Baby Loss (Public Health Guidelines) — House of Commons, 2017-03-21
Topic: Health
William James Quince (Conservative, Centre-right): As my wife will testify, I am rarely early for things, so to be more than three hours early for something is a rare treat indeed. I know that both you, Mr Deputy Speaker, and the Minister will be pleased to know that I intend to take only about two and a half hours of the just over three hours available to me As the House knows, I am a passionate campaigner in the area of baby loss. Having unfortunately experienced it myself, I have always been clear that I want to use my position in the House to bring about change so that as few people as possible have to go through this absolute personal tragedy. In the latest year for which figures are available, there were 3,254 stillbirths in England and Wales, with a further 1,762 neonatal deaths shortly after birth. Every single one of those is a personal tragedy, yet perhaps the most galling aspect is that so many of these deaths—reportedly about half—are actually preventable I strongly welcome the Government’s plans to cut the stillbirth and neonatal death rate by 20% by 2020 and, furthermore, to reduce it by 50% over the next 15 years, but those are just numbers unless we put in the resources necessary to deliver on this. Trusts have received £4 million to buy better equipment and boost training to cut stillbirth and neonatal death. More than £1 million is also being provided to help develop training packages so that more maternity unit staff have the confidence to deliver safe care. It is hugely positive that the Department of Health has recognised the scale of the challenge and set aside this funding, but we need to focus as much on reducing the risks of stillbirth One significant risk factor remains one of the toughest to eliminate and, as a result, carries the greatest reward if we can address it: smoking in pregnancy. Let me be clear that this debate is absolutely not about criticising or demonising women and their partners who smoke during pregnancy. We all know that tobacco is highly addictive and it can be difficult to stop smoking. However, smoking while pregnant is the No. 1 modifiable risk factor for stillbirth. If I may, I will run through a few statistics: one in five stillbirths is associated with smoking; women who smoke are 27% more likely to have a miscarriage; their risk of having a stillbirth is a third higher than that of non-smokers; and mothers who smoke are more likely to have pre-term births and babies are who are small for their gestational age Maternal exposure to second-hand smoke during pregnancy is an independent risk factor for premature birth and low birth weight, yet only one man in four makes any change to his smoking habits when his partner is expecting a baby. If, tomorrow, every pregnancy was smoke-free, we would see 5,000 fewer miscarriages, 300 fewer perinatal deaths, and 2,200 fewer premature births every year. Were children not exposed to second-hand smoke, the number of sudden infant deaths could be reduced by 30% The previous tobacco control plan set targets for reducing rates of smoking in pregnancy. In 2015-16, the number of women smoking at the time of delivery had fallen to 10.6%—below the Government’s target of 11%—yet the fact that the Government’s target has been met nationally masks geographical variations. Yes, we are seeing rates of 2% in Richmond, 2.2% in Wokingham and 2.4 % in Hammersmith and Fulham, but rates of smoking in pregnancy are 26.6% in Blackpool, 24.4% in South Tyneside and 24.1% in North East Lincolnshire Of the 209 clinical commissioning groups, 108 met the national ambition of 11% or less, but that means that 101 did not. It is even more worrying if we look for improvements in the rates of smoking in pregnancy in CCG areas. Yes, 14 CCGs have improved significantly over the past year, but 182 have rates that are about the same and, even more worryingly, 13 have significantly worse maternal smoking rates The Government have committed to renewing targets to reduce smoking in pregnancy. Reducing regional variation in smoking during pregnancy and among other population groups is a high priority for the Minister, and I know the Government are focusing on it as they finalise the tobacco control plan. I was pleased to see the recent news that NHS England granted £75,000 of funding to the 26 CCGs that are most challenged on maternal smoking How do we achieve the Government ambition for a 50% reduction in stillbirth and neonatal deaths by 2030? First, we need to publish a new tobacco control plan. The previous tobacco control plan for England expired at the end of 2015. The Government have promised that a new one will be published shortly. The publication of the strategy is now a matter of urgency, so will the Minister kindly advise on how shortly "shortly" is The strategy needs to include ambitious targets for reducing smoking in pregnancy. The Smoking in Pregnancy Challenge Group—a partnership of charities, royal colleges and academics—has called for a new national ambition to reduce the rate of smoking in pregnancy to less than 6% by 2020. I know the Department of Health is sympathetic to that aim and hope it will be included in the new tobacco control plan.