A research report published today by the National Child Mortality Database (NCMD) shows that better support and care for women during pregnancy and birth could save babies' lives and children who die at older ages.
The research, by a team at the University of Bristol, found that the deaths of one in three children who died under the age of 18 were due to health problems during pregnancy, labour or soon after birth. The biggest impact for three quarters of these babies and children were complications due to prematurity.
The Contribution of Newborn Health to Child Mortality across England report shows that that one in three of these deaths could have been avoided with improvements to care for women and their babies. This means that with better more targeted care, 575 lives could have been saved over the two-year focus of the research (1 April 2019 to 31 March 2020).
What this means for saving babies’ lives
Sands is now calling on the Government to make prevention of pre-term birth a priority, and for the Department of Health & Social Care and the National Institute for Health and Care Research to prioritise research in the area.
"This vital report highlights for the first time, the significant impact care and support in pregnancy and as well care during birth have, not just on the survival rates of babies, but of older children as well.
"Around 40 per cent of all deaths of children under 18 happen in the first 28 days of life. So understanding what happens during pregnancy, birth, and in the early days of life, and how to save babies' lives, can make a difference in reducing the overall numbers of children who die before they reach adulthood."
- Charlotte Bevan, Joint Head of Saving Babies' Lives team, Sands.
The law in England states that all child deaths must be reviewed to understand why the child died and whether that death might have been avoided with better care.
These reviews are done in the part of the country where the child died. The National Child Mortality Database then collects all child death review information from across England to understand what can be done to save children's lives and makes national recommendations for improving care.
A third of the deaths covered by the report happened on a labour ward and one in ten deaths were caused by babies lacking oxygen during labour and birth.
These deaths might have been prevented with better monitoring of babies during labour and escalation of care when things went wrong.
A mother's story
Gemma Price shared her heart-breaking experience of losing her son Barney, due to failures in care, in the report.
Gemma's baby was due in March 2020. It was her first pregnancy, and everything was completely fine right up until about 36 weeks, when she developed a liver condition called obstetric cholestasis, which carries a small chance of stillbirth in late pregnancy.
Barney was born alive but died later that same day.
"Afterwards we met with the bereavement midwives and the consultant, and they tried to explain what had happened. We were able to spend three days in the Sands Butterfly Bereavement Suite at the hospital with Barney, which while difficult also helped us so much. His grandparents were able to come and visit and hold him and the Sands photographer took some pictures of him which we really treasure.
"The post mortem didn’t find anything wrong other than the abruption, which meant that he hadn’t been able to get enough oxygen, otherwise he would have been a perfectly healthy baby boy.
"It was explained to us there would be an independent report from Healthcare Safety Investigation Branch, as well as the hospital report, because of the nature of what had happened. The report was obviously really hard because it threw up a lot of things that we didn’t know at first: being left unmonitored on the antenatal ward and the mistakes during resuscitation meant that the outcome for Barney could have been different if things had been handled differently, so it was a bit of a shock.
"We’d assumed everyone had done their best and they had, but there were still failings in care which we weren’t aware of."
- Gemma Price, Barney's mum.
You can read Gemma's full story, which includes a photo of Barney, on the Your Stories page of our website.
Sands working to save babies' lives
Saving babies’ lives is an absolute priority for Sands, and we know that listening to parents and families is crucial so that this evidence leads to learning that drives changes in practice.
Sands is involved in the development the Saving Babies’ Lives Care Bundle, a package of care that focuses on improving care to prevent deaths, currently in its second iteration.
The bundle includes a focus on preventing prematurity, the importance of women being referred for support to stop smoking in pregnancy, and adequate monitoring in labour by trained professionals, to prevent brain injury, as key actions that might save lives if effectively delivered.
We urge units to deliver the care bundle as this will impact not just the lives of babies but children as well.
Here for anyone who needs support
We understand that the findings in today’s report may be distressing for anyone affected by the death of a baby or child, however recently or longer ago.
Sands is here to support anyone who needs us.
The charity Bliss is here for anyone whose baby was born premature or sick, whatever you’re going through. Find out more at support.bliss.org.uk