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Updated maternity strategy to reduce the number of stillbirths

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Independent investigation is to be offered to families who suffer stillbirth or life-changing injuries to their babies, along with other measures to cut stillbirths, the Department of Health has announced.

The government has today announced a “refreshed” maternity strategy to reduce the number of stillbirths, as part of its ambitions to make the “NHS the safest place in the world to give birth”.

“One thing that can help is getting honest answers quickly from an independent investigator”

Jeremy Hunt

Under the plans, the DH said that families who experienced a stillbirth or life-changing injuries to their babies would be offered an independent investigation to find out what went wrong and why.

The department will take local control for investigating avoidable mother and baby deaths away from health service trusts and give it to the new Healthcare Safety Investigation Branch.

The new safety investigator, which was set up earlier this year, will standardise investigations of cases, with the aim of speeding up learning from what went wrong and sharing it across the NHS.

The government’s update will see the body take over local investigations into around 1,200 annual avoidable deaths in April, as well as cases where babies were born with significant brain injuries.

In a speech on maternity safety, health secretary Jeremy Hunt also revealed plans to potentially change the law to allow coroners to investigate full term stillbirths.

“This revised strategy will give everyone involved in maternity care the opportunity to reflect”

Gill Walton

Mr Hunt also said he was bringing forward from 2030 to 2025 an ambition to halve rates of stillbirths, neonatal and maternal deaths, and brain injuries occurring during or soon after birth.

In addition, the updated strategy – titled Safer maternity care: progress and next steps – sets out an aim to reduce the national rate of pre-term births from 8% to 6%.

Mr Hunt’s announcement looks to fulfil a recommendation from the Morecambe Bay inquiry, which called for “clear standards” for investigating maternity incidents including independent scrutiny.

It also coincides with the publication of latest findings from an MBRRACE-UK review of the quality of care for stillbirths and neonatal deaths of babies born at term who were alive at the onset of labour.

This type of death occurred in 225 pregnancies in the UK in 2015 and means the mortality rate has more than halved in the UK from 0.62 to 0.28 per 1,000 total births since 1993.

However, despite the fall in mortality, the researchers highlighted that better care may have resulted in a different outcome for the baby in 80% of a subset of 78 cases that it focused from 2015.

A key finding was that staffing and capacity problems were implicated in at least a quarter of the deaths and potentially 35.9% of them.

Jeremy hunt new website

Jeremy hunt new website

Jeremy Hunt

Announcing the new strategy today, Mr Hunt said: “The tragic death or life-changing injury of a baby is something no parent should have to bear, but one thing that can help in these agonising circumstances is getting honest answers quickly from an independent investigator.

“Too many families have been denied this in the past, adding unnecessarily to the pain of their loss,” he said.

“Countless mothers and fathers who have suffered like this say that the most important outcome for them is making sure lessons are learnt so that no-one else has to endure the same heartbreak,” he said. “These important changes will help us to make ‎that promise in the future.”

In a joint statement, the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives said they welcomed the refreshed strategy and the targets and commitments it contained.

Gill Walton, chief executive and general secretary at the RCM, said: “Midwives are in a unique position to help achieve this, as they are the one healthcare professional whom all women will see during their pregnancy and birth, and therefore have a clear role in ensuring care is coordinated, safe and, most importantly, personal.

“Much has been done already through an array of initiatives to improve the safety of maternity care, and this revised strategy will give everyone involved in maternity care the opportunity to reflect on past successes and focus on key areas where more still needs to be done,” she said.

Royal College of Obstetricians and Gynaecologists

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Lesley Regan

Professor Lesley Regan, president of the RCOG, especially welcomed that the government had agreed to expand the college’s Each Baby Counts programme.

It had been “hugely successful” in securing the trust of both the midwifery and obstetric communities, with 100% of trusts involved in providing maternity services engaging in this important work,” said Professor Regan.

“The RCOG in partnership with the RCM believes that we can build on this buy-in from frontline clinical staff by providing them with the support they need to translate lessons learned into improvements in everyday care,” she said.

She added: “We are committed to sharing the expertise we have gained from Each Baby Counts, and our understanding of the complex interplay of factors that lead to stillbirths, neonatal deaths and brain damage during term labour.”

The college would also work with partners, such as NHS Improvement and the Healthcare Safety Investigation Branch, as they undertake their future investigations, she said.

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