We respond here to the terrible news that babies of black mothers are twice as likely to suffer a stillbirth.

This article represents an immediate response to recent news. We need to find out what the situation is at Liverpool Women’s Hospital and will report back. We do know that the hospital is aware of the issues and has interventions in place.

It would be wrong to scare mums who are pregnant. The figures are still low, it is still a rare occurance, but any preventable baby deaths are too many. The heartbreak lasts forever.

Infant Mortality: These countries are better than UK in delivering live babies. Japan,1.9 deaths per 1,000 births Sweden, Finland, Austria, Spain, Italy, Ireland, Germany, Portugal, Greece, Netherlands, Denmark, Belgium, France. We have 3.9 baby deaths per 1000 live births. Sadly for our US sisters, we are much better than the USA who have 5.8. In both US and UK, black babies are more likely to die.

Our midwives are not to blame for this. The staffing levels for midwifery are not good enough, even when hospitals meet them. We need more midwives, more antenatal visits, more post-natal care. Our babies are worth it.

Train more midwives and obstetricians. Treat them well. Stop burnout. Stop maternal Poverty. Improve ante natal care. For all our mothers, sisters, daughters, friends, and lovers and for our precious babies. #SaveOurNHS #NHSResistance Source Lancet and LSE COMMISSION on the NHS

Our provisional data show that the number of stillbirths continued a long-term downward trend in 2020. There were 1,835 stillbirths in the first three quarters (Jan to Sept) of 2020, 130 fewer than in the first three quarters of 2019. As a result, the stillbirth rate declined from 4.0 stillbirths per 1,000 total births in 2019 to 3.9 in 2020 so far.

The Nuffield Department of Population Health reported

As in earlier reports ethnic origin continues to have a significant impact on mortality rates:

• Stillbirth rates for Black and Black British babies were over twice those for White babies, whilst neonatal death rates were 45% higher.
• For babies of Asian and Asian British ethnicity, stillbirth and neonatal death rates were both around 60% higher than for babies of White ethnicity.
• The stillbirth rate was 1 in 295 for White babies; 1 in 188 for Asian babies and 1 in 136 for Black babies.

‘These results suggest that a more targeted approach may be required to benefit the Black and Black British and Asian populations’ says Professor Draper. ‘In the New Year we will be starting an MBRRACE-UK confidential enquiry into the deaths of babies born to Black and Black British mothers to investigate the quality of care provided for these mothers to identify whether there are any particular issues.’  

The results continue to show that women living in the most deprived areas had an 80% higher risk of stillbirth and neonatal death compared to women living in the least deprived areas. The rate of stillbirth was 1 in 383 for women living in the least deprived areas, compared with 1 in 214 for women living in the most deprived areas.

Liverpool Women’s Hospital is in a deprived area, serves a deprived city and a multi-racial population, so this very much matters to us.

Our response is that we will campaign. This campaign will include pressure on the government and on MPs and NHS England to:

Drive out racism, in all its forms. Every baby counts.

Mourn the babies and commit to reduce Still Births.

Make the UK the best in the world for all our babies. (This is what we have written previously).

Significantly Increase Funding for Midwifery Services and Obstetrics.

Increase Funding for Hospitals and Universities for Midwife training; training midwives requires sufficent staff in the universities and in the labour wards and maternity services to provide excellent education for students. The NHS needs an effective plan to train many more midwives to world-class standards.

No reduction in professional standards, no subsitution of less well qualified staff, no asking staff to act up beyond their qualifiications.

Maternity needs a more humane, cooperative, and respectful management structure. It needs improved relationships between obstetricians and midwives right from the first training, and all maternity units require 24 hour consultant cover.

Reduce workload and where it can’t be reduced, provide real staff welfare. Good food on site, including some to take home if people are too tired to cook when they get home, free parking, excellent admin support and of course better pay. Support #NHSPay15. See this to help NHSPAY 15.

The pace of work in maternity units must be more humane, and that means more staff, which means changing the recommended staffing ratios. Better working conditions will improve staff retention.

By improving outcomes for Black babies we improve them for all because this will take interventions and improvements that cannot help but improve them for all.

Stop migrant charges. Full stop! These charges are fundamentally wrong and affect black and asian women most of all. The law must change. The charges deter women from seeking timely maternity care and this has caused deaths.

Increase antenatal checks; research has shown that additional antenatal checkups save babies.

Listen to the mums, heed their concerns. Midwives and obstetricans of course spend their lives listening to pregnant women and women in labour but we must find ways to improve that communication. Maternity needs to heed to the mothers, during pregnancy and in labour. Health education needs to to offer much better school and popular education about pregnancy and childbirth.

The NHS must consult the midwives and obstetricians and the communities, openly and democratically, on how to improve the experience of BAME Mums.

Have working parties of BAME staff to research how to drive down the numbers where the cause is medical rather than social.

The removal of bursaries shut out recruitment from many less well off and mature students. Bring back full bursaries. No-one should pay to train as a midwife. There is currently no shortage of people wanting to be midwives. We just have to find the werewithal to train them initally and to provide ongoing professional education, and to persuade those in service to stay.

The maternity service needs full funding.

AUSTERITY KILLS

Austerity was a policy introduced after the financial crash, a decade ago.It not only cut the money spent on healthcare in real terms, it was accompanied by a rise in racism and in racist rhetoric becoming normalised. This rhetoric seeps into people’s thinking unconsciously and has to be challenged. Austerity resulted in contempt and disregard for poor communities.

The Kings Fund reports that “During the period of austerity that followed the 2008 economic crash, the Department of Health and Social Care budget continued to grow but at a slower pace than in previous years. Budgets rose by 1.4 per cent each year on average (adjusting for inflation) in the 10 years between 2009/10 to 2018/19, compared to the 3.7 per cent average rises since the NHS was established.

However during this funding drought the services the NHS was required to deliver increased. In the current White paper the Government said

NHS activity has grown every year since records began (at an average of 3.3% a year) (This while funding increased by 1.4% Our comment)

Most countries have been reducing still birth, but the rate of improvemnt in the UK is grindingly slow.

Maternity Units have been closed in numbers only equalled by the closures in A and E. Staffing numbers were not protected. Our lives did not matter to the government

Poverty as well as race increases the liklihood of still birth. Some still births are to women not living in stress and poverty and we mourn with them too.

In this Austerity time poverty for women grew, Women’s poverty passes on to babies and children. We all need to shout from the rooftops that poverty is bad for mums, bad for babies. The wages and welfare systems have to provide for all. Child Poverty Action group described how families are falling deeper and deeper into poverty.

“The latest annual report by the Social Metrics Commission found that nearly half of Black African Caribbean households were in poverty, compared with just under one in five white families, while BAME families as a whole were between two and three times as likely to be in persistent poverty than white households.“

Whilst our communities grew poor the rich became much richer.”Since the Great Recession hit in 2008, the 1% has only grown richer while the rest find life increasingly tough. The gap between the haves and the have-nots has turned into a chasm. While the rich have found new ways of protecting their wealth, everyone else has suffered the penalties of austerity.“

A huge chunk of our kids live in poverty. This is not personal misfortune, or bad management, it’s policy and it must change. This is a very wealthy country. The UK are part of the G7 group of wealthiest nations. Poverty is bad policy.

We also ask, did the years of focusing on natural childbirth affect the training of midwives? Our campaign supports women in choosing their style of birth but the dangers seem to occur in the most complex cases. We have seen the Ockendon, report into baby deaths in Shropshire and Morecombe Bay, and other scandals. Responding with Continuity of Carer as the answer is contradicted by a shortage of midwives. “Although maternity providers across the UK are striving towards providing full CoC to women, this level of continuity can be hard to maintain in a system with staff shortages and an often depleting workforce, combined with the need to be on-call for births.

The Continuity of Carer system could work if we had excellent staffing, but we do not.

Do we need greater medical emphasis in training?

Do we need to ensure that doctors in training all do obstetrics early in their training? Do we need to look at the professional and working relationships between obstetricians and midwives?

We cannot accept the concept of population funding as described in the White Paper in the context of far too many still births and maternal deaths in childbirth, There has to be flexibility of funding to respond quickly. Health care on the cheap is not health care at all. maternity needs funding and that responsibility rests squarely with the government. The US companies to whom this government is turning to run our NHS has nothing at all to teach us about reducing Still Births. Indeed they are a danger to us.

From 1994 onwards, the United States has consistently had the highest rate, with 5.6 infant deaths per 1,000 live births in 2016. In contrast, Finland had the lowest rate of 1.9. In 2016, the UK had the fourth highest infant mortality rate of the comparator countries, but the highest of comparable European countries.

Chase the US companies out of our NHS, demand full NHS funding with an increase year on year of 5%

Save Liverpool Women’s Hospital Campaign will be one of the sponsors of a national meeting in the autumn on defending and improving maternity.

Good health care pays for itself.

We support Tommy’s charity

Please do get in touch to tell us your views as a mum, a family member, or a midwife

All of this shows how we need a fully funded universal health care publicly provided, and an absolute end to austerity. That is why we are joining in the Cheshire and Merseyside camapign for a fully funded NHS and to say no the white paper.

For all our mothers, sisters, daughters, friends, and lovers and for the precious babies