New Sands and Tommy’s report: ‘Government inaction is costing babies’ lives’

'Saving Babies’ Lives 2023: A report on progress' pulls together data from different sources for the first time, to show the burden of pregnancy and baby loss across the UK. 

Overall, the report paints a concerning picture: progress in reducing baby loss has slowed and there is a risk of going backwards.  

In England, the Government’s target to halve the number of stillbirths and neonatal deaths by 2025 compared to 2010 is not on track, and there is no current target or ambition for reducing baby deaths in Scotland, Wales or Northern Ireland. 

The report also highlights that Government commitments to act on the findings of recent reviews of maternity services still haven’t led to the real changes needed to save more babies’ lives. 

Annually in the UK over 5,000 babies are stillborn or die within the first 4 weeks of life. 

Around 1 in 6 pregnancies end in miscarriage, but this is very likely to be an underestimate as comprehensive data on miscarriage is not collected and reported at the UK-level or by any individual nation – something Tommy’s is still campaigning to change.

There has also been little progress on reducing the proportion of babies born preterm, with around 53,000 babies born prematurely each year. Premature babies are more likely to have lifelong health problems, and being born prematurely is an important risk factor for pregnancy loss and baby deaths - in 2020 almost three-quarters of neonatal deaths in the UK were among babies born prematurely.   

The Saving Babies’ Lives progress report concludes that progress to reduce rates of baby loss is slowing or reversing and parents' experiences of care are deteriorating. 

Why?  

The report shows that: 

• Nationally-agreed standards of care are too often not being followed, which is contributing to avoidable deaths. 

• The voices of parents are still not being heard, particularly those affected by the worst outcomes - women and birthing people from minoritised ethnic communities and deprived backgrounds.  

• There are no national targets to reduce inequalities between ethnic groups or areas of deprivation, despite multiple reports highlighting the impact of racism and discrimination which some individuals experience when engaging with health services.  

• Staff report working in an increasingly under-resourced and stretched system which is having an impact on people’s experience of care. 

• Many NHS Trusts and Boards are still not learning from the mistakes that cost lives when things go wrong. 

Robert Wilson, Head of the Sands and Tommy’s Joint Policy Unit, said:  

“This report makes clear that the UK is not making enough progress to reduce rates of pregnancy loss and baby death, and there are worrying signs that these rates are now heading in the wrong direction. 

“There are stark and persistent inequalities, particularly linked to both ethnicity and deprivation, that have been known about for decades. We all need to move beyond diagnosing the problem to taking meaningful actions that will help address these inequalities, but current limitations in data and evidence are a barrier to progress. 

“This report must be a wake-up call on leaders in Government and the NHS to make the fundamental changes that will save babies’ lives. Losing a baby throughout pregnancy or shortly after birth is not just ‘one of those things’ that must be accepted. Too often losses are occurring because of care that is not in line with nationally agreed standards. There are also significant workforce pressures, which are affecting the ability to deliver safe care.” 

To make the UK the safest place in the world to have a baby, our report recommends:  

• Clear targets for every UK nation to save babies’ lives. 

• Much stronger commitment, and long-term funding, from Government to eliminate inequities which lead to higher rates of pregnancy loss and baby deaths. 

• Maternity services to have the staffing capacity and resources to respond to the changing and often complex care needs of people giving birth in the UK.  

• Culture change in the NHS to ensure openness and that lessons are learned when babies die. 

• Increased investment in research and evaluation. 

• Improvement in the quality and consistency of routine data collection including counting the number of miscarriages each year across the UK. 

Parents’ voices make clear the impact of pregnancy and baby loss 

At the heart of the Saving Babies’ Lives report are the voices of bereaved parents and other family members. It is so important for anyone affected by pregnancy loss or the death of a baby to know that they will be listened to and their experiences will lead to changes that will save lives in future. 

“You go from such a high to such a low in so short a space of time, so happy and jubilant one moment the next your world crumbles down. We were only in that room for about 5 minutes, but it’s never really left me.” - Vik and his wife Sarina suffered a missed miscarriage at 10 weeks 

“We want to know that things will be better for the next parents whose labour and births are like ours.” - Bereaved parent 

“I was lucky enough to have support from the same midwife in my second pregnancy, during my third trimester. My anxiety was off the chart as we had no explanation as to why my first baby died and was in constant fear. We had to see lots of different consultants and she was a constant professional who knew our story. This really helped allay our fears as she knew me and understood my choices and why I made them and helped my partner and I avoid triggers.” - Dawn 

Driving future changes to save babies’ lives 

In 2022 Sands and Tommy’s came together to form a Joint Policy Unit. Together we are focused on achieving policy change that will save more babies’ lives during pregnancy and the neonatal period and on tackling inequalities in loss, so that everyone can benefit from the best possible outcomes. 

Our new report is the first in a series from the Sands and Tommy’s Joint Policy Unit, aimed at policy makers from Government and the NHS, charities, and professional bodies.  

Through a series of progress reports, we’ll be monitoring progress and also reporting on the work that Sands and Tommy’s are doing to support the policy changes that will save more babies’ lives and help tackle inequities.