Baby Loss Awareness Week

Debate between Angela Crawley and Cherilyn Mackrory

Thursday 23rd September 2021 Commons Chamber

[Cherilyn Mackrory]

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.

[Angela Crawley (Lanark and Hamilton East) (SNP)]

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?

[Cherilyn Mackrory]

The hon. Member and I have spoken about this issue. Since that conversation, I have taken her Bill to the Employment Minister, so I hope that we will hear more about it later in the year.

Despite our making good progress, more needs to be done if the Government’s ambition to halve baby deaths by 2025 is to be met. If the current trajectory of reducing stillbirths is maintained, England may be off meeting that 2025 ambition. The Health and Social Care Committee report noted:

“The improvements in rates of stillbirths and neonatal deaths are good but are not shared equally among all women and babies. Babies from minority ethnic or socioeconomically deprived backgrounds continue to be at significantly greater risk of perinatal death than their white or less deprived peers.”

Babies should not be at higher risk simply because of their parents’ postcode, ethnicity or income. I will let my APPG co-chair and Chair of the Select Committee speak to the findings of the report. However, it appears that health inequalities in maternity outcomes have been known about for more than 70 years, yet there are still no evidence-based interventions taking place to reduce the risks.

Continuity of carer could significantly improve outcomes for women from ethnic minorities and those living in deprived areas. Way back in 2010, the Marmot review proposed a strategy to address the social determinants of health through six policy objectives, with the highest priority objective being to give every child the best start in life. Marmot noted that in utero environments affect adult health. Maternal health—including stress, diet, drug and alcohol abuse, and tobacco use during pregnancy—has a significant influence on foetal and early brain development. Midwives have a key role in promoting public health. Individual needs and concerns can be better addressed when midwives know the woman and her family, and continuity of carer is a key enabler of that. This public health work is of most benefit to vulnerable and at-risk families, who may require more time and tailored resources. Additional work is required to address the needs of these groups, because they are simply more at risk.

As well as improving clinical outcomes for mothers and babies, continuity of carer models can also result in cost savings compared with traditional models of care, because there are fewer premature babies, so fewer neonatal cot days are required; the incremental cost per pre-term child surviving to 18 years compared with a term survivor is estimated at nearly £23,000, and most of the additional costs are likely to occur in the early years of a child’s life; there are fewer obstetric interventions, with women 10% less likely to have an instrumental birth; and there are fewer epidurals and so on.