13.06.2024

NHS logging baby deaths as stillbirths ‘to avoid scrutiny’

NHS hospitals have wrongly recorded baby deaths as ‘stillbirths’, in what affected parents fear is a blatant attempt to avoid ‘scrutiny’. Trusts used the term in at least six cases, including one where a child had lived for five days.

The damning allegations, reported by the Daily Telegraph, have triggered fears of cover-ups of errors or poor practise.

Coroners currently aren’t allowed to carry out inquests into stillbirths.

It means any poor care that could have been to blame for a baby’s death can not be fully probed.

Parents of babies wrongly said to have been stillborn also face financial implications, as they are not automatically eligible for statutory ‘bereavement awards’ worth more than £15,000.

The stories will raise further questions about the safety of maternity care in England, following a damming investigation into the death and injury of hundreds babies and mothers earlier this year.

Independent investigators revealed 201 babies and nine mothers died needlessly during a two-decade spell of appalling care at the Shrewsbury and Telford Hospital NHS Trust.

One of the babies, who was born art East Kent Hospitals University NHS Foundation Trust, lived for five days before being classified as a stillbirth

WHAT IS A STILLBIRTH?

A stillbirth occurs when a baby is born dead after 24 weeks of pregnancy.

If a baby dies before 24 weeks of pregnancy, it is known as a pregnancy loss.

Not all stillbirths can be prevented, however, not smoking or drinking, as well as not sleeping on your back and attending all antenatal appointments can reduce the risk.

What are the signs?

Signs may include the baby not moving as much as normal.

Pregnant women should contact their doctor immediately if they notice a difference to their baby’s movement.

What are the causes?

Stillbirths do not always have an obvious cause but may occur due to complications with the placenta or a birth defect.

They are also more likely to occur if women suffer from high blood pressure, diabetes or an infection that affects the baby, such as flu.

Stillbirths are more likely to occur if women are having twins or multiple pregnancies, are overweight, smoke, are over 35 or have a pre-existing condition, such as epilepsy.

What happens after a stillbirth?

If a baby has died, women may wait for their labour to start naturally or they may be induced if their health is at risk.

Bereavement support groups are available to parents who have suffered stillbirths.

Some find it helpful to name their baby or take pictures with them.

Results of another independent inquiry into maternity care at East Kent University NHS Foundation Trust is expected soon.

The Trust was named named as one of the those where incorrect stillbirth recording occurred.

A stillbirth is when a baby is born dead after 24 completed weeks of pregnancy.

This means they had no sign of life, like a heartbeat, outside of their mother’s body even for a few moments.

Stillbirths occur in roughly one in every 200 births in England, according to official estimates.

The fatalities uncovered in the investigation should of been classified as neonatal deaths because the babies were alive for a length of time out of the womb.

All the NHS trusts named as having wrongly classified neonatal deaths as stillbirths have apologised to the babies’ parents and say they have changed their practices.

In one of the six cases, an obstetrician at Stockport NHS Foundation Trust told a coroner that he had been pressured by an NHS manager to claim a baby delivered in the hospital was stillborn.

Dr Mark Tattersall said it was in order to be ‘loyal’ to the trust, though the NHS manager denied this.

Drs Dunstan Lowe and Kelli Rudolph are just one of the parents whose baby’s death was recorded incorrectly as a stillbirth.

Their daughter Celandine lived for five days in 2016 after being born at the East Kent Hospitals University NHS Foundation Trust.

Dr Rudolph was rushed to hospital after meconium, the name for a baby’s first stool, was spotted after her waters broke, and is a sign the baby is under stress.

The expectant mother thought she would have an emergency C-section but instead was taken to the labour ward to have a vaginal birth.

Celandine was eventually born but suffered hypoxic ischaemic encephalopathy — brain damage from lack of oxygen, and needed to resuscitated.

She went on to live for five days, spending her the entire time in hospital with her parents.

Dr Lowe, an academic, said he initially believed Celandine’s case had been a ‘horrible freak accident’.

But as events later unfolded, the couple began to question the openness of staff at the hospital, the newspaper reported.

Before they left hospital, they were handed Celandine’s death certificate, which listed both hypoxic ischaemic encephalopathy and ‘stillbirth’ as the causes of her death.

Dr Rudolph said the registrar was ‘shocked’ when they presented the certificate to record Celandine’s birth and death.

NHS staff also discouraged them from having an inquest into Celandine’s death, they claimed.

Dr Lowe told the Telegraph: ‘The reason they used this word on the death certificate seems quite obvious to us – it’s about avoiding scrutiny.’

While the trust has now admitted that it was wrong to log Celandine’s death in the way it did, ‘stillbirth’ is still listed on her death certificate and her parents have never had an inquest to provide them answers.

The trust’s chief medical officer, Dr Rebecca Martin, said it ‘apologises unreservedly’.

Since 2018, every baby who dies in their hospital from hypoxic ischaemic encephalopathy are automatically referred to the coroner.

This is not the first time concerns about how the NHS records stillbirths have been raised.

In his review of the maternity scandal University Hospitals of Morecambe Bay NHS Foundation Trust in 2015, Dr Bill Kirkup said the ban on inquests for stillbirths was ‘illogical’.

He added that the ban provided a ‘subtle incentive for staff to record a death as a stillbirth’ if there were any potential issues with the delivery.

In 2019 the Government proposed changing the rules to give coroners the power to investigate stillbirths, but never got around to doing so.

Dr Kirkup is currently leading an independent investigation into maternity and neonatal services provided by East Kent University NHS Foundation Trust.

The findings of the report are expected to be published on October 19.

Other incorrect stillbirths were recorded at Warrington Hospital, Milton Keynes Hospital and Wrightington, Wigan and Leigh NHS Foundation Trust.

Maternity care in England has come under intense scrutiny in recent years.

Just last month an inquiry into dozens of baby deaths at a scandal-hit maternity unit at Nottingham University Hospitals launched.

This inquiry is being led by Donna Ockenden, who in March released the findings of a damning review into two decades of appalling care at Shrewsbury and Telford Hospital NHS Trust.

Ms Ockenden’s inquiry into Shrewsbury and Telford found some 201 babies and nine mothers could have — or would have — survived if the trust had provided better care.

At the time she warned the issues at the trust were not unique, and said pregnant women will not be safe until her full raft of recommendations from the report are implemented.

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