and the devastation as her period starts all over again. This is tricky, tricky stuff. It is also about the sister who churns out children like rounds from a machine gun with complete impunity—with no effort at all. Perhaps even worse, it is about the sanctimonious friend or sister-in-law who can do the same. It is about the doubt and the worry. It is about the compounded misery, month on month. Again, our hearts must go out to the people who are so badly affected. It is about the hours crouched over toilets in cubicles, with negative pregnancy tests, bereft at yet again coming on. The list goes on, and it is real and it is happening today in this country to so many of us.
It is also about the agony of putting on a brave face afterwards. It is about going back into the world—going back into the office—as if nothing has happened. It is tough stuff. Then there are the tests, the invasion, the prodding, the poking and the examinations for those who want to find out why they cannot conceive—being on a slab, feeling like a total failure.
And what about men? Well, here we go. I was that man in the day, doing unnatural things in cubicles in clinics across London. I was that man carrying precious cargo on the tube in odd-shaped containers. I could deal with the alcohol bans for three months at a time, although that was difficult, but the loss of caffeine was really tough.
I commend my hon. Friend for having the courage to tell his story. I, too, have been through the experience of IVF. Does he agree that one of the worst things about going through that battle of fertility is people innocently asking, “When are you and your partner going to start a family? When are you going to have children? You don’t want to leave it too late.” A risk in all this is the lack of awareness that infertility is very common.
I thank my good friend for his intervention. He is absolutely right. You often do not want to say anything, but you feel as though you should. You ask why you have not got children, and why others are having children and you are not. There is the expectation of one’s grandparents. It is a difficult business.
On one occasion, I was eating a piece of white toast in the kitchen and this mad, deranged woman grabbed it from me and said, “Don’t.” On another occasion, I was on exercises with my regiment, with the whole unit on parade—I was there with the brigadier on a big visit—and my phone rang. It was my wife, and she said, “Come home, honey; I’m ovulating.” Those words would put the fear of God into any man. But the worst thing of all is the Brazil nuts, chopped up with breakfast—absolutely horrible things. To this day, I have post-traumatic stress disorder from that.
I commend my hon. Friend for his absolute and utter honesty. Having gone through these kinds of experiences, I know the desperation of wanting to have children and then the absolute terror, as a women and a partner, when you are going through pregnancy, about whether you are going to be able to hear a heartbeat, feel that movement and know that everything is all right. Does he agree that the best thing we can do is to talk about this issue openly—I commend my hon. Friend Cherilyn Mackrory for bringing it to the House—because that is the way we will all get through it together?
I thank my good friend from Grimsby. I could not agree more. There is not much I can really add to that; she is absolutely right. From personal experience, seeing the heartbeat on the screen is worth all the effort and I would commend everyone just to keep going because dreams do come true.
Very briefly, as time is marching on, for couples going through IVF, please have respect for what they are doing. They are mortgaging themselves. It is about the money. It is about the anxiety—endless cycles in many cases. It is also about the heavy drugs, the mood swings, the overestimation of the ovaries and the injections in the stomach. It is pretty grim. So feel. Please support and be there for your friends and family who are going through it. There is devastation when it goes wrong and it does go wrong. Spare a thought for the heartache, for the hopes, the preparations, the fears and the tests. It rests, ultimately, on a drop of urine. It is absolutely brutal.
Having debated the horrible reality of baby loss today, what can we do? I am going to rattle through this very quickly. We need to support our loved ones, as I have said. As men or partners, we need to hug, to hold, to reassure and to listen.
I thank all hon. Members for their courageous speeches. The point my hon. Friend is raising, and my hon. Friend Paul Bristow is raising, is that this does not just affect women. We are not just the ones who go through the grief, bereavement and pain. Men do too and we need to talk more about that. Both men and women suffer bereavement through baby loss.
Absolutely—I thank my hon. Friend. This is about two people. It takes two to tango. People go through this collectively as a couple, but also individually. We should recognise the fact that it is difficult for both parties, whoever they might be.
As I said earlier, we need to invest in hospitals an awful lot more: in better baby units, better midwives and consultants who read their notes. We need to make sure that we take some risks politically on this issue and spend more money. As I said, it is only money. Employers, please get a grip. If you have a woman in your employ going through IVF, please just empathise and sympathise. Give her some space.
Before I finish, I want to stick my neck out on a couple of very personal issues—please forgive me. For those who want to have children, go for it is my advice. Stay strong and keep going. My humble advice is not to leave it too late: you cannot turn the clock back and careers are, ultimately, not that important. For those considering IVF, just go for it. It does work. It is successful and it is getting better all the time. For those who might need extra support, I commend the organisation Foresight, otherwise known as the Association for the Promotion of Preconceptual Care, which is absolutely fantastic. Finally, for those for whom it does not work and suffer the loss of never conceiving, we can never do enough for you. In this place, as politicians, we will keep focusing on this very important issue. Please keep lobbying us, too. These are life and death issues that are ultimately more important than anything else.
Lastly, and most importantly of all, please do spare a thought for those poor men eating Brazil nuts for breakfast.
What an honour it is to follow my good friend, James Sunderland. I pay tribute to him for his openness and honesty today. I think we need more of that in this House. I thank my hon. Friend Cherilyn Mackrory for securing the debate and bravely sharing again her story about Lily, and for her tireless work on the all-party parliamentary group on baby loss. Sometimes we end up in these things, but it is what we make of them that counts. In her speech, and in her answers to interventions, it was clear that she really knows her stuff. So I commend her. I also thank my constituents who wrote to me last year after my contribution to the debate and this year asking me to be here today.
This is an opportunity for us to talk about our shared humanity and our shared stories right across the whole Chamber. It is something that affects us all. I have always found that being open in discussing a sensitive subject is a good thing. It encourages others to open up and talk about things. However, as I was preparing for the debate today, I knew why I do not talk about these things sometimes. There is a real physical reaction to bringing those memories back to the forefront of your mind. Your eyes prick with tears, it becomes difficult to swallow and you wonder if you are going to be able to get the words out and speak. We have seen, in contributions across the Chamber, that we are all in that position. Even as I was writing my speech today and writing notes, I could feel that physical reaction to things that happened a long, long time ago.
As I was looking up statistics, as we do in this place, I realised that I am a statistic on a piece of paper—quite an awkward thing to be sometimes. I want to focus my comments on the mental health side of baby loss. On stillbirth and mental health, Tommy’s, a great charity and resource, has stated that women who have suffered stillbirth or neonatal death are more likely to have anxiety and depression afterwards. One study in the US of 800 women showed that women who had stillbirth were twice as likely to have depression, compared with those who had live births. That effect had actually increased when they were studied again two years later, showing that stillbirth has a long-term effect on mental health. Another study of 609 women who had experienced stillbirth or neonatal death showed that women who had loss were four times more likely to have depression and seven times more likely to have post-traumatic stress disorder. In my speech last year, I talked about flashbacks. They catch you by surprise and come at the most unexpected times. Something will trigger one, bringing those physical sensations right to the forefront.
I wanted to talk a little about my story. I have schoolfriends who had to give birth to babies who no longer had a heartbeat and, on the anniversary each year, watch the photos go up on Facebook. It is wonderful that they are able to celebrate—that is probably the wrong word—to recognise that child and that their friends share that with them, even though it is very difficult to look at those photos. I had a very good schoolfriend who, like my hon. Friend the Member for Truro and Falmouth, at 20 weeks found out in a scan that the amniotic fluid was disappearing and that her baby was being crushed slowly in the womb. She had to make the decision to terminate the pregnancy because the baby would never have survived. Because she was such a good friend, I lived that with her.
Last year, I talked about the three miscarriages I had in a row. Life was wonderful and fine and we managed to have our first child. I am one of those people who is very lucky in that I am incredibly fertile—I am sure my husband wishes I was not quite so fertile—and we were able to fall pregnant very easily. I talked about the fact that we had contracted a horrible SARS-like illness back in 2003 and that, in the following year, I had three back-to-back miscarriages. I think it says something about my character that I was so driven to have another baby that I would have a miscarriage and then two weeks later in the cycle I would ovulate and fall pregnant. That happened three times in a row, so I suffered the loss of a baby and then was pregnant again two weeks later. That happened three times. When we fell pregnant with our second child—he was my rainbow baby—I had been pregnant for 18 months. I think there were a lot of missed opportunities to pick up on the fact that I was having mental health problems, both perinatal and postnatal. Towards the latter stages of my pregnancy with him, I was absolutely desperate to give birth. I almost could not cope with being pregnant any more. It was very difficult looking after a toddler as well.
After I gave birth the second time, the same thing happened to me as the first time: I had retained placenta, I haemorrhaged and I had to be returned to hospital to have blood transfusions and IV antibiotics. The first time, I had my baby with me; the second time I didn’t have my baby with me, because I couldn’t—I just had to get better, and I needed to leave him to be looked after by my mum. As many in this House know, my second baby is on the autism spectrum.
Does my hon. Friend agree that it is so important to understand the mental health issues that can surround pregnancies and can occur soon after birth? We need a better understanding of that.
I could not agree more. By the time I had got to my third baby, they realised that they needed to do more to make sure that postnatally I was in a much better position. In the debate last year, I talked about one of the babies I lost, in the second trimester; I asked for a test to be done, but the hospital did not do it. They just sent the foetus to the incinerator, and they had to apologise for it. I was left wondering for a long time what I had done wrong.
With my son, who is on the autism spectrum, I had post-natal depression and I did not take him to hospital with me. I spent years feeling guilty, because that is what happens to us as mums: we feel guilty for everything and we spend years making things up to our children. That is one of the things that I think we really need to address in looking after the mental health of mums, because it impacts not just on our children, but on their siblings, on our husbands and on family members who are not even in the same country as us.
I commend my hon. Friend for talking so openly about her experiences. We talk about statistics and about how one in four pregnancies do not end in the way that we would like, but when we talk and when we look at items in the media, there is constant pressure on women—specifically women, although there is pressure on men as well. We are expected to be superwomen, we are expected to be super-mums and we are expected to be perfect, when actually we are all fallible human beings and we all need help.
We need to make sure that we talk about it. When I told friends that I had lost babies, I was shocked that it had affected virtually everybody—I would be surprised if it is not well over 90% of people who have experienced this. We need to talk openly with each other, make sure that we look after parents as well as children, before pregnancy but also after pregnancy, and make sure that it is not something that is shameful. Quite often, women will not talk about trying for babies, because they are worried about what their employer will do or say and it is a very private thing anyway.
It is also about the time afterwards. This is probably the one taboo left that we really do not talk about, because we feel like failures. Does my hon. Friend agree that we need to continue to fight for this and make sure that people do not feel that they are a failure when things do not always go right?
I thank my hon. Friend for her intervention and for giving me a bit of time to compose myself. I agree with her.
My hon. Friend commented about our having to be superwomen and have everything together. I did not get the help that I needed because I spent so long trying to be tough. It was months and months after I had given birth to my second baby before I even went to see a doctor, but I know that the midwife who was visiting me after I had given birth was concerned because she had been with me after my first delivery as well. I think she knew that I was not quite right. That is what I mean about missed opportunities: there were lots of points where people could have picked things up and I would not have got to quite the state that I was in.
What I want to do is encourage people who are watching today. Sands is a wonderful stillbirth and neonatal death charity. Its website has such a host of information that people can use to get the support that they need.
Last year, I said to those who have suffered baby loss: please be patient with yourself and be kind to yourself. It is really hard to do—if you are driven, like I am, with the relentless desire to have a family, it is really difficult to stop. I was given very good advice to give my body and mind time to rest and recover, and I did not listen. I say to anybody out there who is listening today: please listen to my story. I hope that it will give you some insight and some food for thought.
I thank everybody who has participated today. I do hope that the Minister will take away those thoughts and comments about how we can better support women and their families with mental health.
I have very much appreciated being able to listen to this debate and hear very moving speeches from Members on both sides of the House. I pay particular tribute to my hon. Friend Cherilyn Mackrory for her leadership on the issue, and to the Chair of the Health and Social Care Committee, my right hon. Friend Jeremy Hunt, for his work. I join him in commending the work that has taken place in recent years to improve maternity services and reduce baby loss in our NHS, but I note his comparison with Sweden, the fact that we could do so much better, and the need for changes to services and to the culture of how we support babies and mothers in the NHS.
I was born in the old Westminster Hospital, which looked over the Houses of Parliament, so it could be said that my path was set. My children were born in Queen Charlotte’s Hospital, looking over Wormwood Scrubs prison; I hope that their path is not set, but my wife and I have done a lot of work in prisons. In the context of this debate, I would like to draw attention to yesterday’s report on the very tragic and scandalous events at HMP Bronzefield in 2019.
A young woman, a girl aged 18, was left alone in her prison cell to give birth. The baby died, and nobody found out until the next day that the woman had given birth. There have been a series of reports on and investigations of the tragedy; they conclude that a litany of mistakes were made, with a confusion of services and staff. There was obviously no malice anywhere along the line, but there was a lot of misunderstanding and dysfunction in the system.
I wonder—it would be good to get an indication of the Minister’s views on this—whether it is appropriate for pregnant women to be in prison at all. In recent decades, there has been a significant reduction in the incarceration of women, and indeed of pregnant women. That is very positive, but we still have women’s prisons, although their numbers are reducing. I remember going many years ago to the women and babies unit at HMP Holloway, which was actually a very impressive and wonderful place. That prison has now closed because we do not lock up so many women.
I thank my hon. Friend for highlighting the report. Does he agree that questions have to be asked about why an 18-year-old who was on remand and pregnant should be in prison?
That is the point that I am making: there is a big question about the incarceration of women and the appropriate punishment for women, but I think that it is absolutely the right question for us to consider. I know that in their sentencing, judges take into account whether women are pregnant, but I suspect that something went wrong in this case. From what I read, it sounds as if the girl was very troubled; in my uninformed view, she should not have been in prison at all for the time that she was pregnant.
Given the sophistication of modern electronic tagging, which is increasing all the time—the Government are investing significantly in it, and I commend them for that—I wonder whether consideration should be given to changing the rules around the incarceration of pregnant women.
I am delighted once again to participate in the baby loss awareness debate, which has become such an important feature of the parliamentary calendar. I pay tribute to Cherilyn Mackrory and all those who have shared their experiences today. We have come a long way since I secured my first debate on the issue of stillbirth in 2016. In those few short years, this Parliament has, in so many ways, matured into one in which stillbirth and baby loss, as in the rest of society, has gone from being barely mentioned save for in hushed tones to something that, on a yearly basis at least, has a light shined upon it—shining a light on the worst thing that can happen.
To move from the joy and anticipation of expectation to the depths of utter despair and unspeakable grief, often in no more than a few moments, has far-reaching and devastating consequences. Only last night I was speaking to a colleague about how my baby Kenneth was lost on the very day he was due to be born. This healthy 8 lb 5 oz baby died because three nurses, one midwife and two consultants did not investigate the inexplicable pain I was suffering, and no one considered that I may have had pre-eclampsia, which did not only kill my baby but almost killed me.
After seven years of fighting for an official explanation, which was never given even though lawyers were reluctantly involved, I, my husband and my wider family were left to pick up the pieces with no proper closure or explanation. When that process was ongoing, I was afraid of it coming to an end because I did not know what I was going to do after—seeking the answers was keeping me going. What was I to do at the end of this with all this pain? What about the sense of betrayal—that was how it felt—by the very people who were supposed to be looking after me and my baby after five years of fertility treatment? How could I fill the gaping hole of grief that was left?
The only answer, of course, is to keep talking and campaigning for the other women, couples and families who go through this terrible experience, so that they know that they are not alone. I remember when my baby died how people I knew would cross the street because they were so terrified of saying the wrong thing, and I do not blame them for that, because in their position I may well have done exactly the same. The kind of grief that follows an event that defies nature—burying your own child—is compounded by the isolation, and debates in this House on this issue have reached out to those who believe they are alone, giving them the encouragement that they too can share and talk about their pain.
That is why I remember how emotional it was when we finally passed the Parental Bereavement (Leave and Pay) Act 2018—a groundbreaking piece of legislation under which parents who lose a child up to the age of 18 or through stillbirth have two weeks’ paid leave enshrined in law. I remember at the time feeling like the Act did not go far enough, but I was also mindful of how carefully we all handled it; like a piece of crystal, terrified that it would break on the hard-headed reality of Treasury spending decisions. We all protected it like the precious thing it was.
The 2018 Act is hugely significant because it established an important principle. For the very first time the law recognised the magnitude of the loss of a child and provided a small bit of breathing space—a moment or two to try to find your feet again when your world has been turned upside down. The fact that the Act included stillbirth was really important too. It is because of that Act that we are now allowed to call for more to be done around loss and bereavement when a child is involved. It provided a vital starting point upon which all other work in this area will be built.
Baby loss can happen to anyone, but we know that health inequalities matter too, so we must ensure that addressing baby loss takes place in the context of an all-inclusive plan that reaches out to all women, whatever their background. For example, pre-eclampsia leads to 1,000 stillborn babies each year. Women who suffer pre-eclampsia have a fourfold risk of heart failure later in life. Studies have shown that women with pre-eclampsia are twice as likely to develop heart disease and twice as likely to have a stroke or die from a cardiovascular incident. Who is monitoring these women in the longer term? What work is being done to mitigate the risks? Where is the long-term follow-up? We need to do more because wellbeing—this year’s theme for baby loss remembrance—matters. We need to think about wellbeing not just when someone is going through the traumatic experience of baby loss, but during the aftermath in the years that follow.
Fourteen babies die every day through stillbirth—5,110 babies have died since our last debate. I express my thanks to everyone who participated in this debate today. It is always a little cathartic, and it is important for those Members who have experienced the rawness of baby loss to share their views with the House and with those listening outside the Chamber. Baby Loss Awareness Week has a particular poignancy for me because it culminates in Baby Loss Awareness Day on
In conclusion, this baby loss awareness debate is not only for all the little Kenneths out there who did not get the chance to live their lives and fulfil their potential, but for all the babies yet to be born. We must continue to campaign for them and for better maternal health and neonatal care.
There is nothing that fills me with more pride than having the honour of following all the incredible speeches that have been made from both sides of the House today. There are so many things that divide us in this place, but is it not wonderful that this is not one of them? I thank everyone who has spoken today for their courage.
This annual debate is about having voices heard, and all who have spoken today have said incredibly moving things, but I want to pay tribute to a few people. I thank Cherilyn Mackrory for moving this debate. In you, Lily lives on, and she will always continue to do so.
Patricia Gibson did Kenneth proud, and I know that
Jeremy Hunt, with his honesty, reminded us that grief is a lifelong process. The honesty in the words of my hon. Friend Alex Davies-Jones truly highlighted that the journey to parenthood can be fraught with challenges. It is often not easy to admit some of our dark thoughts about other people’s happiness or about the failures we may see in ourselves if we feel that we do not fall into the social construct that society has created for women.
I am going to answer the rhetorical question that James Sunderland posed about the validity of his being here and speaking today: yes, you should be speaking. It is important to represent everybody who has gone through the same lived experiences, and you brought them to the Floor of the House.
Turning to Angela Richardson—my goodness—the guilt surrounding parenthood is so rife, and we must be kinder to each other in society. There is nothing worse than sitting in an NCT group full of people who delivered their wonderful babies in a water bath when you went through a crash C-section and feel like a failure, crying into your cake as you wonder what is wrong with your body that meant that you could not give birth in a bath with some whale music. What you highlighted today shows us the importance of understanding that the journey through the birth process does not end once you have given birth. We have to look after each other and keep an eye on people’s mental health.
It is so important that we talk about stigma. I know about this from my work as a doctor in the emergency department over the last 16 years. I have seen countless parents come into that department. I have seen a mother, bleeding, pleading with me to tell her whether she is losing her baby, and I have known the heartbreak of performing the examination and either confirming her very worst fears or sometimes, even worse, saying, “I do not know—and I am really sorry, but it is Friday afternoon and you will have to wait for your scan on Monday morning to find out.” I see mothers who ask, “Did I eat the wrong cheese? Did I exercise too much? Should I have given up work and just stayed at home? Have I done this, doctor, have I done this?” No, you have not.
I say to every mother who is watching the debate today and asking herself if she has done something wrong, “You have not done anything wrong. Your baby was loved; your baby was wanted; you did everything right.” It is so important that we support mothers on this journey—mothers who are living with the guilt, living with the stigma, wondering if people are thinking to themselves, “Well, she clearly did not read the rules properly. We seem to have managed just fine.” To every mother who worries about that, I say, “You are not alone.” I thank all the charities that are out there doing such incredible work to eradicate the stigma, but there is still so much more to do.
To all the partners—supportive partners—who are told not to share their emotions, and told that their emotions are not as valid because they were not carrying the child, I say, “That is rubbish.” They are told not to acknowledge their grief, and are encouraged just to go back to work. It is a case of “Stiff upper lip—these things happen.” I say to them, “You are entitled to grieve. You are entitled to feel every single emotion that is due to you, because these are your emotions and that is your right.” Everyone does it differently: there is no one-size-fits-all model. We have to understand, and our health services have to be built to have a capacity that understands the nature of grief and understands that it is different for everyone. However, when we are doing this together here today, we are already going some way towards breaking down that stigma, and we are breaking it down every year when we have this debate.
It has been an incredibly difficult 18 months, and people’s experiences of baby loss during this time have been incredibly heartbreaking. During the pandemic there has been reduced access to face-to-face appointments, and when appointments have taken place in person, partners have been excluded, leaving women to receive the very worst of news on their own. Expectant fathers pace the car park, wondering when they will be allowed in to hear that very worst of news. Women are often forced to take decisions alone. I want to thank the NHS staff who have worked tirelessly throughout the pandemic, and have had to go above and beyond when visitors were not allowed into hospitals following a loss. However, I also want to highlight the important fact that there are babies that are lost when the loss could have been avoided. In the House we discuss many cases in which loss cannot be avoided, but this is not one of them.
That leads me on to the importance of inequalities in this debate. It is the saddest fact of all that where a family live and how socioeconomically well off they are can determine the likelihood of their baby’s surviving or not. Black and ethnic minority women are more likely to deliver by emergency caesarean section and less likely to have pain relief during labour, and receive fewer home visits from midwives. Stillbirth rates for black babies, including black British babies, were over twice those for white babies, while neonatal death rates were 45% higher. Black women are still four times more likely than white women to die in pregnancy or childbirth in the UK. With an ongoing inquiry into systemic racism in NHS maternity services, we must ensure that action is taken to eradicate these gross disparities. We need change now: women cannot and should not wait any longer. It is not acceptable, and these families deserve better. Many of us will have heard stories of women who were told that they needed an extra scan between the 20-week scan and giving birth, but professionals were concerned that because they were Muslim they might want to sex-select, and they were therefore denied the scan. That is atrocious. Preventable deaths have occurred because of such practices, and they must be eradicated.
Research published last week found persistent inequalities for ethnic minority women accessing mental health care after giving birth. It found that 98% of women were willing to be treated for their mental health, but one third had not received any treatment. including talking therapies such as cognitive behavioural therapy or counselling. About one third of the women surveyed felt that
“receiving treatment for emotional or mental problems carries social stigma.”
We have to understand, in our multicultural society, that everyone deals differently with mental health matters, particularly in relation to having children. We must have services that are able to handle the differences in our communities.
The major treatment stigma-related barriers to accessing services were found to be women’s concerns that they might be seen as “a bad parent”; not wanting mental health problems to be on medical records; concern that their children might be taken into care; and concern that they might be seen as “weak”. Those are the voices that we need to recognise today. We are in a place of privilege. We can stand here and talk about our experiences, people can learn from them, and we can feel that we are doing our bit to deal with our grief, but what about all those thousands of women’s voices across the country that are not heard? Today we are speaking for all of them as well.
Post-natal depression or anxiety in black, Asian and ethnic minority mothers is 13% higher than in white mothers. A 2011 study found that black women are the group least likely to initiate treatment for post-natal mental illness, and the least likely to receive follow-up treatment. We must do better, we can do better, and I truly believe that there is a collective will across the House to do better.
Let me ask a few questions of the Minister, whom I welcome to her place. Will bereavement support after the loss of a baby be standardised to avoid the postcode lottery that too many families experience? No one should have to lose three babies to receive miscarriage support; what are the Government doing to ensure that people have the support they need when they need it, not after miscarriages? Has data begun to be collected on miscarriage, stillbirth and pre-term rates, and if not, will the Government commit themselves to that? What is the current progress on the women’s health strategy, and who from the Government will be taking this forward following the reshuffle?
By talking about these issues so openly and honestly, we work to remove the stigma surrounding them. The pandemic has undoubtedly brought additional barriers that make the experience of losing a baby even more isolating, but it is stigma and the lack of understanding that can make people feel most alone. I will finish, as Nickie Aiken did, by saying to anyone watching today: you are not alone.
I thank all Members of the House who have taken part in the debate this afternoon. The shadow Minister, 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 Cherilyn Mackrory, who spoke extremely bravely about her experience of losing baby Lily; and my right hon. Friend 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 Alex Davies-Jones, my hon. Friend James Sunderland and 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 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 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.
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.
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.
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.
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?
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 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.
I thank all right hon. and hon. Members who have spoken today for the support that we have given to one other and for the timely interventions. I will not go through all the speeches because I have only a short time to sum up, but I would like to extend my gratitude to my hon. Friend Nickie Aiken and accept her invitation to meet the team at St Mary’s Hospital in Paddington. I give special thanks to my right hon. Friend Jeremy Hunt for his candid testimony, which is both personal and full of bags of experience. I could not be more grateful for being able to co-chair the all-party group with him. With our new Minister on the Front Bench, this all-party group can continue to do great things and I very much hope we will be able to do so.
I also pay tribute to Patricia Gibson, who religiously attends the all-party group and carries baby Kenneth in her heart. She spoke powerfully about the isolation of grief, and I can completely relate to that. I hope that events such as today’s debate bust that stigma and that people start talking to each other. Year after year, this is the toughest debate in Parliament to participate in, but it is oh so very important.
Pregnancy and baby loss has often been seen as a women’s issue, and it is a very powerful women’s issue—we have heard about the mental health side of things and we need to not let women down on that. More than that, however, it is a family issue and a community issue. We need to be looking out for each other and to make sure that families are looking out for each other, and that we all talk about these things. You name the children, you talk about that baby; it is not something that should be shied away from because we do not know what to say. Anything we say will be the right thing to say simply because we are talking about it.
I conclude by thanking all colleagues once again for their powerful testimony, and I look forward to continuing the very important work of the all-party group.
This has been a very moving and, indeed, important debate not just because of the subject matter itself but because it reflects the progress that we have made as a modern legislature, in that the matters we now deal with in this House, on the Floor of this Chamber, truly reflect the concerns and experiences of all the people we represent.
I hardly need to put the Question, but I am obliged to do so.
Question put and agreed to.
That this House
has considered Baby Loss Awareness Week.