Guest post: "Why aren't we up in arms about the UK's stillbirth rate?"
Posted on: Fri 12-Feb-16 16:48:59
(33 comments )
A stillbirth is every mother's worst nightmare - and Britain has a poor record. More than 3,500 babies are stillborn in Britain every year - that's more per head than in other European countries including Poland, Croatia and Holland.
These alarming figures have just come to light and will be published by the Office for National Statistics later this year. But what is really shocking is how easily so many of these tragic deaths could be avoided, just by doctors, hospitals and midwives following procedures and guidelines that are already in place. The most important change that could be made to reduce stillbirths would be listening to mothers who say that their baby is moving less (or not at all) in the later stages of pregnancy, and taking their concerns seriously.
The Sunday Times Safer Births Campaign is calling for a 60% reduction in stillbirths, which experts say could be achieved by applying basic care guidelines on monitoring and intervention, and the presence of a consultant obstetrician in all maternity hospitals. If you think this should be every family's right, please sign our petition at change.org.
But first read this incredibly moving piece by Judith O'Reilly, a former colleague of mine, who went through this terrible ordeal.
My baby son's body lies in a tiny white coffin in an Essex churchyard, where we buried him 16 years ago. A whole life. A future taken away before he drew breath.
Among the words certain to bring me out in a cold sweat is "stillbirth". Another trigger is "dead" attached to "baby", "son" or "child". There's a theme, you see.
I should have a 16-year-old wandering round the house, watching YouTube videos and stress-eating to cope with his GCSEs. Except I don't.
I don't, because my baby son's body lies in a tiny white coffin in an Essex churchyard, where we buried him 16 years ago. A shocking thought. To me, anyway. But stillbirth is like that. Shocking. A whole life. A future taken away before the child draws breath.
When I see the UK has a higher rate of stillbirths than countries with a less developed healthcare system, I wonder what is going wrong.
What is Iceland doing right to have the lowest rate of stillbirth among 186 countries? What changes are being made in Holland, where between 2000 and 2015 there has been an annual decrease in stillbirths of 6.8% compared with our measly 1.4%? Why aren't we up in arms? Are we such fatalists that we bury our babies and think, "That's life for you," and "Is it Call the Midwife tonight? Put the kettle on, will you?" My son died in utero two days before his due date. I enjoyed a good pregnancy — ate organically, quit drinking, took up pregnancy yoga, avoided blue cheese, prawns, liver and bad influences. I bloomed with happiness.
The only problem: I could not sleep. One night, though, I slept well and late. Almost at the moment of waking, I realised the baby was not moving. I had a hot bath, ate vanilla ice cream — an instinctive part of me already knew, but the rational woman decided I was wrong. Because I had to be wrong.
At Guy's Hospital in London, the room was dark as the midwife swept my pregnant belly for the heartbeat on the ultrasound machine. I waited for the grainy pulse, for the baby to move. In vain. She called in a more experienced colleague and my husband gripped my hand. Terror. Fear. Think of your worst nightmare. Then double it.
A woman with a kind face and efficient manner arrived. Silent, she watched the screen as she moved the scanner over my stomach, pressing it to find a scrap of life and finding instead death, horror and desolation.
When she left us, I sat up awkwardly on the bed and my husband wrapped his arms around me. Screaming, I held on to him in the darkness. I know the exact sound a heart makes when it breaks — it sounds like a wolf. Both of us heard it.
Judith O'Reilly is a writer and former education correspondent for The Sunday Times.
By Judith O'Reilly
Heartbreaking, absolutely heartbreaking.
This is something very important to me. My son was moving less and I was ignored, and very narrowly avoided a stillbirth. He ended up very ill on a ventilator because of it, and we are the lucky ones.
to anyone affected by this, it is very upsetting
Very sorry to hear these stories.
Just to let you know that something is happening (sorry about the photo) www.gov.uk/government/news/new-ambition-to-halve-rate-of-stillbirths-and-infant-deaths
People are up in arms about this, and people are directly campaigning and introducing things to make a difference.
It is the intent of this charity to bring our stillbirths down rapidly
Judith I'm so so sorry to hear your story. My heart goes out to you
I read Judith's article in last Sunday's Times .While I have every sympathy for her and her partner and it well illustrated the agony of a still birth ,the main article was calling on government to improve maternity services and is worth reading.I have written to the paper suggesting they focus their campaign on persuading the government to provide more beds and more midwives .
Heartbreaking. This is a brilliant campaign and I'll be signing the petition. Has anyone else's experience been that in the last weeks of pregnancy you are left to fend for yourself a bit? My last few midwives appointments were always optional "if you feel you need to see us" which have the impression of "don't bother us, this is the easy bit". You don't have scans, you might wee on a chart but essentially it's a countdown to d day rather than a period when you still need 'active care'. I wonder if the message during the last trimester was more "your health in these last weeks is of the utmost importance to us" and you had absolutely more midwife appointments, meetings, more pregnancy health "tasks" then it would empower women to be more proactive about seeking attention if there is a change. I did feel, with all three of my pregnancies, that my low risk status made me a bit of an admin burden and I didn't feel confident asking for more attention from my over worked midwife.
Sorry to add: I am very lucky to be low risk, it was more whether we ARE quite fatalistic about pregnancy and birth after the initial anomaly scans.
Thanks for the support (both personal and for the campaign). Too many of these tragedies are considered "one of these things" and all part of 'the mystery of childbirth'. Research/investment/a change in attitudes is long overdue.
I'm sure I read somewhere that France has a standard later scan after the 20 week anomoly scan specifically to pick up placental issues. (I know stillbirth is not always linked to placental issues)
I remember reading the sands leaflets we were given after loosing dd2 and being horrified at the stillbirth rate in the uk.
My dd2s death was utterly unpreventable (we had a tfmr after a T18 diagnosis). I cannot imagine the pain of dealing with the death of a baby that is unexplained or possibly preventable.
They need to be testing for group b strep as standard as most other countries do too.
The death of my nephew at birth was entirely avoidable.
This utterly heartbreaking.
A late scan at, say 37 weeks, can help identify a failing placenta. I paid for this privately each time.
I'm so so sorry for your loss, Judith. My heart broke for you reading that.
I'm in France and had a final scan at 33 weeks. I'm quite shocked that you don't have one later than 20 weeks in Britain.
The Royal College of Obs and Gynaes started their campaign to reduce stillbirth, neonatal death and brain injury during labour in Nov 14. Love to everyone affected by the loss of a baby, i lost my son at term nearly 8 years ago (random true knot) www.rcog.org.uk/en/guidelines-research-services/audit-quality-improvement/each-baby-counts/
When pregnant in France, you have monthly blood tests where they check for various dangerous infections as well as certain markers for dangerous conditions at each stage such as preeclampsia. This became useful in the last trimester of both pregnancies, when uric acid started rising in my blood and I was hospitalised for a while. We also knew through monthly blood tests that I didn't have HIV, was immune to rubella, and did not get toxoplasmosis Hepatitis B at any point of the pregnancy.
You have monthly appointments with the doctor (obstetrician) who follows you. I am surprised to hear from friends in the UK that they have not seen a doctor at any point, and that a midwife feels their bump in the last months of their pregnancy and passes judgement about the size and presentation of the baby (breech, head down etc).
I had a scan in the 8th month of pregnancy with each baby where size, presentation, possible problems etc were checked.
As DC1 was quite large (over 4 kgs), I had a pelvis scan to see if she would be able to pass through my pelvis, with all measurements including baby's and mine.
I was sad to hear that a friend's baby was born with Hep B in London and this was only realised later because she had no blood tests during pregnancy to check for it. Here in France, if a pregnant women tests positive for Hep B, the baby would be born via c-section and vaccinated at birth.
In France, babies are also closely followed by their paediatrician who checks the baby while in hospital (baby can't leave hospital without first getting an OK from her paediatrician) and then every month for the first year. Visits then become once a year. Each baby gets a "Carnet de Santé" at birth, which is then filled out during these visits with the paediatrician - height, weight, hearing tests, vaccinations, various motor skill controls etc. Many problems are picked up during these visits with the paediatrician - one picked up cancer in the mouth of a friend's baby which was then operated on. This contact with the paediatrician continues through the life of the child. DS was 5 when both of her eyes quickly swelled up the night before we were to fly to another country. I texted a picture to his paediatrician to ask if I needed to seek emergency help before leaving.
Again, I learn from friends and family that this sort of follow up is unheard of in the UK. To the contrary, I hear stories of how concerned parents are fobbed off by GPs who, to be fair, are not specialised in the care of babies and children and so cannot be expected to understand the gravity of some situations. GP in UK told another friend that her baby is perfectly fine despite being non-verbal and not walking at 18 months. She saw a paediatrician in the US when on holiday there, who said there are serious red flags. Now back in London, they saw a neurologist who saw reason for concern and they are now doing genetic tests.
In all, there seems to be a lot that can be improved in the UK re care of babies in the womb and after birth.
Cote-is that state funded health care or do you have private medical insurance?
I lived in Belgium and the situation is the same as Cote described there as well. All women have a gynaecologist they see privately throughout pregnancy and very thorough checks (too thorough in my opinion, Ie internals at every visit, but I suppose erring on the side of caution is certainly better than the opposite). It's paid for through 'mutualite' which is a form of insurance part funded by the state and the rest by the individual (I think) and at a very reasonable low rate. It is a great system.
I think it's a good balance between the NHS model of free at point of care and the system we have here in Ireland where you have to have private insurance at high cost or go public where there are long delays in accessing most treatments and a trip to the GP costs €50..... This way the majority of people pay a small amount quarterly and are able to access care as needed with a small top up for certain treatments/visits depending on ability to pay etc
State-funded if you go to a state hospital. I did and all I paid throughout pregnancy & birth was my amnio (which I demanded although dr thought was low-risk) and the visitor's bed in my room for my mum.
If you go private, state pays what the same procedure costs at at state hospitals. You get the rest from your complementary insurance (called mutuelle.
Am I the only person who sees no reason for a non complicated pregnancy to be overseen by an obstetrician, and no reason for a healthy child to be overseen by a pediatrician?
My sister in law, who comes form Spain still uses the fact that I was allowed to give birth vaginally to my over 10 pounder as a stick to beat the NHS with, despite the fact that it was a)what I wanted to do and b) was a completely straightforward no problems labour and birth. She genuinely thinks that I should have had no option but a Caesarian and that I received negligent care.
I'm sorry- now I have read the thread properly, I realize that my last post was inappropriate for this particular thread. Please ignore- or I will ask for it to be removed.
Bert I think I agree. A low risk pregnancy seems a bit of a waste to be overseen by an obs.
However, I think there is a middle ground between the very thorough care of France and here. My dad is still amazed that you get a 20 week scan and then nothing.
My dd1 had a shoulder dystocia at birth, I think it was fairly minor and there were no major side effects however it could have been a very different story.
I will now be having regular growth scans under the nhs (partly because of my anxiety after dd2 but also because of dd1s size at birth) and will be having a late positional scan to make final decisions on birth.
I'm surprised that there isn't a later scan or more thorough medical exam a bit further on in pregnancy.
I think the whole point of the thread is that you don't know if a child is healthy or if a pregnancy continues to be low-risk without regular check-ups done by a doctor and proper diagnostic scans.