Health inequalities are embedded before birth, according to new report

Babies are being harmed before parents even conceive them, a new independent report for NHS Glasgow and Greater Clyde has warned.

Difficulties developed in utero can lead to birth defects, speech and language problems and poor health outcomes in later life.

According to the report by former policy director at Children in Scotland Jonathan Sher, decisions to have children are often “unspoken conversations”, and by the time parents first contact health services many of a baby’s life chances have already been affected.

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Using evidence from international research, Sher said would be parents would benefit from regular advice about stress, tobacco, alcohol and obesity when it comes to family planning.

Those who wanted to avoid a risky pregnancy would then delay it, he suggested.

A greater emphasis is needed on women’s health and wellbeing, he said, “whether or not a woman ever becomes a mother”.

Rather than imposing on parents, he said it would “inform and empower” them.

“Many women wait to start any steps toward preparation until after the pregnancy test, or after the booking visit or even until after the initial ultrasound scan. At that point, ‘detoxing’ or initiating healthy habits is doing the right thing... but not at the optimal time. In some cases, ‘better late than never’ simply does not apply,” Sher said in his report.

A spokesperson from NHS Glasgow and Clyde said the report should be seen in the context of “stubborn” health inequalities in the region.

“The report highlights the importance of this issue. At present there is no international evidence of effective interventions that improve pre-conception health of both future parents, the pregnancy outcomes and the health of the child,” she said.

Sher has used the example of Kirsty, the Holyrood baby, of how policy makers and services can empower parents to give their children better life chances.

“While individual choices are crucial, it also is the case that larger societal forces, political choices and structural issues can powerfully shape what is true for individuals and couples,” he said.