Seven out of 10 stillbirths, neonatal deaths and babies brain damaged at birth could be avoided if the NHS provided better care during labour, a new government-funded report has found.
The inquiry identified lack of staff, the pressure on maternity units and a failure by midwives and obstetricians to follow guidelines as common factors in such events.
They are three of the main reasons why more than 1,100 of the 700,000 babies born every year in the UK either die during or soon after birth or suffer serious injuries to their brain, it found.
The conclusions, from the Each Baby Counts project, are intended to improve maternity care and reduce potentially avoidable deaths and serious harm to babies during birth and in their first seven days.
Its second report into such incidents found that, while such events were “rare”, of those that occurred in 2016, 71% might have been avoided if the mother had received higher quality of care while giving birth.
“Sadly, this latest report from Each Baby Counts shows that different care might have made a difference to the outcome for almost three-quarters of affected babies,” said Edward Morris, the co-investigator of the initiative and vice-president of the Royal College of Obstetricians and Gynaecologists (RCOG).
He said a lot more work was needed to enable midwives and doctors who deliver babies to give women in labour the safe care that national guidelines state all should have, and so prevent further “tragedies” occurring.
The inquiry, led by the RCOG, looked at the results of local investigations into many of the 1,123 babies who were stillborn, or died during labour or within their first week of life, or suffered brain damage during 2016. Of those, 124 (11%) were stillborn, 145 newborns died and the other 854 were brain-damaged, often as a result of being deprived of oxygen.
“The stillbirth, death of a newborn baby or the birth of a baby with brain injuries are life-changing events that profoundly affect women and their families,” said Prof Lesley Regan, the RCOG’s president and a leading expert in the NHS on miscarriage.
The workload faced by staff, the time they have to care for women in labour and the capacity of maternity units could all add to the risk of any of these events occurring, the inquiry found.
In 45% of cases, staff had not followed guidelines and best practice because, for example, they lacked training, did not recognise the problem or were overworked.
In each of the cases examined, an average of seven different things had gone wrong or not been adequate, the investigating team found.
Jackie Doyle-Price, the minister for maternity care, said that NHS care for mothers in labour needed to improve. “Whilst this report acknowledges that important progress has been made, there is still more to do to ensure every mother and child receives the world-class care they deserve as part of our ambition to halve the rates of stillbirth, neonatal deaths and brain injuries caused during and after birth by 2025,” she said.
Doyle-Price said ministers were supporting staff to make maternity care better and to increase training for midwives.
Elizabeth Duff, the senior policy adviser at the parenting charity the National Childbirth Trust, said its research had found that half of all women who gave birth experienced at least one “red flag” lapse in safety during the process.
“These are indicators of dangerously low staffing levels, such as women not receiving one-to-one care during labour or there being an undue delay in a time-critical activity,” she said. “Maternity providers and policy makers need to take immediate action to improve the quality of care so that all preventable deaths and injuries are avoided.”
An NHS England spokesperson, said: “Stillbirths fell by 20% after NHS England introduced new guidance and nine in 10 maternity services report they are now adopting best practice. We now want to build on the progress we’ve made to make maternity services in England among the safest in the world.”
