The principle
No Breath Required is calling for a route to independent coronial investigation where concerns arise following a stillbirth.
The ability to examine serious concerns about care should not depend on whether a baby showed signs of life after birth.
The same harm should result in the same access to justice.
Where questions exist about the circumstances surrounding a stillbirth, those questions should be capable of independent judicial scrutiny.
Why independence matters
When a baby is born alive and later dies, concerns about the circumstances can be examined through an independent coronial investigation.
But where a baby is stillborn, families are currently denied access to that same independent process.
Instead, concerns are typically examined through healthcare-led reviews or national investigations. In some cases, the only investigation available to families is carried out by the same NHS Trust responsible for providing the care in question.
These processes may identify learning or make recommendations, but they do not provide the same independent judicial scrutiny as a coronial investigation.
For many families, this raises a difficult question: why should the circumstances surrounding the death of their child be treated differently simply because a baby did not take a breath?
The current threshold
Under the current framework, the threshold that determines whether a death can be independently investigated is not whether a baby was capable of independent life.
Instead, it depends on whether signs of life were observed after birth.
In practice, this means that two very similar circumstances may be treated very differently depending on whether a baby took an independent breath.
Families may therefore be denied access to independent investigation either because a baby did not take a breath after birth, or because a death occurred before an arbitrary but survivable gestation.
In England and Wales, stillbirth is legally defined from 24 weeks of pregnancy. Babies born at or after this gestation may be capable of surviving outside the womb with medical support, and significant numbers of babies born at later gestations such as 34, 35 or 36 weeks survive.
The campaign believes that where serious concerns arise about the circumstances of a stillbirth, those concerns should be capable of independent investigation regardless of whether a breath occurred.
When an investigation could take place
The campaign is calling for a system in which a coroner could investigate the circumstances of a stillbirth in certain situations.
These may include cases where:
• there are concerns about the care provided during pregnancy or labour
• parents have concerns about the circumstances of the stillbirth
• the stillbirth was unexpected
• clinicians or healthcare organisations identify serious concerns about the care provided
In such cases, a coroner could consider whether the circumstances warrant independent investigation.
A proportionate change
The campaign is not calling for every stillbirth to be investigated by a coroner.
Rather, the proposal is that where concerns arise, there should be a clear route to coronial investigation.
This would ensure that where serious questions exist, they can be examined through a process that is independent of the healthcare provider involved.
The aim
The aim of this change is straightforward.
Families should not be denied access to independent scrutiny simply because a baby did not take a breath after birth.
For families seeking answers, the circumstances surrounding the death of their child should be capable of independent examination.
In that sense, the campaign is advocating for access to justice with no breath required.
To understand the legal framework and how this gap arose, see the law.
To follow the timeline of delay and decisions, see the timeline.
Use the template letter to contact your MP.