New MBRRACE-UK report says care gaps may have cost babies’ lives
In 2 reports published today, MBRRACE-UK looks at the care given to women and birthing people from different ethnic groups in the UK whose baby was stillborn or died within 28 days of birth.
Of all the cases it reviewed – whether the mother was Black, Asian or White – it says only a minority received high quality care.
Overall, MBRRACE-UK says: “Most deaths may have been prevented with better care.”
Experts examined the medical records of 36 Black women, 34 Asian women and 35 White women whose babies were born in 2019.
They reviewed the care given when mothers were pregnant; care for their baby after birth; postnatal and bereavement care after their loss and any tests or investigations that were carried out to try to understand why their baby had died.
MBRRACE found disturbing differences in the experiences of ethnic groups during pregnancy, underlining the inequities which we are working hard to tackle through Tommy’s research and support.
A test for gestational diabetes – which causes complications for the mother and baby - was made available to ‘almost all’ of the White women who should have been offered it.
Among Black women, it was not offered to 1 in 3 who should have had it. Among Asian women, it was not offered to 1 in 5 who should have had it.
The report says all of the Black women and all of the Asian women whose cases it reviewed should have been offered a high dose of Vitamin D to take during their pregnancy. In fact, none of the Black women and only 1 in 10 of the Asian women were given this option.
Overall, antenatal care was assessed as ‘good’ for 1 in 3 White women, 1 in 4 Asian women and 1 in 5 Black women.
The report says the ethnicity, nationality and citizenship status of women was not always correctly recorded in medical notes, which may have made it harder to offer the necessary personalised care.
And it says: “When a woman’s first language wasn’t English and she needed an interpreter, this wasn’t always provided. Sometimes, family members were used as interpreters instead of professionals. This meant the woman might not have received the information she needed or been able to talk about some things in private.”
Across all three ethnic groups, 3 in 5 women received care assessed by MBRRACE-UK as ‘poor’ after their baby died.
Kath Abrahams, Chief Executive of Tommy’s, said:
“It is truly shocking to read that better care might have spared so many families from the devastation of losing a baby.
“Once again, MBRRACE-UK has found distressing disparities between the standards of care offered to different ethnic groups.
“Report after report tells us things must change, yet we are nearing the end of another year when those calls appear to have gone unheard by some of the people who could help us tackle this problem.
“We need a collaborative approach that recognises the impact of what is happening to families around the UK and the urgent need for progress towards ending an increasingly scandalous situation.”
The MBRRACE enquiry was based solely on what was written in medical notes, so did not take into account other factors such as the way staff interacted with women or how they behaved.
Those aspects of care are explored in a ‘Listening Project’ carried out by the charity Sands, which spoke to bereaved Black and Asian parents about their experiences and publishes its findings today.
Sands says some of the families who took part believed that not being listened to or having their concerns taken seriously led to important warning signs going unnoticed, investigations not being carried out and missed opportunities to save babies' lives.
Also published today is the National Perinatal Mortality Review Tool (PMRT), which says it is ‘reassuring’ that the vast majority of baby deaths in the UK are now reviewed formally.
However, it stresses that the quality of these reviews must be considered, particularly in relation to the involvement and engagement of bereaved parents.
The report also says there is no one single issue at any organisation that could significantly improve babies’ survival, concluding: “This underlines the fact that multiple, incremental and sustained improvements across all aspects of care are required to make a substantial difference to the perinatal mortality rate of individual trusts and health boards, and nationally.”
If you need help or support
Kate Marsh, Tommy's Midwifery Manager, said:
We know that reading the findings of reports like MBRRACE can be very difficult if you are currently pregnant.
Please be reassured that stillbirth and neonatal deaths are still very rare occurrences, and the care reported by MBRRACE is looking specifically at where there has been a baby death, rather than the care of all pregnant women and birthing people.
If you have any concerns about the care you are receiving, please do speak to a Professional Midwifery Advocate (PMA) at the hospital where your care is booked, or you can contact the Patient Advice and Liaison Service (PALS).
Remember to be aware of your baby’s fetal movements, and seek help at your maternity triage if you experience any symptoms during your pregnancy that you are concerned about.
Our Tommy’s Black and Black Mixed-Heritage Support Helpline provides extra 1:1 midwife-led care before, during and after pregnancy. We know that Black women experience higher risks of complications during pregnancy, which is why we are offering extra support. Book your 1:1 call here.
You can also call our Tommy’s Midwives Helpline on 0800 014 7800 with any pregnancy concerns. This is a non-bookable service available Monday-Friday, 9am-5pm.
For peer support after a pregnancy loss, you can join our Tommy’s Baby Loss Support Facebook Group. If you are pregnant after a previous loss, you’ll find peer support in our Tommy’s Pregnancy and Parenting After Loss Support Facebook Group.