House of Lords Preterm Birth Committee report: ‘Reducing risks and improving lives’

Approximate read time: 10 minutes

The House of Lords Preterm Birth Committee was an ad hoc committee established by the House of Lords on 24 January 2024 following the recommendation of the House of Lords Liaison Committee.^[1] The committee’s inquiry was suspended as a result of the dissolution of Parliament prior to the general election on 30 May 2024. However, the committee was reappointed and resumed its inquiry on 29 July 2024.^[2]

The committee’s report ‘Preterm birth: Reducing risks and improving lives’ was published in November 2024. It is scheduled to be debated in the House of Lords on 6 June 2025.

1. Committee conclusions

1.1 Reducing preterm birth rate

One of the focuses of the committee’s inquiry was how to reduce England’s preterm birth rate. Preterm birth is defined as a labour which happens before 37 weeks of pregnancy.^[3] Figures from the Office for National Statistics (ONS) indicated that 7.9% of all births in England in 2022 were preterm births.^[4] The total number of live births in England where the gestation age was less than 37 weeks was 45,020 in 2022.^[5]

The committee concluded that, while most babies born prematurely went on to do well, preterm birth can have significant and often long lasting impacts on babies and their families.^[6] For example, it noted preterm birth had been identified by the National Institute for Health and Care Excellence (NICE) as the biggest cause of neonatal mortality and morbidity in the UK.^[7] Preterm birth has also been identified as a contributor to mortality in childhood. The committee also noted babies who survive preterm birth have increased rates of disability and long-term health conditions.

In November 2015, the then Conservative government announced the national maternity safety ambition—a commitment to reduce stillbirths, neonatal and maternal deaths in England.^[8] The national maternity safety ambition was revised in 2017 to bring forward this deadline to 2025.^[9] The then government also introduced an additional target to reduce the rate of preterm birth from 8% of births to 6%. The House of Lords Preterm Birth Committee concluded the target for reducing the preterm birth rate to 6% in England would not be met noting the most recent figures available suggest there had been no significant fall in the rate of preterm birth since this ambition had been announced.^[10]

1.2 Outcomes for babies and their families

The committee also argued the government and NHS England needed to focus on improving the outcomes for preterm babies and their families.^[11] The committee said it was important to recognise that preterm birth cannot always be avoided and, in some instances, may be the best health outcome if continuing the pregnancy would be a risk to the mother or her baby. It noted preterm birth was “often sudden and unexpected” and that many women who give birth preterm may not have any apparent risk factors.^[12] It had heard from witnesses that many parents of preterm babies spend weeks or months in neonatal units, often in hospitals far from home. The committee argued this experience could have profound psychological impacts as well as presenting practical and financial challenges for parents.

It concluded one of the problems faced by parents of preterm children was the lack of accommodation for parents during neonatal care. It found provision of this accommodation was inadequate in most cases. A further problem the committee identified was that follow-up assessments for children born prematurely were often not being carried out. The committee argued these assessments were vital to ensure that parents could access both emotional and practical support. It also reported it had heard evidence from parents that community healthcare professionals were often unavailable to provide support.

1.3 Disparities in preterm birth rates

The committee noted that many of the witnesses it heard from during the inquiry had also expressed concern about the disparities in preterm birth rates that exist between different socioeconomic and ethnic groups.^[13] The committee described the causes of these inequalities as “complex and interconnected”.^[14] For example, it noted that the preterm birth rate was highest amongst Black babies (8.7%) and second highest among Asian babies (8.1%) in England and Wales in 2021.^[15] The rate in the overall population in 2021 was 7.6%.^[16] It also noted there were disparities in the way national clinical guidance relating to preterm birth was being implemented across hospitals and regions in England.

2. Committee recommendations

The committee noted that, because of the change of government mid-way through its inquiry, its conclusions focused on policies that had been announced by the previous government.^[17] However, it said its recommendations were addressed to the Labour government and that it hoped the report “[would be] of value to the government as it shapes its policy in this important area”.^[18]

It made several recommendations, including that the government and NHS should:

• Set out plans to revise the current national maternity safety ambition. The committee argued these plans should focus on targets that would reduce both the incidence and impact of preterm birth.^[19]
• Focus on decreasing the rate of preterm birth across all women as part of any future strategy for women’s health, in order to address the disparities in preterm birth rates between different socioeconomic and ethnic groups.
• Ensure clinical guidance on preterm birth is implemented consistently across the NHS.
• Fully implement the commitments to develop the maternity and neonatal workforce set out in the NHS long term workforce plan, as published by NHS England in June 2023.^[20]
• Set targets for improving the training available for health visitors, noting the importance of developing specialist knowledge of the needs of preterm babies to support families during the period following their discharge from hospital.
• Publish the findings of NHS England’s maternity and neonatal estates survey which sets out the proportion of neonatal units that are currently available to provide accommodation for all families. The committee also recommended the government and NHS England should set out plans for future investment for parental accommodation on neonatal units.
• Address the lack of consistency in the way in which follow-up assessments for children born preterm are carried out.

3. Government response

The government published its response to the committee’s report in January 2025.^[21] It welcomed the committee’s report, agreeing there were multiple serious issues within maternity and neonatal services which needed to be addressed. It noted these problems included the inconsistent implementation of good practice across the NHS and problems with the suitability of facilities across the maternity and neonatal estate. The government said the report would support “its future work to ensure everyone receives the safe and compassionate care they deserve so they can thrive”.^[22]

Responding to the committee’s recommendations that it revise the national maternity safety ambition, the government said it was currently considering what future ambitions or targets it should set. However, it committed that any future ambition would address the disparity in the preterm birth rate that existed for Black and Asian women and babies as well as for women and babies from deprived backgrounds.

In response to the recommendations concerning improving the maternity and neonatal workforce, the government said it planned to increase the number of trained midwives and health visitors in the NHS as part of its 10 year health plan launched in October 2024.^[23] It also said it intended to “refresh” the NHS long term workforce plan.^[24]

The government noted the committee’s recommendation regarding the provision of parental accommodation in neonatal units. It said improving provision would require additional investment and that this would be considered in the context of the 10-year health plan and phase 2 of the spending review. Chancellor Rachel Reeves announced the total level of funding planned for phase 2 of the spending review would be published in late spring of 2025.^[25] The government also committed to publishing the findings of the NHS maternity and neonatal estates survey “early next year”.^[26]

4. Reactions to the committee’s report and government response

The committee’s report was welcomed by the Royal College of Obstetricians and Gynaecologists (RCOG).^[27] President of the RCOG Dr Ranee Thakar said if the committee’s recommendations were implemented by the government “we would start to see real improvements after a period of stalled progress”.^[28] RCOG has also welcomed the government’s response to the committee’s report, although it said it was disappointed not to see more detailed targets or timelines from the government on reducing the rate of preterm births.^[29]

Bliss, a charity which provides support to the families of preterm babies, also welcomed the report and endorsed the committee’s recommendations.^[30] It said any plans set out by the government in its response should include a commitment to address problems with accommodation in neonatal units. Following the publication of the government’s response, Bliss urged the government to publish the findings of the estate’s review.^[31] It also recommended the government should address the problem of accommodation in neonatal units in the forthcoming 10-year plan.

5. Read more

• House of Commons Library, ‘Quality and safety of maternity care (England)’, 19 February 2025
• House of Lords Library, ‘Performance of maternity services in England’, 18 January 2024

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