Call for national target amid rise in Scottish neonatal deaths

In addition to setting an overall target, Sands is calling on Scotland and the other UK nations set targets for reducing inequalities with regards to baby loss.

The calls follow the publication of a report which demonstrates progress made on reducing baby deaths in Scotland over the last decade stalling since the pandemic. Rates of neonatal deaths in Scotland in 2021 were almost 8% higher than they were in 2010.

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This rise was driven largely by a substantial increase in deaths between 2020 and 2021, which the Scottish government has commissioned Healthcare Improvement Scotland to conduct a review of.

The joint report by Sands with Tommy’s, an NGO which funds research on miscarriage, premature birth and stillbirth in the UK, paints a picture of slowing progress in the reduction of infant mortality rates across the UK.

Having a target would facilitate the government address contributing factors identified in the report, as it would require action in the form of policies and investment, Georgia Stevenson, data and policy lead at Sands, explains. “Targets are not an answer in and of themselves, but as soon as the government sets a target, the expectation is that support is then provided to individual hospitals and trusts to deliver that target. So it’s a goal for everyone to aim towards,” she said.

Such areas where improvements could be made across the UK are identified in the report, including issues surrounding staffing and resources. Stevenson told the Herald: “I think broadly across each of the national health services, either in England or Scotland, that resourcing point is really important. Enabling the staff who want the best outcomes for the women, giving them the resources and the capacity to do the best they can, which is what they want to do and what they are trying to do. Sometimes the system is holding them back,” she said.

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The Sands report and its recommendations have been welcomed by Scottish baby loss charity Held in Our Hearts, who said they would also like to see a minimum framework for bereavement care in Scotland.

Nicola Welsh, CEO of the charity, told The Herald: “Held In Our Hearts support and welcome any research and commitment to reducing the number of babies that die in Scotland.  We have seen a 300% increase in monthly referrals to the charity in the last year which is due to more families knowing of the charity and more families being referred to us for support. 

“The NBCP (National Bereavement Care Pathway) is a wonderful resource for Health Boards to improve care at the time of loss.  We are keen for Scotland to have a minimum framework for Bereavement care in the community so there is more uniformity and equity of care available to all families after their baby dies.  As a bereaved parent myself, I understand the heartbreak and agony of your own baby dying, and anything we can do to prevent this happening to families should be a priority.”

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Lindsay, a bereaved mum who lost five babies over the course of three years, said: “Having read through the report from Sands and Tommy's I think it's great there is a focus on trying to reduce the number of babies dying during pregnancy or shortly after birth. I've often said I wouldn't wish this pain on my worst enemy, you never want to think of another family having to go through this. If making improvements to care can help even just a few families avoid a lifetime of heartache, then that can only be a good thing.”

The Scottish Government’s Women’s Health Minister Jenni Minto said: “We welcome the report by Sands and Tommy and are considering the findings. We have also commissioned a national review by Healthcare Improvement Scotland (HIS) to understand any contributing factors to the increase in neonatal mortality in 2021-22, as part of our constant effort to maintain the highest standards in maternity care.”

The minister added: ““Every baby’s death is a tragedy and has a profound impact on their loved ones. We are committed to ensuring that all maternity care is as safe as possible for mothers and babies and that when deaths occur, any improvements are identified and acted on.”

Findings of the Healthcare Improvement Scotland review into the pandemic era increase in baby deaths expected to be published by the autumn of this year. A spokesperson of the body said: “The purpose of the review is to understand any contributing factors to the national increase in neonatal mortality. The review should assess and determine whether there are any themes, underlying causes or safety factors, from both a clinical and system perspective, and, if there are, should identify key learning points and make recommendations for improvement in the quality of care.”

The Sands National Helpline provides a safe, confidential place for anyone who has been affected by the death of a baby. The telephone helpline is free to call from landlines and mobiles on 0808 164 3332.