Still-Birth (Definition) Bill [HL]

Baroness Bottomley of Nettlestone Excerpts

Friday 4th July 2025 Lords Chamber

[Baroness Bottomley of Nettlestone (Con)]

My Lords, I also speak in the gap, and I apologise for not having been able to put my name down earlier.

I most warmly congratulate my friend—we have worked together for about 30 years—the noble Baroness, Lady Benjamin, on her powerful, evocative and sensitive presentation of her Bill. I quickly declare my interest as a mother of a consultant gynaecologist, so I am all too aware that a gynaecologist is constantly dealing with the most difficult situations of women having babies they really cannot bring up. Therefore, they look for a termination. Other women are in the most acute heartbreak because they are desperate to have a baby that they do not seem able to produce. So I was struck by the right reverend Prelate’s—he is my Bishop—earlier experience south London, where I also used to work. This is extraordinarily difficult.

I was also the Secretary of State who handled the Human Fertilisation and Embryology Act. This was such complex and emotional legislation in 1990. It marked the time limit of 24 weeks at the time for the Abortion Act and when it was thought by consensus that a foetus was viable. I am extremely concerned about opening up that debate again. While I certainly support a Second Reading, I feel that in Committee there needs to be careful scrutiny about how the Bill would lie alongside our present arrangements concerning termination.

That was a very important Act. It opened the door to the extraordinary number of IVF babies. They are now saying: every classroom has an IVF baby. Some one in 31 babies is now IVF, which is remarkable. Those babies are desperately wanted, so those involved in a stillbirth have all the greater agony.

I was also involved with the Rosie Barnes Bill, which became the Still-Birth (Definition) Act, although a junior Minister handled it, where Lord Kilmarnock spoke very powerfully in this House.

My particular debt is to a former colleague of this House, Baroness Cumberlege, who did so much on maternal health, infant well-being and infant viability. She was a supporter of midwives and nurses, and her lasting impact on the improvement of services is absolutely one I recognise.

To look at this debate, we have to look at the context. As women we are very aware that generations ago, we would have lost any number of children in childbirth. We would have lost our own lives in childbirth; so many would have experienced the loss of a child. Now the situation is very different. A hundred years ago, for every 10,000 births, there were 800 deaths: now, for every 10,000 births, only 40 deaths. So, the loss of an infant by stillbirth is ever more unusual and all the more painful.

The other thing we see is the changing age at which women are having babies. Whereas many women used to have their babies in their late teens and 20s, now 31% are over 40 when having their children. Therefore, a lot of complications and comorbidities, like diabetes, are more likely to be present. I am certainly one of those who says to young women: get on with it while you can, while you are young and healthy. But many do not have that opportunity. Something like 11% of IVF births are for people between 40 and 45—a remarkable achievement.

I applaud the noble Baroness. I applaud the efforts that have gone in by others, such as, in the last Government, Tim Loughton, the MP for East Worthing and Shoreham— next door to my husband. I want to ask the Minister what she is going to do about implementing the criteria for coroners to become involved. This is really important. This was Part 2 of the Bill.

I must finish quickly—I did not know the rules—by saying I support the Bill, but it needs careful scrutiny before it becomes legislation.

--- Later in debate ---

[Captain of the King’s Bodyguard of the Yeomen of the Guard and Deputy Chief Whip (Baroness Wheeler) (Lab)]

My Lords, I thank the noble Baroness, Lady Benjamin, for introducing the Bill, and I know the importance this House places on ensuring that bereaved parents, regardless of the baby’s gestation, get the support and care they need.

I pay tribute to the noble Baroness for the huge amount she has done in the service of a very personal cause. She has raised awareness of pregnancy loss and campaigned for baby loss certificates, helping women and families to receive better support. I know what strength and courage is needed to speak about issues so near to one’s heart, and I thank all today’s speakers for their contributions about their own and friends’ experiences of treatment and care.

I also congratulate my honourable friend in the other place, Sarah Owen, and the Women and Equalities Committee, for highlighting the gap in current support for those who experience a pregnancy loss before 24 weeks. Bereaved people need time to recover and grieve, and it is important that they are supported at work as they do so.

We also recognise, as was underlined by the noble Baroness, Lady Benjamin, the vital role played by the many charities supporting families who have experienced loss—including Sands, the Miscarriage Association, Birthrights, Mariposa International, Tommy’s and Bliss—in raising awareness and campaigning for the additional care and support that is needed.

Overall, good and steady progress is being made to address the treatment, care and support for women and their families experiencing the trauma of pregnancy loss. I thank noble Lords for recognising this, as well as for highlighting the considerable amount of work that is in progress and still needs to be done. For example, the importance of bereavement leave has been stressed by a number of speakers. This Government have made it clear that we fully accept the principle of bereavement leave for those who have experienced pregnancy loss, in supporting women and families during such a distressing time. Under our flagship Employment Rights Bill, currently in this House, parliamentarians from both sides have spoken strongly on these issues. We look forward to further discussions on the matter as the Bill moves into its later stages. The noble Baroness, Lady Benjamin, again acknowledged this movement forward.

However, I must address the Government’s reservations about this Bill in relation to the proposed definition of stillbirth. The current definition is based on the gestation at which a foetus is considered viable—24 weeks. Sadly, babies born at 20 weeks do not survive: in 2022, 98% of the 305 babies born alive before 22 weeks in England and Wales died in their first week; and in 2020-21, only 5% of babies born at 22 weeks survived.

Changing the definition of stillbirth to 20 weeks would, therefore, remove the link to foetal survival, moving us away from a clinically evidenced position. There is no medical consensus that the age of foetal viability is reduced below 24 weeks. Therefore, this proposal would create an inconsistency with the Abortion Act 1967.

I understand the sentiments and force of the arguments and principles put forward by noble Lords, but I am afraid we cannot support the definition in the Bill. However, as I have stressed, I very much welcome the focus of the debate on the other important ways to support women who experience miscarriage, which is what baby loss before 20 weeks is treated as. In this context, I thank the noble Baroness, Lady Benjamin, for highlighting that changing the definition would also allow bereaved parents access to support such as maternity pay and leave.

The care that families receive after the death of their baby can have long-lasting effects. We cannot remove the pain, but we know that poor care can make things worse. Loss matters, as the noble Baroness, Lady Featherstone, emphasised. That is why the baby loss certificate is so important and why the Government extended eligibility for the scheme, allowing parents to officially recognise their loss, regardless of how long ago it occurred. The feedback has been incredibly positive and part of the healing process for many women experiencing loss, as noble Baronesses have said, with over 100,000 certificates issued to date, as a lasting memory of their babies. We are also improving bereavement services and making them available seven days a week. We will look closely at the outcomes of Tommy’s graded model of care for miscarriages pilot, which is due to report later this year.

Noble Baronesses have particularly referred to the trauma of pregnancy loss leading to or worsening mental health issues, which is why we have introduced maternal mental health services in all parts of England to provide care for women with mental health difficulties arising from baby loss. As I have stressed, we accept that there is much more to do to improve care for women and families who have experienced loss.

I now turn to address some of the points raised. I will endeavour to answer these, but I hope that the noble Baronesses will forgive me if I have to write to them. First, the noble Baroness, Lady Benjamin, said that, if her Bill were implemented, those having terminations between 20 and 24 weeks would be exempted from registering them as stillbirths. But changing the definition is likely to have other unintended consequences for abortion services and wider impacts; for example, around the disposal of the foetal remains and other issues. The noble Baroness, Lady Finn, pointed to a number of the potential consequences that would occur.

The noble Baroness, Lady Benjamin, and other noble Baronesses mentioned that there is a variation among other nations. We recognise that there is such variation in the definition of a stillbirth and that the UK’s position is not aligned with the World Health Organization. Countries may take a different approach to defining terms such as “stillbirth” and “miscarriage”. Reasons for variation include legal and administrative difficulties and approaches to collecting data.

The noble Baroness, Lady Barker, raised support for LGBTQ people. We recognise the complexities of baby loss for people from LGBT and other communities. Personalised care and support plans should be offered to all those accessing maternity services to ensure that care is tailored.

The noble Baroness raised the concerns about the mandatory nature of declarations of abortions and the impact on the most vulnerable individuals, and I certainly understand that concern. She raised an important point about the recording of stillbirths, and I recognise the impact that this can have on the most vulnerable and on their decisions to have an abortion. We very much have regard to this.

In closing, I thank the noble Baronesses—

[Baroness Bottomley of Nettlestone (Con)]

I would be particularly grateful if the noble Baroness could come back to me on Part 2 of the 2019 Act, which authorises coroners to become involved in stillbirths.

[Baroness Wheeler (Lab)]

I will certainly write to the noble Baroness on that.

I thank the noble Baroness for bringing the Bill, and all who participated in this important and moving debate. We must continue to deliver services that acknowledge and support the heartbreak of losing a baby. The Government will work with the noble Baroness and others, endeavouring to support this and to consider how to offer families the care and support they need in all areas of their lives.