Infant Mortality on the rise.

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.

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.

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.

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/

Thanks Wyllow. I trained as a HV after midwifery, and it saddens me to see the decline in HVs along with midwives and nurses in primary care, where I was an integral part of my local team.
Other stats such as the increase in particularly under one’s but also under four year olds attending A&E in the last 10 years is startling. Many apparently not found to be ill, but mainly there for reassurance.

Ashcombe

*growstuff*: I imagine that removal of lower garments would be necessary in order for a scan to be conducted or the bump measured to check that growth was in line with the number of weeks of the pregnancy.

I never had to remove my lower garments for scans or measurements. Pull down to give access to the bump but never below that.
Obesity and smokingg being risk factors, it is very rare for women of Pakistani heritage ( or Indian or Bengali) to smoke or drink unlike many British women, obesity doesn't seem to be a problem amongst children of childbearing years either
What the article says is that areas of deprivation have 3 times the rate against the least deprived. That's a big difference.

Another factor that worries me is the lack of support after a mum gets home from hospital, back when I had my babies you had midwife visits for 10 days, now nothing like that, mums have to go out to clinics which is all well and good if you have access to a car or can afford a taxi, but expecting a mum to go out after a c section when she should be home recovering and establishing feeding.If you can't you have to fight for a visit.
And if a mum cant addo rd to feed hereditary won't be able to buy formula, thankfully mums even when poorly no He used can produce enough mil!, fh e.g. may need to feed mode often , but her body prioritised the baby

Why do I keep reading that child benefit is capped at two children.
It isn't. Child benefit is paid for all children.
The benefit that is capped is the rising of universal benefit over the 2nd child limit.
Universal benefit used to be paid per head in a family but now only includes 2 children.
Child benefit is not affected.

Women do need to be examined thoroughly at antenatal clinics to ascertain that they are actually pregnant, can give birth naturally, amongst other things, and to ascertain the size, position and growth of the fetus/baby in the womb etc.

oodles

Another factor that worries me is the lack of support after a mum gets home from hospital, back when I had my babies you had midwife visits for 10 days, now nothing like that, mums have to go out to clinics which is all well and good if you have access to a car or can afford a taxi, but expecting a mum to go out after a c section when she should be home recovering and establishing feeding.If you can't you have to fight for a visit.
And if a mum cant addo rd to feed hereditary won't be able to buy formula, thankfully mums even when poorly no He used can produce enough mil!, fh e.g. may need to feed mode often , but her body prioritised the baby

Ahem! I suspect that's been the case for a long time. My daughter was born in 1992 and I had one post-birth visit. Nobody visited me after my son was born in 1997. Both births were C sections. I was discharged the day after birth when my son was born.

SparklyGrandma

Women do need to be examined thoroughly at antenatal clinics to ascertain that they are actually pregnant, can give birth naturally, amongst other things, and to ascertain the size, position and growth of the fetus/baby in the womb etc.

Women don't need to remove their underclothes for most of those procedures

Can we please put aside the daft notion that Asian women are somehow responsible for poor outcomes because of cultural norms around modesty? Like Farzanah I practised in a city with large proportions of Asian and black Caribbean and African women: with culturally sensitive care any difficulties are easily overcome
BUT asGrowstuff pointed out upthread , other factors are at play. These same ethnic groups have far worse maternity outcomes than their white counterparts and are far more highly represented in investigations into sub optimal NHS care. The link below explains further. It makes sickening reading

www.theguardian.com/commentisfree/article/2024/jul/25/the-guardian-view-on-maternity-care-failings-black-women-and-babies-are-hardest-hit

One big difference is trust I feel.
It started in the 1980s I think with the change in focus of midwifery. And I don't mean the individual midwife I mean the medicalisation of childbirth - there are lots of studies on this. The personal midwife who you saw at each visit and learned to trust was gradually eroded until midwives worked in teams and the pregnant woman never saw the same person twice.
The outcomes dropped at that point and in spite of reviews and studies always showing better outcomes with continuity of care The funding has never matched the need.

If the "harder to serve" mums always saw the same midwife I'm sure that would help!

No... most definitely not blaming midwives BTW!

Long long ago in the early 70s, the family allowanc as it was known then, wasn't paid for the first child. I thought I had won the pools having twins after my daughter, wo family allowance at once. Can't recall anyone moaning about it being unfair not being paid for first child. No baby boxes either.

Should read ; two family allowance at once.

Nanny27 Thank you for your correction on child benefit. I thought David Cameron brought in a two child cap on child benefit but clearly having checked, that is wrong.
However what seems to be even worse morally is that universal benefit is capped at two children. This isn’t making sense to me. Surely families on universal benefit are financially struggling?

My children were born in the 70s and had absolutely no visits from midwifes or health visitors. I had to go to local clinic.

Yes it was 90p a week in 1974 when DD2 was born, I was thrilled.
It’s strange to think we were apprehensive about the HV coming round and because the new grans weren’t at work they were on hand as well. What a different world.

That is a good article Calipso and indeed racism is another factor identified by Ockendon,, sometimes not only suffered by the patients but also by the staff I’m afraid.

If the "harder to serve" mums always saw the same midwife I'm sure that would help!

A fair point NotSpaghetti but only if that same midwife delivers a high standard of care.....
If you read the Guardian article that I linked above you'll see how racism and poor institutional culture has a shocking impact on maternity outcomes. Who can blame women for not engaging with care when they are failed so miserably?

Pregnant mothers living in poverty experience much higher levels of stress and anxiety than those living comfortably. It's not a time of balloons, congrat gifts and parties for those facing an uncertain future.

People have babies, even oopsababies, because sex is a human passion.

I had a home birth back in the 70s. Had a lovely midwife who took another job towards the end of my pregnancy. Sad but she handed me over to another lovely midwife who I saw a few times. Unfortunately her husband had a heart attack a few days before baby decided to arrive so I met the midwife who delivered my baby a few hours before he was born. Best laid plans and all that.

Also, sazz, although I understand your point about the link between poverty and poor diets in pregnancy, I would challenge the idea that a vegetarian puts her baby at risk.
I am a vegetarian mother of four healthy adults and grandmother to healthy children born to vegetarians.

Yes. Chocolatelovinggran
Vegetarian mother to 5 healthy babies here 8lb 7oz to 11lb 13oz
...and grandmother to 8 (5 born to vegetarian mums)

I think it depends on your diet, just as it does if you are an omnivore!

I am definitely blessed though.
And have always been able to eat well (even in the days when I had to turn the sofa over looking for bus fares!).