Royal Bolton Hospital Reduces stillbirth Rate

It was quite heartwarming to read online recently that the Royal Bolton Hospital have reduced the number of babies who are stillborn.

According to the Bolton News, there are 3.5 stillbirths per 1,000 – down from 12 in January and there were no stillbirths in January this year, compared to 4.3 across the region. The hospital is apparently two years ahead of the national schedule.

The Chairman of the hospital acknowledges that whilst some stillbirths are unpreventable, others are caused by smoking in pregnancy, growth restriction, reduced fetal movement and the monitoring of CTG in pregnancy. On a professional note, I have sadly handled many cases involving the later three causes of stillbirth with monitoring of CTG (primarily lack of or poor interpretation of) being the central allegation in the stillbirth cases that I handle.

To try and reduce their stillbirth rate, the hospital have provided extra training to Midwifes in relation to fetal movements (supporting mums), tested the level of carbon monoxide levels in women, invested in Dawes-Redman CTG monitors to provide enhanced monitoring and they have trained more staff to scan small babies.

Stillbirth (and neonatal death) receives a lot of negative press in the media in relation to our dire statistics and lack of major improvements. In this vein, it really is amazing to see that some Trusts are investing time and resources into reducing the stillbirth rates and ensuring that as few parents as possible experience the gut wrenching pain of losing their much loved and wanted babies.

I just hope that the wonderful achievement of the Royal Bolton Hospital in relation to the reduction of stillbirth rates are mirrored by other hospitals too. Fingers and toes crossed……


If you or a loved one would like to discuss a stillbirth compensation claim or neonatal death compensation claim, please do not hesitate to contact Amy, a specialist stillbirth claims solicitor and medical negligence expert. You can call Amy on 020 8209 0166 or email her at abennett@gadllp.co.uk.

My Interview for the Legacy of Leo Blog: Working on Stillbirth Claims & Neonatal Death claims

So, to start us off, please can you let us know a little about your current role? What motivated you to do the job that you are doing now, and in what ways does it allow you to get involved in the baby loss cause?

I am a Medical Negligence Solicitor in the North West London office of Gregory Abrams Davidson. I have been a Solicitor for nearly 10 years and have, following qualification, specialised exclusively in Medical Negligence. 

My eldest daughter, Arella, was stillborn a week before her due date on 30 June 2012. When I finally returned back to work, I decided to focus my practice on assisting families who had suffered a stillbirth or neonatal death as a result of Medical Negligence.  The primary reason behind my decision was a passion and drive to help bereaved parents through the litigation process. 

I am not only a practicing Medical Negligence Solicitor, but I am also a bereaved mother and therefore, I (sadly) understand the gut-wrenching pain of losing a baby. This is in addition to having years of legal experience behind me. 

Following the stillbirth of Arella – during my darkest of days – I became a “walking encyclopaedia” on Stillbirth. Unbeknownst to me at that time, this would arm me with information which would help me in my working life. 

Another motivator that led to my decision to specialise in Stillbirth is to make change; thus continuing my Arella’s legacy. Whilst I would never have chosen to be in the position I found myself in after losing Arella, there is a part of me which feels “lucky” to be in a position to make a difference to peoples’ lives. 

Whilst some stillbirths sadly cannot be prevented even with the best of care, some deaths are avoidable and are caused as a direct result of a lack of care. This, in my opinion, should be a “never event”. 

I should add that I am a huge fan of the NHS. I myself received exemplary care from the hospital where Arella was born (the Whittington Hospital in North London) followed in later years by my three subsequent children, but I acknowledge that not everyone is as fortunate as me. 

Many hospitals are failing to provide a high enough standard of care to their patients. It is my intention that with the passage of time, I will be able to collate data from the cases I settle, identify the issues and weaknesses in the system and with this information, approach the various maternity bodies with the intention of ultimately educating doctors and midwives, thus reducing the number of stillbirths. This is a further driver behind my passion to spend my working days helping bereaved parents.

Whilst prevention is my longer-term aim, I strive to support bereaved parents through what is undoubtedly an extremely distressing time. As well as dealing with the pain of losing a baby, I cannot imagine how difficult it must be to deal with the stresses and anxieties caused by the litigation process.

I strive for justice on behalf of my clients, bereaved parents. I strive for change. 

What are the biggest frustrations or constraints that you face in supporting those affected by baby loss or preventing baby loss in the first place?

I love my job. However, I can get frustrated at times by needless, protracted litigation that, in my opinion, should have settled earlier. The average claim takes 2-3 years to settle. This obviously puts a huge emotional burden on my clients. There are occasions when a stance taken by a NHS Trust is so unreasonable (and illogical) which results in unnecessary drawn out litigation.  Such cases are ultimately successful, but it is upsetting to think that my clients could have been spared some pain and anguish, had a reasonable approach have been taken by the hospital trust at the outset.

I also find the end of a case, whether successful or not, incredibly sad. For those parents whose cases settle, I feel immense sadness sending them a cheque. And for those parents who bring unsuccessful cases, I feel immense sadness that they never got what they had originally set out to achieve. However, I believe that either scenario, despite the potential of igniting grief and giving it an additional element, it does bring with it a sense of closure. 

For those parents whose claims are unsuccessful, the majority should in time have the peace of mind that an independent expert has concluded that their precious baby did not die as a result of negligence.

I am not a Counsellor. I am not a befriender. I am a Solicitor. It can be hard to find the right balance on occasion.  However, I believe that my personal experience sadly equips me with the necessary skills to offer support and guide my clients throughout their legal process. I have the deepest of empathy which helps me to approach a case with the utmost care and sensitivity. 

Do you think that Baby Loss is still a taboo, and if so, why? Do you encounter issues with it being a taboo in your day to day work?

I think that Stillbirth/Neonatal Death is still a taboo. It is a grief left unspoken. It is every parent’s worst nightmare. Stillbirth/Neonatal Death is too awful to think or talk about but the harsh reality is that it happens.

Nevertheless, I definitely think that since Arella’s stillbirth 6.5 years ago, people are speaking more and the subject is attracting media attention. Sadly, stillbirth is far more common than people realise. 

Who else do you work alongside in terms of baby loss support or prevention? Are there any charities that support you, or perhaps a colleague that you couldn’t manage without?

As a result of Arella, I am able to guide people to help and support if they so wish. Grief is subjective. What works for one, does not work for another. We all have different coping mechanisms. I am able to point people in the right direction for help, should they so wish. 

With claims that are successful, as part of the settlement, I am able to ensure that my client(s) gets the right level of help to support them through the healing process as best as possible, for example in the form of Cognitive Behavioural Therapy (CBT). As a result, I work with leading psychiatrists/psychologists.

When the job is hard, what one thing reminds you to keep on keeping on?

I’d be lying if I said my job was easy (emotionally). It’s not. I have cried over every single stillborn or neonatal death baby for whom I have sought justice and many of their stories deeply resonate with me. However, I try to focus on the bigger picture of why I do what I do and try not to lose sight of that. In addition, my job ensures that Arella’s legacy is continuing and that her little life is not lost in vein.

It’s likely that a newly bereaved parent is reading this. What would you like to say to them?

To a newly bereaved parent, I would like to say the following:

I truly understand the gut-wrenching agony of losing a baby. There are simply no words to describe it. You will find a way, your way, to get through it. My husband and I always grieved differently, but always as one. Be kind to yourself. Don’t expect too much. There will be days when you are literally drowning in grief and others that are more bearable. You’ve got to do whatever YOU have to do to get through the dark days. There is a lot of support out there. Take whatever is on offer. Don’t expect too much from yourself. There is some truth to the cliché that “time is healer”. Whilst the passage of time does not eradicate the pain, it will enable you to find your own coping mechanisms. 

Be kind to yourself.

We have some ambitious targets for baby loss currently in the UK. What are your specific hopes for the future in terms of maternity and baby loss?

It is not until you experience the pain of a stillbirth that you realise that’s it’s not such a rare occurrence: Everybody knows somebody. The statistics on stillbirth in the UK are shocking: According to SANDS (Stillbirth and Neonatal Death Charity), around 15 babies each day died before, during or soon after birth every day in 2016. One in every 227 births was a Stillbirth and there were a total of 3,434 stillborn babies in 2015. That’s around 9 babies stillborn every single day. The pattern of bereaved parents’ lives is torn apart in a way which renders them forever-changed. 


These bleak statistics are illustrative of the fact that in an era of medical advancement, we are not improving our knowledge and understanding surrounding stillbirth. 


Stillbirth is more common than cot death and yet every mother knows about and is fearful of cot death – I was given a booklet by my midwife on one occasion, outlining “how to prevent a cot death”. I appreciate that there is a fine line between educating and scaremongering but that said, I believe that the appallingly high stillbirth rates signal the need for immediate change.

As things stand at the moment, we cannot educate mothers as we have no answers to offer; “Your baby may have a cot death but we have carried out a lot of research and here is a list of things that you can do to prevent it” sounds far more palatable than “Your baby may be stillborn but I’m afraid we don’t know what warning signs to look out for as very little research has been carried out”. Why can’t the same attention and detail that was rightly given to cot death be applied to stillbirth in order for us to similarly improve our understanding and limit our number of stillborn babies?


I hope that government action be taken to tackle the unacceptably high level of stillbirths in the form of funding into research. It is pleasing to see evidence of a gradual shift towards recognition of the fact that more could be done to prevent stillbirth. 

I hope that we reduce our numbers and also improve our bereavement care, which is something of a postcode lottery. The stark contrast in the standard of care offered by different Trusts to bereaved parents is something that needs to be addressed. I was lucky. I had the most wonderful Bereavment Midwife and Consultant who I will forever hold a special place for in my heart. Experiences vary and not all bereaved parents are as fortunate as me; lacking the support of health professionals following the death of their baby. They are left to try to cope on their own, save for the odd visit from the community midwife. 

It horrifies me to learn that not all hospitals have allocated funds for a Bereavement Midwife and for those that do, many of the Bereavement Midwives are hopeless. I realise how “blessed” I am to have had such a wonderful Bereavement Midwife in my life; I have sadly met many bereaved mums, none of whom have this vital lifeline. I have met women who, 6 months on, are still on a waiting list for counselling. What good is that when for some women, ending their lives immediately after losing their baby is seen as the only way out?


Whilst the care that I received was exemplary, on the other hand, I cannot help but partly “blame” the NHS as a whole for failing to do all it could to find out that I was having a “high risk” pregnancy before it was too late. We do not have the necessary screening tools in place due to a lack of research funding. A third of stillborn babies are perfectly formed and born at gestations when they might safely be delivered but routine antenatal care is failing to detect far too many babies who need help. Research is urgently needed to identify new reliable, diagnostic tests.

The interview can be found here:


Approaching Medical Negligence Cases with the Deepest of Empathy | Amy, Bereaved mother & Solicitor for the #Itstilltakesavillage blog series

If you or a loved one would like to discuss a stillbirth compensation claim or neonatal death compensation claim, please do not hesitate to contact Amy, a specialist stillbirth claims solicitor and medical negligence expert. You can call Amy on 020 8209 0166 or email her at abennett@gadllp.co.uk.

New Report Suggest it’s Safe to Fall Pregnant Again Shortly After Stillbirth

I read an interesting article last week. It was about the fact that recent research suggests that it is ok not to delay having a baby after a stillbirth.

This is really good news to read as I know that many women (me included) worry about having another baby straight after a stillbirth or neonatal death. Different Consultants have different opinions. The physical toll aside, there is the argument that a woman should give herself time to grieve before embarking upon what it inevitably going to be a difficult pregnancy (emotionally). In addition, there is also the opinion that stress does not help conception.

A study in the Lancet revealed that of 14,000 births (of babies born after a stillbirth), there was no increased risk of problems if conception happened earlier.

Ultimately, it is the parent’s choice as to when the try for another baby after a stillbirth or neonatal death. For those wanting to try straight away, it is reassuring that a recent study confirms that it is safe to do so (an opinion already held by many Consultant Obstetricians).

To see more articles relating to stillbirth and neonatal death, go to www.stillbirthclaims.co.uk

In addition, you can find more information at www.gadlegal.co.uk

If you or a loved one would like to discuss a stillbirth compensation claim or neonatal death compensation claim, please do not hesitate to contact Amy, a specialist stillbirth claims solicitor and medical negligence expert. You can call Amy on 020 8209 0166 or email her at abennett@gadllp.co.uk.

Each Baby Counts: 2018 Progress Report

“Each Baby Counts” is the Royal College of Obstetrician and Gynaecologist’s (“RCOG”) national quality improvement programme to reduce the number of babies who die or are left severely disabled as a result of incidents occurring during labour (see earlier blog).

The key findings of the Report are as follows:

• Of the nearly 700,000 babies born in 2016, 1,123 babies fulfilled the Each Baby Counts criteria. There were 124 stillbirths, 145 babies who died early and 854 babies who sustained severe brain injuries during labour at term (babies born after 37 completed weeks of gestation).

• The number of incidents where different care might have led to a different outcome still remains too high, with 71% babies who might have had a different outcome with different care.

• For the babies reported to Each Baby Counts, the reviewers concluded that there was rarely one single cause of the stillbirth, early neonatal death or brain injury. The report identified an average of seven critical contributory factors for each baby where different care might have had made a difference to the outcome.

• In almost half (45%) of these affected babies, guidelines and best practice were not followed. Reasons for not following guidelines included gaps in training, lack of recognition of problems, heavy workload, staffing levels and local guidelines not being based on best available evidence.

Amy Bennett, medical negligence Solicitor who acts on behalf of numerous bereaved families, believes that “The Each Baby Counts project is a significant step towards the recognition of the unacceptable high levels of avoidable stillbirth, neonatal death and brain damage cases as well as recognition of the life changing effects losing a baby or raising a severely brain damaged baby can have on a family. The findings of the 2018 Progress Report do not look promising at all in terms of meeting the targets set but time will tell.

If you or a family member or friend would like to discuss your potential stillbirth, neonatal death or brain damage claim, please contact specialist Stillbirth and Neonatal claim solicitor Amy Bennett on 0208 209 9712. Alternatively, you can e-mail Amy at abennett@gadlegal.co.uk or fill out our online contact form and she will contact you directly. Please see the “Contact Me” section for more information or visit www.gadlegal.co.uk.

Campaign for Safer Births

I recently came across “Campaign for Safer Births” an organisation set up by two mothers in memory of their sons, Louie and Harry, both of whom died as a result of negligence during labour.

The Campaign’s mission is to improve NHS Maternity Services in order to reduce the avoidable deaths and injuries of babies and mothers during labour.

They highlight the scale of the problem on their website

http://www.campaignforsaferbirths.co.uk/page1.html, providing the following data:

* Over 500 babies are dying unnecessarily every year in labour or soon after, Perinatal Mortality Report 2009, Centre for Maternal and Child Enquiries 2011 & ITV Tonight programme

* The cost of litigation relating to obstetric mistakes was £3.1 billion over 10 years to March 2010. Obstetrics is the highest area of litigation by cost, NHS Litigation Authority Report: Ten Years of Maternity Claims An Analysis of NHS Litigation Authority Data, October 2012

* The UK has very poor stillbirth rates 33rd out of 35 similar high income countries, V Flenady et al. Stillbirths: the way forward in high-income countries. The Lancet 2011, Vol. 377, Issue 9778, Pages 1703-1717

* Having a baby through the night or at the weekend is associated with a 45% increased risk of neonatal death due to oxygen starvation during the birth. This is thought to be due to poor staffing and junior doctors being left alone, even though 70% of babies are born through the night 38 D Pasupathy, A Wood, J Pell, H Mechan, M Fleming, GCS Smith. Time of birth and risk of neonatal death at term: retrospective cohort study, BMJ 2010

* Overstretched maternity wards having to turn women away – An RCM report found more than half of NHS trusts had to close their door an average of seven times a year, Royal College Midwives: State of Maternity Services Report, 2012

* Lack of Consultant cover Royal College of Obstetricians and Gynaecologists (RCOG) agree that 24/7 consultant cover is required urgently

* Hospitals not consistently following national NICE (National Institute for Health and Care Excellence) guidelines procedures and staffing levels

* Midwife numbers not keeping pace with the rising birth rate

* Lack of quality control and monitoring both internally and externally and lack of Coroner involvement – Coroners are involved in all deaths that are sudden, unexpected or due to neglect, except for babies dying at birth. Why?

* Hospitals not disclosing their mistakes and therefore not learning

The facts and statistics speak for themselves. Urgent change is required to reduce our unacceptably high stillbirth and neonatal death rate.

If you or a family member or friend would like to discuss your potential stillbirth or neonatal death claim, please contact specialist Stillbirth Claims Solicitor Amy Bennett on 0208 209 9712. Alternatively, you can e-mail me at abennett@gadllp.co.uk or fill out our online contact form and I will contact you directly. Please see the “Contact Me” section for more information.

 

 

Each Baby Counts: RCOG Initiative

Following on from last month’s Panorama, the Royal College of Obstetricians and Gynaecologists (RCOG) have launched a new five-year initiative, “Each Baby Counts”, to help reduce the UK’s stillbirth rates. They aim to reduce the number of stillbirths, neonatal deaths and brain injuries as a result of incidents during full-term labour by 2020.

Stillbirth rates in the UK remain unacceptably high. According to the RCOG, current estimates suggest that around 500 babies a year die or are left severely disabled as a result of something going wrong in labour. The starvation of oxygen at birth can lead to severe brain injury such as cerebral palsy. The RCOG does not accept that all of these are unavoidable tragedies and has committed to halving the number by 2020.

From January 2015, the RCOG will start collecting and analysing data to improve future care. For the first time, information will be shared nationally. Jane Brewin, CEO of Tommy’s states that “recognition that some stillbirths are preventable feeds into a wider change in mindset across the field and we can now see real and meaningful action starting to take shape”. Jane goes onto correctly state that “..Whilst this is an important step forward towards saving babies’ lives, it’s only part of the answer”, referring to the fact that far more needs to be done in terms of carrying out research to learn why babies die in pregnancy with this accounting for the majority of stillbirth cases.

The UK’s stillbirth rates during pregnancy need to be reduced as well as those that occur during pregnancy but for now, Each Baby Counts” is a step in the right direction after decades of doing virtually nothing.

If you or a family member or friend would like to discuss your potential stillbirth or neonatal death claim, please contact specialist Stillbirth and Neonatal claim solicitor Amy Bennett on 0208 209 9712. Alternatively, you can e-mail me at abennett@gadllp.co.uk or fill out our online contact form and I will contact you directly. Please see the “Contact Me” section for more information.

Breaking the Taboo: Every Little Helps

Following BBC Panorama’s documentary, “Born Asleep”, it is fantastic to see that stillbirth and neonatal death has been given so much well-deserved media attention, especially during October, International Baby Loss Awareness Month.

Professor Kypros Nicolaides told Panorama that more than half of all stillbirths (there are approximately 3,500 each year) could be prevented. He claims that offering a Doppler scan, which measure the blood flow from the placenta to the baby was the key to the reduction.

Many stillbirths are caused by the failure of the placenta, starving the baby of food and oxygen. Professor Kypros Nicolaides claims that as many as 90% of these cases can be identified from as early as the 12 week scan which would result in the adjustment of antenatal care. King’s College Hospital, London (where Professor Kypros Nicolaides is based) offers Doppler scans routinely at 12, 22 and 32 weeks.

Placental Failure often occurs at the end of pregnancy. It is therefore argued that with the help of the Doppler scan, babies lives can be saved as any abnormality in the placenta can be seen and the baby can be born by C-section before it is too late. Currently, Doppler scans are only used in high risk women which account for only 15-20% of all pregnancies.

Introduction of the Doppler would eradicate the over reliance by health professionals on the tape measure, an antiquated method of measuring a baby’s growth in pregnancy.

St George’s Hospital in London has also introduced the Doppler scan to all first-time mothers at 20 weeks, which costs £15 per mother when given at the same time as a foetal anomaly scan. The hospital claims that since this introduction, it has seen its stillbirth rate drop by 50% in three years.

A clinical trial is needed and further research carried out before the NHS introduce the Doppler as part of routine antenatal care but the statistics look promising.

In the meantime, NHS England is encouraging hospital trusts to adopt the Growth Assisted Protocol (GAP), at a cost of 50p per pregnancy. It is claimed that this method cuts stillbirth rates by up to 22%. It was created by Professor Jason Gardosi, director of the Perinatal Institute in Birmingham and works by giving each mother a customised growth chart which is developed using factors such as her height, weight at beginning of pregnancy, ethnic origin and how many children she has had. The chart estimates the expected growth of the baby for each week in pregnancy and the theory behind it is that if a baby’s growth falls outside what is expected, the mother is then referred for extra scans which would highlight any baby in need of early delivery.

Almost two-thirds of Trusts have signed up. A definite step in the right direction.

I sincerely hope that Professor Kypros Nicolaides and his team are able to convince the NHS of the need to introduce routine Doppler scans as part of antenatal care.

If you or a family member or friend would like to discuss your potential stillbirth or neonatal death claim, please contact Amy Bennett, Stillbirth and Neonatal expert solicitor and Medical Negligence claims Lawyer on 0208 209 9712. Alternatively, you can e-mail me at abennett@gadllp.co.uk or fill out our online contact form and I will contact you directly. Please see the “Contact Me” section for more information.