Saving Babies’ Lives Report 2009 - Welcome to Sands Saving babies lives  · PDF...

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Transcript of Saving Babies’ Lives Report 2009 - Welcome to Sands Saving babies lives  · PDF...

Saving Babies LivesReport 2009

Sarah and Martin Speakewith their daughter Amlieshortly before she died on

March 17th 2005

Sands is extremely grateful to the scientific and medical experts, campaigners and parents who havecontributed to this report in different ways.

These include: Gavin Ruddy, Richard Chapman, Claire Storey, Maria Viner, Brenda Ashcroft, Chris Wildsmith,Andy Cole and Bob Phillipson from Bliss, Fiona Smith from the Royal College of Nurses, Dame Joan HigginsChair of the NHS Litigation Authority, Dr. Phillip Cox and Professors Jason Gardosi, James Drife, Jim Dornanand Gordon Smith.

We would like to say a huge thank you to all the Mums and Dads who took part in our Parents survey. Yourhelp has been truly invaluable.

We would like to thank all those families for sharing their precious photographs, including: Peter and LynnBrady, Grev and Carolyn Bray, Kylie Bowditch, Clare and Wayne Roberts, Martin and Sarah Speake, Peter andPatricia Tan, Chris and Nichola Wildsmith.

We would also like to acknowledge all those who have already contributed considerable funds to theWhy17? campaign. Each donation goes directly towards the funding of research into the preventionof stillbirth and neonatal death, so a big thank you to:

Bath & Trowbridge College of Midwives, University of Bedfordshire Midwives 2007, Burley & Woodhead CEPrimary School, Foot Anstey solicitors, NDS Ltd, OES Lanarkshire District, Walsall Lions Club.

Clair Vanden, Deb Bourn, Fiona Donald, Jeanne Nicholls, Jo Cameron, Kat Anderson, Mahri-Claire Beere, Mrand Mrs Dixon, Paul Foulkes, Rob and Lucy Smedley, Sue Hale, Sean and Sian Casey.

Aberdeen Sands, Ayrshire Sands, Banff Sands, Bedford Sands, Birmingham Sands, Boston & PeterboroughSands, Cambridge Sands, Coventry Sands, Dumfries & Galloway Sands, Fife Sands, Glasgow Sands, GrimsbySands, Leeds Sands, Milton Keynes Sands, Northern Ireland Network, Nottingham Sands, Sheffield Sands,Tayside Sands, Tunbridge Wells and West London Sands.

There are many others who have been instrumental to the Why17? campaign. To all those families, staff,volunteers and supporters of Sands who have backed the Why17? campaign since its inception, you arethe driving force behind the campaign and our thanks go out to each and every one of you.

Together we canmake a difference.

Saving Babies Lives Report 2009

The report was written by Janet Scott and Charlotte Bevan.

Proofing was by Carolyn Bray, Marion Currie and Katie Duff.

Designed by Mutual-Media (UK) Ltd and printed by J. Thomson Colour Printers.

Address: Sands, 28 Portland Place, London, W1B 1LYWebsite: www.uk-sands.org Head Office: 020 7436 7940

Charity Registration Number: 299679 Company Limited by Guarantee Number: 2212082Copyright Sands 2009. May not be reproduced in whole or part without written permission, all rights reserved.

Saving Babies Lives Report1

Acknowledgements

ABBIE MAE CARDWELL ABBY CARSLAW ABIGAIL SHEPPARD ADAM CHILDS ADAM ROTHERY AIDANIRVING CRAIG AIDAN NEWTON SOPHIE MCKAY AILEEN BAKER AISLING MILES AKEEM SIRFARAZ ALANRICHARD STURGEON ALISON HANNAH MCMAHON AMALIA NICOLE DEVINE AMBER DINMAMODE TREVOR JUNIOR AMELIA KNIGHT AMELIE SAMANTHA NEWMAN AMY WRIGHT ANGEL SIMPSON ANGELJOSHUA CHILLMAID ANGELIQUE HENSON-BAILEY ANNA COKAYNE ANNABELLE LUCY KELLY ANNAMARIEHICKS ARCHIE JACOBY-KELLY ARRAN CAMERON-LYNCH BABY COYLE BAILEY CLYDE BOTHWELL BEANCROME BENJAMIN HOGAN BENJAMIN NEWBOLD BERTIE WHALE BETH CARRUTHERS BRADLEYBRUMPTON ALICE MAY LELLIOTT BRADLEY MARK LITTLE BRUCE LESLIE CALEB ALBERT BROOK CHARLEY CORDEN CHARLIE JACK SMITH CHARLOTTE RODRIGUES CHARLOTTE SEARS CHLOE KEARS CHLOE BAILEY CHLOE MEDLEY CHLOE AMBER GARBETT CHRISTOPHER SHEPPARD CIANN BOON CONNOR BARNARD DAISY LOVE DAISY CATHERINE PIDGEON DANIEL STEWART DANIEL GOULD DANIELMCDERMOTT ROBERT DAVID SCOTT DANIEL LEWIS DALTON SEREN MORGAN DAVIES KATHERINE ANNEHOOLE JON ALEXANDER CURRIE LESLEY KATHRYN CURRIE DANNY HARRINGTON DARREN KELLY DYLANO'CLERY DYLAN JAMES RUSSELL EDDIE PASKIN EDEN THOMPSON ELEANOR CHILDS REBECCA BRAY ELEANOR LEYLAND ELLA HURST GRACE ASHWORTH ELLA GRACE SHERAZEE ELLIE NEWMAN ETHANFOX ETHAN NATHANIEL MURPHY-LUCAS JUDE BRADY EVAN THOMAS WHITTAKER TYLAN GORGUN EVE ROBINSON EVELYN MAUD PORTER EVIE SACKS EWAN STOCKTON EWAN CAMPBELL EMILY GRACE REBEKAH HOOK FREYA DEACON FREYA CHAPMAN FREYA GELDART GEORGE BEANSE GEORGINANORTHROP GETHIN WILLIAMS GRACE JACKSON-FARRELL GRACIE FREARSON DANIELLE GUY GRACIENELL WALKER HABIB HUSSAIN HANS PETER BUDD THIEMANN HARMONY BANFIELD HARRIET ROOKE HARRISON DAVIES HARRY ELSTON HARRY PEART HARRY JAKE GREEN HARRY JOHN BROWN HARVEYLEE BROWN HAZEL HORNBY-EVANS HAZEL LAWRENCE HELEN COYNE HIMAT SINGH LALI HOLLYMITCHELL THOMAS DUFF HOLLY MOORE HOLLY BANFIELD HONEY ADAMS DENVER CLARK BEARPARK I MOGEN JOHNSON INES WILDIG ISAAC FITZPATRICK ISABEL SPENCER BABY SHANE ISABELLA BOEM ISABELLA LATHAM ISABELLE GILLAM JACK TIPTON JACK BUCKLEY JACK CROSS GARY SHA RPE JACK FOSTER JACOB DICK JACOB LAKE JAKE MONTGOMERY JAKE VINCENT SMITH JAMES FREEMANCLEMENTS JAMES EDGAR JAMES ARTHUR ROLFE JAMES MCCARTNEY JAMIE RUSHTON JASMINEJACKSON JENNI CLARKE JESSICA MORRIS JESSICA CORNWELL JO CHETTLE JOEY RIGG JONATHANCLACK JONNY MARTIN BAYLISS JOSEPH TANNER JOSEPH MILTON JOSEPH ANDERSON JOSHUACHAMBERLAIN JOSHUA NATHAN BASS JUN LI BUCKNELL KANAN GEORGE TAYCUR EMILY ROSE PACK KATHARINE ANNE ELLIOTT AMELIE SPEAKE KAYLEIGH HANCOX KELLY REBECCA SADLER LENNOX-GORDON KIAN WOODALL KIRSTY SPIERS KITTY CHISNALL AMY LYNAGH KORA BASSETT-HUCKSTEPP LARA BETHANY HOPE GRANT-HINES LAURA MCCAFFREY LAUREN BAKER LEAH ELIZABETH LUZDICKINSON MCDERMOTT SOPHIE STREETER SOPHIE GALE MATTHEW HALE SOPHIE MCKELVEYMCINALLY WILLIAM JOHN BUTTERFLY WARREN STEVEN KAY TEDDY BREWER THEA LEWIS-WOODHEADTHOMAS HARWOOD HEULWEN GITTOES THOMAS DAVID FORDYCE THOMAS EDWARD CORKER ELLIOTAUSTIN WILDSMITH LEE DALY TIERNAN QUIGLEY AMY CLARE BIRLEY TOBY CLARK-MORRISON EMILYNICHOLLS JENNIFER NICHOLLS JULIA NICHOLLS DIANE STANDRING TOTTIE DALGARNO-PLATT TWINSFLOWERS VICKI MITCHELL HOPE WILLIAMS WILLIAM HALL WILLIAM RADICE WILLIAM LEONARDCROSSLEY WILLOW BEGGS ZACK MILLINGTON LENI LAYCOCK LENNI SHAFFER LEO JAMES DILLONLEWIS ADDY LEWIS DENT LEWIS WILLIAM JOHN BRUCE LILY BLAND LILY GRASSO LILYA CLARK LISARUSKIN LORNA GROVES LOUISE KNIGHT LUCAS CRAVEN LUCY VICTORIA CHILD LUKE BALLINGER LUKE BURKE LUKE HARRY MCINTOSH LYDIA DYSON LYDON DALLEY LYLA HERBERT-LEWIS MADISONPAIGE BOWDEN MAISIE LOACH MALACHI DUNCAN MARI LOIS JONES HOPE REGLER HUGO SCOFFINGS MARLEY BURRELL MARTHA STANLEY-DUKE MARY ELIZABETH ROSE BUTLER FAITH ELIZABETH BAILEY-LAWTON MAX DAKERS MAX BURKE MAX WILLIAM HAYWOOD MIA HURST MIA BEAL MILLIEMOUNTFORD-SWINBOURNE MITCHELL STAMMERS MOLLY TAYLOR-BRITTAN MOLLY FRANCESMCDONOUGH MURRON CATHERINE MARGARET WATT NATALIE GUEST NENI PALACIOSNIIA MAYER NILSVERLE NOAH LAMERTON NOAH MUNGO WILSON NYAH LINTERN OLIVER TWEDDELL OLIVER JOSEPH OLIVER CHAPMAN OLIVER BOWEN OLIVER JOHNSON OLIVER ROBERT WILLSHER OLIVIA BLACKMORE-BOLEY OLIVIA GRACE GRIFFITHS OLIVIA PAIGE FROST OLLIE WARDLE OWEN NEWELL PAMELA MCGRORY PATRICK MILLAR PENELOPE JEMIMA KNIGHT PHOEBE CHURCHILL PHOEBE MCGUIRK PIP WELBURN POLA JACHEC-NEALE POPPY BATTEN POPPY-ROSE HOUSTON REESE ANDERSON RHYS JOHNSON ROBERT 'SPARKLE' PHILLIPS RONALD HISLOP RONAN FRASER ROSE FOZARD-BRADLEY ROSS IGGLESDEN RUBY SPEAKMAN-DASH RUBY WINTER SANTOS RUDY CLARKE SAI PATRICK MURPHY GULATI SAMI KHAN SAMUEL TUDOR SAMUEL NOBLE SAMUEL RICHARD OSBORNE SCARLET BONNER SERENA BARONE SHAKIRA GHANEY SHONA LENNON SKYE MARIE MOTTRAM SOFIA PETTIS SOPHIA PENN DANIEL JOHNLAWLOR SOPHIA JANE ATKINSON DAVID NEWTON MATT PROUDFOOT MARIA WOOLLEY

4 Foreword

5 Summary

7 When a baby dies

9 Introduction

11 Stillbirths

15 Intrapartum-related deaths

17 Neonatal deaths

19 Research

21 Learning lessons

22 Post mortems

23 Resourcing improvements in care

25 Working collaboratively

27 References

29 Definitions and statistics

30 What else Sands does

Saving Babies Lives Report 2

Contents

Saving Babies Lives Report3

Peter Tan with his son Jeremy TanMing Ken who was stillborn

February 12th 2005

Sands, the stillbirth and neonatal death charity,was founded in 1978 by a small group ofbereaved parents devastated by the death of theirbabies, and by the total lack of acknowledgementand understanding of the significance and impactof their loss.

Over the past 30 years Sands has supported manythousands of families whose babies have died,offering emotional support, comfort and practicalhelp. Working in partnership with healthprofessionals and service providers, we havetransformed the culture and practice ofbereavement care in the UK. Gone are the dayswhen stillborn babies were delivered and thenwhisked away before their parents could seethem, in what became known as the rugby pass.

Our Guidelines for Professionals is the referencetext for best practice when a baby dies.Increasingly Sands is recognised as aninternational leader in the bereavement field, andwe have been invited to the Far East, Australia,Africa and Europe to share our model of working.

Every parent whose baby has died wants to knowwhy it happened, and what can be done to stopother parents experiencing the same heartache.Over the years we have heard a growing numberof stories from parents, and more and moreinformation from health professionals, whichstrongly point to the fact that many perinataldeaths are avoidable.

Bereavement sup