According to Tommy’s, the largest charity which funds research into the causes of miscarriage, stillbirth and premature birth, there are, sadly, nine stillbirths every day in the UK. That adds up to too many families each year affected by the tragic loss of an expected baby, often with no clear explanation as to what caused their baby’s death.
What is stillbirth?
The NHS defines stillbirth as a baby that is born dead after 24 completed weeks of pregnancy. If the unborn baby dies before 24 completed weeks, this is known as a miscarriage or ‘late fetal loss’.
The cause of the stillbirth may be unexplained. Stillbirth may be caused by problems with the placenta or the mother’s health. In a baby that was known to be healthy immediately before birth, it can also have been caused by negligent management of the delivery. Unfortunately, many bereaved families are left not knowing why their baby was stillborn.
What is a Coroner’s inquest?
An inquest is a judicial inquiry led by a coroner. The purpose of an inquest and the coroner’s role is to find out what caused a person’s death. Unlike a clinical negligence claim, a professional disciplinary hearing or criminal proceedings, the coroner’s role is not to blame anyone but to consider the facts surrounding a person’s death.
As the purpose of an inquest is specifically not to attribute blame, it is hoped that witnesses will tend to be more open and transparent with the coroner than they might be in other judicial circumstances, which can make the process easier for a family to go through. The witnesses can include any clinicians involved in the person’s care prior to their death, and the inquest gives families an opportunity to ask the clinicians involved any questions they might have about the circumstances of their loved one’s death.
Will there be a Coroner’s inquest after stillbirth?
Under current law, in certain circumstances, the coroner has a duty to open an inquest into deaths of adults, children and babies who were born alive. If it is not clear whether the baby showed signs of life at the time of birth, then a coroner may investigate that, but the coroner has no power to investigate stillbirths.
Where the unborn baby appeared healthy during the pregnancy but the baby was stillborn, the hospital or Healthcare Safety Investigation Branch (HSIB) may carry out its own investigation into the stillbirth but the Coroner has no power to do so. This means that significant numbers of families each year are left with unanswered questions relating to the circumstances leading up to the stillbirth of their previously healthy child. This only adds to the emotional and psychological impact of the stillbirth, making it even more difficult to come to terms with what has happened and causing stress and anxiety in future pregnancies.
What is the government doing about stillbirth?
The government has pledged to halve the number of stillbirths in England by 2025. The Maternity Safety Strategy aims to make pregnancy safer by improving maternity care and learning from mistakes so that fewer people will experience the tragedy of losing a child.
The government recognises that many parents have raised concerns about the inconsistency of maternity investigations and have called for a more transparent and independent system to investigate when things go wrong.
As part of the government’s wider plans to help prevent future stillbirths and improve maternity care they are considering giving coroners new powers to investigate stillbirths.
What will the proposed changes allowing inquests for stillbirths do?
If the proposed changes to coroners’ inquests for stillbirths go through:
- coroners will have powers to investigate all full-term stillbirths (from 37 weeks of pregnancy);
- the coroner will consider whether any lessons can be learned which could prevent stillbirths in future;
- coroners will have an independent right to investigate stillbirths – they won’t need consent or permission from anyone else;
- coroners’ investigations will not replace any of the investigations which are currently undertaken by hospitals or NHS agencies (such as HSIB) in stillbirth cases;
- any reviews carried out by other organisations, such as HSIB, may form part of the coroner’s investigation into a stillbirth;
- coroners’ inquests and investigations into stillbirths will follow the same rules that apply to other types of inquest, allowing them to:
- compel witnesses to give evidence;
- call for disclosure of documents;
- order relevant medical examinations, such as post mortems, of the stillborn baby and placenta;
- retain legal custody of the stillborn baby’s body whilst needed for the investigation.
- The proposals would apply in England and Wales.
The government’s Consultation into Coronial Investigations (i.e. Inquests) of Stillbirths
The Ministry of Justice and the Department for Health and Social Care have issued a joint consultation seeking views from a wide range of people, including bereaved parents, support and advice organisations, researchers, health professionals and healthcare providers, about whether coroners should be given powers to investigate stillbirths.