THE fight to return consultant care for women and children to Withybush Hospital is kick starting again in light of evidence pointing to an increase in baby deaths.

The Save Withybush Action Team (SWAT) has been out of the public eye for some time but this week has launched a new petition calling for the return of 24 hour consultant led obstetrics, paediatrics and SCBU (Special Care Baby Unit) to Haverfordwest.

SWAT chairman Chris Overton, a consultant obstetrician, said that the removal of the service for Withybush in 2014 has “left the people of Pembrokeshire with an unsafe, inequitable and poorly accessible third class health option for, in particular, mothers, babies and children”.

He has also analysed figures for Hywel Dda’s perinatal outcomes audit 2012 to 2016 carried out by the All Wales Perinatal Survey (AWPS) and The Royal College of Obstetrics and Gynaecologists’ (RCOG) Each Baby Counts initiative in 2015.

However, the health board has expressed concerns that the audit data or methodology was not shared for “validation and verification prior to publication”.

Medical director Phil Kloer assured residents that “obstetric and maternity services across the Health Board area are safe as reflected by the nationally recognised studies to which the Health Board is subject”.

Dr Overton’s review states in 2012 there were seven perinatal deaths, deaths of babies, including still birth, after 24 weeks and first week neonatal deaths, in Pembrokeshire and a total of 16 across Hywel Dda.

In 2013 there were three such deaths in Pembrokeshire, 18 across the health board area. There were four in the county in 2014, of a total of 13, this jumped to nine in 2015 of a total of 19 and then in 2016 there were ten such deaths in Pembrokeshire, and a total of 25 across Hywel Dda.

His analysis also records a three yearly rolling – triennial - average number of perinatal deaths with Pembrokeshire’s increasing from 4.67 in 2012-2014 to 7.67 in 2014-2016.

Antepartum deaths – babies 37 weeks or more – have also increased, found Dr Overton.

He reports that only one death meeting RCOG qualification occurred before service change in August 2014 and four following it.

The number of antepartum deaths overall rose from six in 2013 to eight in 2016 in Pembrokeshire, with none occurring in 2013, four in 2014 and seven in 2015.

He concludes: “Rather than improving outcomes the centralisation of services onto the Glangwili site appears to have had a detrimental effect on perinatal and intrapartum stillbirth rates in Pembrokeshire residents in particular and across Hywel Dda as a whole.”

He is calling on people to get involved and download the petition via the SWAT Facebook page.

Hywel Dda’s Dr Kloer added: “Hywel Dda University Health Board routinely collects and monitors data on all births (including rates of perinatal mortality and intrapartum stillbirth) for both local review and submission to a number of Wales and UK wide surveys including the nationally recognised AWPS (All Wales Perinatal Survey) and the MBRACCE (Mothers and Babies: Reducing Risk Through Audits and Confidential Enquiries Across the UK) perinatal mortality surveillance report. Latest available data from both reports demonstrate perinatal mortality and intrapartum stillbirth rates in Health Board area compare favourably with other UK units of comparable birth numbers.

“We are concerned with the publication of an audit via social media during the weekend which suggests that the reconfiguration of obstetric and maternity services across Pembrokeshire and Carmarthenshire in 2014 appears to have had a detrimental effect. There are significant discrepancies between the data reflected in this audit and the validated data available from within the Health Board.

“The audit appears to utilise historical data to inform future predictions regarding perinatal mortality rates in the coming years. In contrast to the conclusion offered by the audit, the latest AWPS report confirms that the specific cause of perinatal mortility nationally cannot be attributed in approximately 50% of cases. Furthermore, more detailed assessment of Health Board data highlights that changes in stillbirth rates in the past 2 years primarily relate to the antenatal period and not the place of birth or residence. Antenatal care provision in Hywel Dda has remained unchanged since 2014 and continues to be provided locally in each county in accordance with NICE and Antenatal Screening Wales (ASW) standards.

“The audit was conducted by one of our former permanent Consultant Obstetricians who did not share the audit data or methodology with the Health Board for validation and verification prior to publication.

“In its 2015 review of the impact of changes to maternity, neonatal services and paediatrics in Hywel Dda, the Royal College of Paediatrics & Child Health stated ‘we did not see evidence of any worsened outcomes in maternity or paediatric care as a direct result of the reconfiguration’.

“Most importantly, we wish to reassure our local public that obstetric and maternity services across the Health Board area are safe as reflected by the nationally recognised studies to which the Health Board is subject. Our staff continue to participate in a number of national initiatives designed to reduce the incidence of stillbirth and we would encourage any women who may be concerned by the publication of this audit to contact their midwife.”