Spike in stillbirths caused by lockdown

@LimpLettice

Sounds like a totally shit experience.

Mine was similar, apart from OH being kicked out after birth, and mine was 19 months ago so they can’t even blame covid for the shit show treatment.
I have a heart condition so should be consultant led- didn’t see a doctor once during my labour as the ward was so busy!

This doesn't surprise me either. I gave birth at the end of July after a fairly complicated pregnancy and much as they tried a lot of care was diminished. I had the same condition in 2018, where much was made of the risks and need for lots of care. This time during lockdown, the condition was much more severe, but most of my care was simply cancelled. I saw my community midwife once, consultant twice. Scans were cancelled (altho some were reinstated as I progressed) and replaced with the offer of a tape measure. The birth itself was a shambles, and after an extremely traumatic delivery DH was chucked out after 40 mins. So I was wheeled up to post natal in a right state and just left.

I spoke with a woman on a rare spot in the waiting room who had suffered a stillbirth the year before and was supposed to be having weekly monitoring from about 32w but that had all been cancelled too. I think of her often. Hope she was ok.

I have noticed a number of threads/posts from women being told they can't be seen/assessed for issues that, back in my day, (1980s) would have made us tell them to come and be checked out. Things like obvious signs of pre-eclampsia, prem labour, DVT/PE, all told not to get checked but wait and see.
I have a fairly serious, chronic condition myself and haven't seen my consultant for a year. It is scary.
What is the point of having a system of antenatal care, developed over years of researching best practice and outcomes, if it all just goes out the window?
It should be possible to keep basic care going, given that hospitals actually aren't that busy and GP surgeries are very quiet too.
Many things can be dealt with by phone and video but antenatal care really isn't one of them.

Thats sad to hear @Dontbelonghere, although its not surprising the powers that be dont really care. Ive found in my trust, just about third trimester, that the community midwives are noticing stuff not being done correctly, and my local hospital unit is just passing the buck constantly. I think the midwives are very frustrated.

This is such sad news, along with everyone whose care has been affected for other medical problems. I cannot begin to imagine the heartbreak that accompanies a stillbirth.

I don't want to say too much but I have a very niche job and during lockdown was vaguely involved in some decision-making around maternity/covid risks. I strongly felt that birthing mothers were absolutely being thrown under the bus, and both they and the fathers/birth partners were massively affected. Needless to say I wasn't really listened to and my view was pretty much written off as being 'too emotional'. The rationale for that being that I have small children and have given birth relatively recently, oddly enough I thought that gave me better insight into the issues

Very sorry to everyone on this thread who has been affected. I'm hugely saddened maternity care has suffered though not surprised at all.

As other posters have said it won't just be about what healthcare was available it's also about the vulnerability of pregnant women and their confidence and/or means of accessing the care during the pandemic.

I’ve been reading through all these comments and nodding hard. I’m in my third trimester and absolutely agree that antenatal care has been treated as a ‘nice to have’ throughout lockdown. I’ve had to chase appointments, samples and blood pressure readings. My trust have lost so many of my blood test samples (including GTT) that I suspect they’re selling them on the dark web. Every time I go for a check up, someone is shocked at an oversight on the part of a previous midwife or sonographer. This week it was shock that I hadn’t been referred for a growth scan at my last appointment. Stories from other pregnant women in my area are all so similar and this is definitely a feminist issue.

I’m not surprised that women are reluctant to get things checked out either. I hated going to my clinic in March/April because staff were so hostile and receptionists wouldn’t even return my hello when I walked through the door. I recognise now that this stemmed from their own fear of Covid rather than hostility (they’re now quite lovely). But in the hormonal stages of early pregnancy during peak pandemic, I used to dread calling my community midwives to ask questions because they were so clearly stressed and brusque. I doubt I’d have gone in for fetal monitoring had it not been for the encouragement of the fab people on the Mumsnet pregnancy threads.

I’m usually pretty good at advocating for my own healthcare but pregnancy can make us so vulnerable. Add a pandemic and it’s a recipe for disaster. I used to volunteer at a clinic for undocumented migrants and the antenatal care those pregnant ladies received was definitely better than mine during this pandemic.

Is it normal for hospitals to report their own stillbirth figures? Absence of evidence isn't evidence of absence and other hospitals may be keeping quiet.

Absolutely agree that absence of evidence isn't evidence of absence. But absence of evidence certainly isn't support for the claim!

I'm pointing out that the evidence we have for the claim that the pandemic has lead to increased stillbirths in the UK consists of the data from one hospital. To draw the conclusion that this is a national concern, let alone that it is one that is due to the policies implemented by the NHS as part of the pandemic response, requires quite a bit more than that.

We may well get more data that does indeed show that. We may not. Neither would be a huge surprise based on what we have now.

Amongst the things that help to reduce stillbirths are good, accessible, antenatal care, close monitoring of high risk mothers, and having a reliable birth partner to advocate for the woman.

All of which have been affected by lockdown and the changes to healthcare delivery. It’s devastating, but sadly not too surprising. Women need good perinatal care, pandemic or not.

A note of caution about the numbers though, which are small enough that percentages could look very skewed.

to bitoffun and anyone else whose healthcare has been affected.

I'm so sorry deathswiftlyfollows and bitoffun.

@2bazookas it's not even clear, yet, that there is a rising number of stillbirths.

Can we really fucking not “poor menz too” on the feminist board?

BitofFun I’m so sorry, that’s shit

Honestly, this makes me livid. When are we going to realise that vital care must continue? Someone, anyone with the power should have been tasked with working out how antenatal care could have been continued. The horrific stories we hear about women fighting for early scans when they were bleeding, having to wait until 12 weeks or between 12 and 20 weeks and attend the scan alone, being denied D&C and being sent home with pessaries to pass their babies over an extended, painful period. This has been barbaric.

I have no words for people who think there couldn’t have been protocol developed to protect mothers and babies.

This increase in stillbirths appears, so far, to be just St Georges hospital in UK (I can't find any reports for other UK hospitals despite St. Georges raising concerns about their own figures months ago). The Nepalese study is compromised by the swing to home births - which will likely be the less complicated births - and the lack of coverage of those stats. None of that is to say it isn't a concern and shouldn't be looked at, just that the data is far from conclusive that this is more than a localized issue.

Even if the Nepalese Study is documenting something that isn't skewed by its selection method while, obviously, everything counts, the drop in pre-term births is far, far greater than this increase in stillbirths (assuming the reports on prem rates are also documenting a real phenomenon and not just the result of normal variation or selective reporting).

Pre-term births are roughly 10% (so 100 in every thousand births) and are down 40% - 90%. So, splitting the difference, down by approx 65 in every thousand births. The Nepalese study and St George's saw stillbirths increase by about 7 in a thousand births. A good dent in the prem birth numbers but not really an explanation for the phenomenon as a whole.

Too soon to blame lockdown for rising number of still births.

It would be interesting to compare stillbirth curve in countries that didn't lockdown.

Maybe covid itself causes foetal abnormalities and miscarriage.

This makes me so sad. A stillbirth is truly awful (my DD died 18months ago) and so much effort and work has gone into lowering the rate it's horrible to see it increase again.

God how awful. And for bitoffun. Awful all round.

As for the ‘what about the dads’ comment it really beggars belief that women can’t centre women in a discussion about failures of healthcare during pregnancy and labour meaning women have to go through the physical anguish of birthing a stillborn.

My dd was stillborn
Do not come at me with "it's a fathers loss too"
My body carried my dd, felt her kicks, nourished her, gave birth in the knowledge she was gone, my body bled, my milk that came in, my arms that ached to hold her, my "maternity leave" my ptsd, my lived horror.
Yes my dh was devestated, but this was not his personal physical horror-that is why it's a feminist issue,

And sorry, to clarify, the type of woman who could normally opt out of NHS care I imagine have far more sway. Just because we always know money talks loud.

I fear this level of care will become the "new normal

The only hope I have that this won't be the case is that there is hardly any private maternity care to speak of outside London so there's going to be a critical mass of women impacted who will hopefully be vocal about it.

I find it quite saddening that a mother of a woman who has just given birth seems to think her son in law would be just as hard-hit by a stillbirth as her daughter would be. If your own mum is so dismissive of her own daughter experiencing the most traumatic birth imaginable, then who does she have in her corner?

Of course poor maternity care for women is a feminist issue.

I also agree with a PP that it would take enormous political will to get maternity care back on track, and I don't think politicians really care enough about women-specific problems like this. I fear this level of care will become the "new normal".

So upsetting.

Maternity care has been treated as a nice to have, not an essential service. It is no surprise that if you remove the services that are specifically to support maternal health care that this is going to cause issues.

It honestly feels like pure arrogance to me that they thought they were so disposable. Clearly we're going to see the same happen in other areas where vital care has been removed.

I gave birth 3 weeks ago and I would say there has definitely been a change in care. This is my 3rd pregnancy and I developed complications during pregnancy that were not picked up or monitored well. I also found post natal care to be not so good. I had a difficult birth that ended with 2 tears and 2 cuts, the Dr says i am unable to give birth naturally again. I was rushed out of hospital so quickly despite finding movement incredibly painful and it has been impossible to get medication or appointments for me and my baby. My daughter has had issues with feeding and reflux and I still can't get support. Thankfully I know a little about what I am doing but if I were a first time mum I would be struggling I think.