Promoting prevention and research

Sands is working to promote research and improvements in practice which could save babies' lives. 

Almost one in every 100 births in the UK results in the stillbirth or death of a baby in the early weeks of life. We believe this number of deaths is too high and that more can and should be done to reduce these tragic deaths.

Though sadly many stillbirths and early deaths are unavoidable, there is evidence that a significant number of stillbirths and perinatal deaths could potentially be prevented.

We want to see:

• Improvements in antenatal care, particularly in monitoring of babies during pregnancy.

There are many risks for stillbirth in pregnancy which are well known. Obesity, smoking, diabetes, pre-eclampsia are just some of the risks. Mums with known risks are monitored more closely during pregnancy than so-called 'low-risk' mums. Generally this works well but not always. Some apparently 'low-risk' mums do in fact have high-risk babies. One in two stillbirths still remains unexplained. Why does current monitoring of these apparently perfectly healthy babies not identify them as at-risk? More must be done to improve how they are monitored. 

• Better resourcing of maternity services, better training and improved staffing levels for midwives and consultants.

It’s well known that poor training and poor staffing levels lead to greater risk for mothers and babies. The new coalition government plans to make £20billion worth of savings in the NHS in the coming years. Despite a pledge that this will not affect front-line services, maternity units are already seeing budget and staffing cuts at a time when birth rates are rising and the pregnancy population is becoming more complex, as more women with existing risks become pregnant.

• Improvements in neonatal care, particularly in nursing ratios for babies in intensive care.

Adults receive one-to-one nursing care in intensive care but babies are not guaranteed these levels of care. Because of a shortage of neonatal nurses, babies needing specialist care often have to be transferred to other units away from those units where they were born, putting them at greater risk. The government has outlined a strategy for improved neonatal care but there has been no funding pledge to ensure this happens.

• A better review process to learn lessons from perinatal deaths and greater resourcing for perinatal pathologists.

When a baby is stillborn there is no standardised process for reviewing the death and hospitals review information leading up to the death differently. If there was a standardised and transparent process for reviewing deaths and for collecting data about them, we could potentially learn much more about what is going wrong. We might be able to identify patterns that could highlight particular problems. We would also like to see better resourcing for perinatal pathologists throughout the UK, so that more parents felt confident in the process of post mortem and were supported to make an informed choice about whether to have a post mortem or not.

•  More research into the medical conditions causing stillbirths and neonatal deaths.

In the last two years Sands has begun to fund research directly into the causes of baby death. We are also funding a group of clinicians and scientists who will help direct research into stillbirth in particular. While there is some government funding to try to understand pre-term labour, pre-eclampsia and prematurity, we would like to see a greater commitment from the government to fund research into understanding some of the conditions that contribute to a baby’s death (but may not be the direct cause) and those areas where the death appears inexplicable.

Thanks to research, in the last three decades cot death has declined 70%. Can we do the same for babies at earlier stages of life?