Infant Mortality on the rise.

The shortage of Midwives and health visitors.

Great article January 2024 here includes

\'There is a national shortage of around 5,000 health visitors in England and families face a postcode lottery of support.

79% of health visitors said that the health visiting service lacked capacity to offer a package of support to all children with identified needs.

Only 45% of health visitors were “confident” or “very confident” that their service was able to meet the needs of vulnerable babies and children when a need is identified.

80% of health visitors said that other services were also stretched and lacked capacity to pick up onward referrals for children with additional needs. Thresholds for children’s social care support had increased and other services had long waiting lists.

ihv.org.uk/news-and-views/news/health-visitors-raise-the-alarm-as-more-families-struggle-with-poverty-and-poor-health/

mum2three

Do they mean at birth or infant death syndrome? A midwife told me that Asian women refuse to remove their underclothes at the ante-natal clinic. This means it's impossible to examine them properly and any problems go undetected.
Sorry to sound heartless, but if people cannot afford to take care of their children properly, why have them?
There are more and more cases of child cruelty, which doesn't come to light until the child is killed. Is this a reflection of social care failings? Are there no health visitors any more?
It sounds as though this is another area where cutbacks have caused children to suffer.
It's time this country got its priorities right.

I was a midwife in a predominately Asian area, and delivered many Asian babies. As previously stated there isn’t usually any need to remove underwear at ante natal visits. When women did need to undress they did so and I never encountered such a problem, ever.

Infant deaths are under one year. The most notable statistic associated with infant deaths is a much higher rate of deaths in the most deprived areas, and lower in the least deprived. This is preventable in a relatively rich country, and no we haven’t got our priorities right.

Whatever the cause of an increase in infant mortality, it can hardly come as a suprise. Many people, including pregnant women cannot afford to feed or clothe themselves properly any more, or heat their homes properly.

I assume that amongst those worst off, any vitiamins or other supplements, or even a reasonable amount of milk suggested by a midwife or obstetician to expectant mothers is not something they can afford, so babies may well be weaker at birth.

Poorly heated homes in autumn and winter are likely to have an effect too, as is the forementioned inability to afford proper food - mother's milk is likely to be in short supply, and can poor families afford powdered baby milk?

Yes, blame smoking alcohol, drugs or obesity if you like, but I doubt there is a signifcant rise in families with these problems.

Elegran

The ethnicity and the culture from which first or second generation immigrants have come influences their attitudes to first-cousin marriages as well as to their take-up of pre- and peri-natal medical attention. A combination of thsese factors could affect the data in some areas (eg Birmingham) which itself could have an effect on the national average.

Mentioning that is not focussing on Asian women (or "getting at them" which is implied by people who object. It is pointing out one of the factors that could predispose a section of the community to the damage or deaths of newborns.

It is not either a reason to do nothing. Clearly there is a need for more contact with some pregnant mothers, in a setting where they will understand the language used and feel welcomed and included. This includes a wider demographic than just the "Asian women".

I agree with you, but that doesn't explain why the group with the highest infant mortality rate is Black Caribbean or African.

Clearly genetics is one factor (which is why - especially in the US - Ashkenazi Jews are offered genetic counselling), but other factors include sociological and socio-economic.

It's nothing to do with the 2 child benefit cap. People who have kids choose to have them so should pay for them.

Sick of everyone living off the tax payer.

But it's on the rise because of many factors no doubt. Sad statistic all the same esp in a G7 country - 5th richest in the world. The tory government should hang its head in shame. We hardly have a functioning health care system anymore 🤬

This is a long read (and I confess I've only skimmed through some of it), but it's interesting:

raceequalityfoundation.org.uk/wp-content/uploads/2024/02/ZOI231630-2.pdf

It suggests that some ethnic groups are reluctant to engage with ante-natal services as a result of negative perception. There's no 'one fit' simple solution.

I think it may be linked to poor diet, caused by poverty, vegan, vegetarian and religious diets, where vitamin deficiency has not been tested for or addressed during pregnancy

The ethnicity and the culture from which first or second generation immigrants have come influences their attitudes to first-cousin marriages as well as to their take-up of pre- and peri-natal medical attention. A combination of thsese factors could affect the data in some areas (eg Birmingham) which itself could have an effect on the national average.

Mentioning that is not focussing on Asian women (or "getting at them" which is implied by people who object. It is pointing out one of the factors that could predispose a section of the community to the damage or deaths of newborns.

It is not either a reason to do nothing. Clearly there is a need for more contact with some pregnant mothers, in a setting where they will understand the language used and feel welcomed and included. This includes a wider demographic than just the "Asian women".

theworriedwell

Thanks for that information Galaxy. Very encouraging.

It would be interesting to find out how that happened Galaxy and theworriedwell
It wouldn't surprise me if an increased take up of support and monitoring services for pregnant women made a substantial difference (ie detecting problems in advance as well as health advice). But as Elegran said, ""it needs the active co-operation of patients".

My dd has worked as a junior medic in Obs. Her ‘takeaways’ are that there are more pregnancies that are high risk due to obesity and older first time mothers. Also in some areas consanguinity is an issue.

I do wonder if the poor state of our maternity services contributes. We only need look at the East Kent, Nottingham and Lake District hospitals for evidence of poor care of mothers and babies.

In 2021 Birmingham council produced a report that showed 7 in 1,000 babies died before their first birthday, the national average is 3.9.
All these deaths ( in Birmingham) were related to first cousin marriages.
Nazir Afzal comments in the linked article. He is very vocal on this contentious subject.

www.birminghammail.co.uk/news/midlands-news/silence-must-end-call-action-20348860

Thanks for that information Galaxy. Very encouraging.

The number is decreasing I think, the studies I am aware of were in Bradford.

Tragic if that is avoidable. Do we need more education about it or ultimately legislation to protect the unborn.

Yes they are.

Aren't cousin marriages an issue with some genetic problems? I don't think it is much of an issue as a one off but repeated for generations the danger mounts up. At least I think that's how it works.

Elegran

A rise from 3.8 to 3.9 per 1000 is a rise of 0.1 per 1,000
This is one child per 10,000 births.

The article mentions obesity and smoking as risk factors. in addition to having Black Caribbean/African or Asian Pakistani ethnicity.

What proportion of UK births are to people of these ethnicities migrating to the UK from countries where they are under stress from wars, poverty, officialdom, or lack of pre-natal care, and are also likely to be youngish and more likely to be having children? They may also be less likely to make full use of the pre- and peri-natal services available.

Smoking and obesity can be only partly minimised by official policies, advice and support clinics. They also need the active co-operation of the patients concerned.

Let's not just focus on 'Asian' (ie Pakistani/Bangladeshi) women, who are some of the least likely people to be obese. There are obviously a number of risk factors, some of which might overlap. One of the reports already cited states one of the biggest causes is some kind of congenital/genetic abnormality, about which there's little people can do.

Starmer does not seem to agree with universal benefits, as indicated by the removal of the winter fuel allowance for all but the poorest pensioners.
The idea that we all contribute to the welfare state and we all benefit from it is not one that he seems to share, as indicated by his casual dismissal of the WFA, as a "badly designed policy", which he knew was introduced by Gordon Brown.

It is not actual child benefit that is affected by the cap. It is the level of social security a family can receive. Social security used to be based on need. It is now based on some arbitrary figure decided by the last Government and continued by the present Government. The link between the needs of a family and the welfare state has been broken.

Maybe the Labour government doesn’t want to increase child benefit beyond two children families because richer parents will also benefit. It feels a repeat of the WFA removal but in that case those on pension credit remain eligible. Perhaps a similar system needs to be applied to the poorest families? Or was the argument back in the day that poor people only had children to claim child care?

Jeanathome

A baby born into a poorer area is almost 3 times more likely to die than one born into a wealthy area.

I don't think that's connected to Asian women refusing to remove clothing (?) or young people not wishing to have children.

Of course it isn't related to Asian women. It is, as you infer, related to poverty.
Does the Government want to reduce child poverty? Well, perhaps, but not yet. At present they have made it very clear that those MPs who would like to help children NOW are not welcome in Starmer's party.

Personally I think housing and education are both big issues we need to address.

And I think it would be impossible not to say the NHS is in a mess.

The info shows that 15% of infant deaths caused by deprivation are attributable to being born preterm. - so if people are not getting prenatal medical support, help with smoking cessation and proper nutrition I would think babies are more likely to be preterm.
Some years ago there was a project locally that was extremely successful in reducing smoking. It had small but still significant financial rewards and held regular meetings. It was funded by the last Labour government. I don't know if anything like that is still available.

Also, most women (even when pregnant) put themselves last if there's not a lot of food in the home. They will sacrifice themselves for the rest of the family.

This is just my thoughts.
I hope we get some truly excellent data to know for sure what's possible to fix.

Yes and it's quite a complex picture even through the lens of the guardian.

A rise from 3.8 to 3.9 per 1000 is a rise of 0.1 per 1,000
This is one child per 10,000 births.

The article mentions obesity and smoking as risk factors. in addition to having Black Caribbean/African or Asian Pakistani ethnicity.

What proportion of UK births are to people of these ethnicities migrating to the UK from countries where they are under stress from wars, poverty, officialdom, or lack of pre-natal care, and are also likely to be youngish and more likely to be having children? They may also be less likely to make full use of the pre- and peri-natal services available.

Smoking and obesity can be only partly minimised by official policies, advice and support clinics. They also need the active co-operation of the patients concerned.

The National Child Mortality Database (NCMD) is the first of its kind anywhere in the world. It records comprehensive data, standardised across a whole country (England), on the circumstances of children’s deaths.
It didn't start till 2016 so I expect yhe patterns are only emerging over the last couple of years.