Babies in Midlands and North ‘more likely to die around birth’

Babies in the Midlands and North of England are more likely to die before, during or shortly after birth than those in the South, a new study has found.

Researchers analysed data from 121 maternity services in England to see which centres repeatedly produced outcomes better or worse than the average between 2013 and 2022.

The 10 worst-performing centres were in the Midlands and North of England, and the 15 best-performing in the South.

A review into maternity care is ongoing, with Health Secretary Wes Streeting saying “systemic failures causing preventable tragedies cannot be ignored”.

The study, by researchers at the University of Calgary and published in the Journal of Public Health, was based on death surveillance reports by the body MBRRACE-UK, which looks at late fetal losses, stillbirths and neonatal deaths in the UK.

It found that three of the 121 Trusts that report figures – Sandwell and West Birmingham Hospitals NHS Trust, Leeds Teaching Hospitals NHS Trust and Royal Devon University Healthcare NHS Foundation Trust – had a higher-than-average rate of death in each of the 10 years it looked at, compared to services of comparable size.

Shrewsbury and Telford Hospital NHS Trust, currently the subject of an ongoing police investigation, had worse-than-average rates in nine of the 10 years.

In comparison, three Trusts were found to have lower-than-average death rates in each of the 10 years analysed – Norfolk and Norwich University Hospitals NHS Foundation Trust, Royal Free London NHS Foundation Trust and the University College London Hospitals NHS Foundation Trust.

The data has been adjusted for factors known to affect mortality rates, including socio-economic deprivation, ethnicity and the gestational age at birth.

MBRRACE-UK has been producing data for 10 years, with its reports instructing the worst-performing ‘red flag’ maternity services to conduct a review or investigation to identify factors that might be responsible for their comparatively higher death rates.

But the study’s authors say they found no evidence that, if changes were made, they were having any impact.

They hope this latest study will enable lessons to be learned by allowing these services to visit and observe “the policies, culture and clinical practices within those reporting consistently lower-than-average or falling rates of deaths”.

In total, the study found there had been 33,943 perinatal deaths in England between 2013 and 2022. Of these there were 10,478 neonatal deaths, which occur in the first 28 days of life, and 23,465 stillbirths.

In 2015, the then-Conservative government announced an ambition to halve the rate of stillbirths, neonatal and maternal deaths in England by 2030 – later brought forward to 2025.

The report authors said that this target had been missed, but that a 36% reduction in stillbirth and neonatal deaths during this time – to 4.84 per 1,000 total births – was still “significant”.

A review into maternity care in England, led by Baroness Amos, will be published in the Spring.

Publishing an interim report in December, she stated that what she has seen so far “has been much worse” than she’d anticipated.