Sands response to publication of MBRRACE-UK perinatal mortality report on deaths in 2013

A national report published today shows that economic inequalities continue to be strongly linked to an increased risk of a baby dying before, during or shortly after birth. It also reveals wide variations in the rates of baby deaths at trusts and health boards across the UK. 

The overall rate of baby deaths – 7.3 per 1,000 births in 2013 – has declined since 2003. Nevertheless, every day in the UK in 2013, 15 babies died before or during delivery (a stillbirth) or within 28 days of being born (a neonatal death). The UK rate remains high compared with other European countries. If the UK could reduce its rate to that of Sweden or Norway, 1,000 more babies would survive every year.

The report found that 1 in 12 deaths occurred as a result of complications in labour; many of these are deaths that could be prevented with improvements to the quality of care. It also found that one in three deaths occurred at term (37 weeks gestation) or beyond, when a baby would have a good chance of survival if delivered in time.

Glaring inequalities underlie the national statistics.  Poorer mothers have a 57% greater risk than those from wealthier backgrounds. Black or black British, Asian or Asian British mothers have a 50% increased risk.

There are other risks associated with the mother’s health: one in five mothers whose baby was stillborn smoked during pregnancy and one in five were obese. 

Nevertheless, the majority of stillbirths occur unexpectedly in what are thought to be straightforward pregnancies, where no risk was identified.

The report’s findings suggest that quality of care for women and families remains a postcode lottery. Only in Barnet and Dorset are mortality rates substantially better than the UK average.

The report urges trusts and health boards to use local review to understand each death and whether it might have been prevented with better care. Sands has called for standardised perinatal mortality review since its 2012 report Preventing Babies Deaths: what needs to be done.

Sands welcomes the report’s key recommendation that the findings act as ‘the starting point of a national dialogue about the mortality rates we aspire to achieve.’  

Janet Scott, Research and Prevention Manager at Sands said:

“Over 5,700 families were devastated by the death of their baby at or around the time of birth in 2013; this number is unacceptably high. And while there may not be a single solution to saving lives, the lesson from other countries is that it can be done.

“Care across the country should be the same for every mother and baby, regardless of where they live and who they are.

“Not all clinicians properly review the care families receive to understand whether a death might have been prevented. The recent Morecambe Bay report illustrated this all too painfully. Lessons weren’t learnt and mothers and babies continued to be put at risk. We urge the government to move forward to establish a standardised review process for all deaths as a priority. Much of the work for this has already been achieved, so the door is open for full scale implementation.

“It’s no longer acceptable to assume every baby’s death is a sad but unavoidable tragedy. With collaborative work between the government, the NHS and parents themselves, we can save babies’ lives. This report is part of that vital effort.”

MBRRACE-UK will publish findings from its confidential enquiry into term stillbirths in November this year. This in-depth analysis will give invaluable insight into how quality of care impacts on deaths in late pregnancy.

The full report will be available to download from the MBRRACE-UK website.