Data released by the Office for National Statistics (ONS) this week emphasises the urgent need for system-level changes in England and Wales to save more babies’ lives and tackle inequalities in pregnancy and baby loss.  

In England, the neonatal mortality rate was 1.4 per 1,000 live births in 2024 for babies born at 24 weeks or over. This rate remains unchanged since 2023 and there has been little progress over the past decade to reduce this rate. The data show that the government is highly unlikely to meet its target of 1.0 neonatal deaths per 1,000 live births by 2025 for babies born at 24 weeks or over.  

Although the target only includes births after 24 weeks’ gestation, lowering rates of extremely preterm birth is vital for reducing the number of babies that die shortly after birth. Over a third (39.7%) of neonatal deaths in 2024 were among babies born before 24 weeks of gestation in England and Wales. 

The stillbirth rate in England was 3.8 per 1,000 total births in 2024, a slight decline from 3.9 in 2023 but the same as the 2019 rate, showing little progress over the past five years. The rate is also significantly higher than the 2025 target of 2.6, which the government is now unlikely to meet.  

There has also been little progress to reduce baby deaths in Wales. The stillbirth rate in 2024 was 4.4 per 1,000 total births, an increase from 4.0 in 2023.  The neonatal mortality rate for all gestational ages was 2.7 per 1,000 live births in Wales, with little change over the past four years. 

We have previously called for the UK governments to set new ambitions to reduce perinatal mortality and preterm births, focused on matching the best-performing countries in Europe. Achieving these ambitions will require a comprehensive policy strategy to improve the quality and safety of maternity and neonatal services as well as a cross-government approach to tackle causes of health inequalities. 

The data continue to show stark and persistent inequalities by ethnicity and deprivation. In England and Wales in 2024, the neonatal mortality rates for all gestational ages among Black African and Black Caribbean babies (5.2 and 5.4 per 1,000 live births respectively) were over double the rate among White British babies (2.3 per 1,000 live births), with similar disparities for stillbirth rates. 

In England, perinatal mortality was higher among babies from the most deprived areas, with neonatal mortality among those living in the most deprived areas (4.3 per 1,000 live births) double the rate among those from the least deprived areas (2.1), with a similar disparity for stillbirths (2.5 per 1,000 total births in the least deprived areas compared to 4.7 in the most deprived areas). While the difference in rates between the most and least deprived has remained the same for stillbirths and slightly decreased for neonatal deaths, concerted effort is still required to eliminate these unacceptable disparities. 

There is widespread agreement on the need for fundamental changes to improve the safety of maternity and neonatal services and save more babies’ lives. A national assurance assessment of maternity and neonatal care and services in Wales was recently published, and Baroness Amos’s Maternity and Neonatal Investigation in England will publish its findings next month. In England, the National Maternity and Neonatal Taskforce will be responsible for translating the recommendations into a national action plan. We hope the investigation and taskforce recognise the scale of the challenges facing services and  design and implement the system-level change that is so desperately needed.