Maternity care debate flags concerns over rising stillbirth rates - what's being done to improve patient safety

Since the inception of the All-Party Parliamentary Group on Baby Loss in 2016, an annual debate has taken place at Westminster Hall to mark Baby Loss Awareness Week.

This year’s debate also encompassed the topical subject of safe staffing in maternity care. This was further to the publishing of a joint report by the All-Party Parliamentary Group on Baby Loss and Maternity urging government action to address the maternity staffing crisis. There's currently a shortfall of 2,000 midwives and 500 consultant gynaecologists and obstetricians.

The Government’s maternity safety ambition is to halve the 2010 rates of stillbirth, neonatal and maternal death, and brain injuries in babies occurring during or soon after birth. Sadly, the Office for National Statistics (ONS) has confirmed that rates of stillbirth in England and Wales increased in 2021. As such, this debate is as important now as ever.

The debate was secured and opened by Jill Mortimer, MP for Hartlepool, who powerfully shared her own experience of suffering baby loss. Many MPs contributed to the discussion and submitted their questions to Dr Caroline Johnson, former Parliamentary Under Secretary of State at the Department of Health and Social Care.

Maternity staffing 

During the debate, it was referenced that a recent survey conducted in 2021 by the Royal College of Midwives (RCM) warned of an “exodus” of midwives from the NHS. The same survey found that eight out of 10 midwives were concerned about staffing levels and two-thirds were unsatisfied with the quality of care that they can deliver.

Over half of midwives surveyed said they were considering leaving their jobs and 57% said they would leave the NHS in the next year. Notably, the highest dissatisfaction was among midwives who had spent five years or less working in the NHS.

More recently, the RCM has urged its members to vote in favour of industrial action raising concerns not just about pay but also about the standard of care staff can deliver.

Other key issues discussed

The debate also covered a number of areas, including:  

• Keeping open and reopening temporarily closed local maternity units.
  
• Incidents of negligence.
  
• The need for more trained bereavement specialist midwives and the roll-out of bereavement suites.
  
• Racial biases in maternity care.
  
• The impact of bereavement on fathers.
  
• Disparities in care based on location.
  
• Use of technology to ensure “consistency of diagnosis and safety in pregnancy”, such as the Tommy’s app.
  
• Access to testing following miscarriage.
  
• Lack of recording of national miscarriage figures.
  
• Coroners’ powers to investigate stillbirths.
  
• Recognising stillbirths that take place before 24 weeks.
  
• Long-term health risks of pre-eclampsia.
  
• Leave from employment following pregnancy loss.

Concluding Remarks 

While Dr Johnson addressed some of the issues raised above directly, she concluded the debate with three broad points:

Firstly, she stated that the Government appreciates “how difficult and distressing baby loss can be at any point in pregnancy and childbirth” and highlighted “the importance of sharing experiences and coping mechanisms that may guide other families through their own bereavement." She acknowledged the importance of continuing “this conversation past this year’s campaign”.

Secondly, she noted how she had “touched on the important range of targeted programmes” being developed “to better support families with their bereavement and ensure all families have access to the care they need and deserve”. The targeted programmes include “pregnancy loss certificates and the national bereavement care pathway”.

She expressed that “families deserve compassionate and personalised care from their local health professionals”. 

Lastly, Dr Johnson reiterated the Government’s ambition “to halve the 2010 rates of stillbirth, neonatal and maternal death, and brain injuries in babies occurring during or soon after birth”.

In doing so, she confirmed that “NHS England will consider the actions from both the Ockenden report and the East Kent report and map a coherent delivery plan for maternity that will be delivered through the maternity taskforce programme”. 

She also explained that a joint working group led by the RCM and the Royal College of Obstetricians and Gynaecologists has been established “to help deliver the plan as effectively as possible”. 

My conclusion

Sadly through our work we often see first-hand the devastating impact of maternity failings and how families are left requiring support to overcome their loss or access to life-long therapies and rehabilitation following a birth injury. Therefore I can only hope that moving forward prompt government action is taken to improve maternity care. To achieve this aim safe, sustainable, and productive staffing of services must be ensured.

Find out more about Irwin Mitchell's expertise in supporting families affected by issues in maternity care at our dedicated birth injuries section.