Sarah Robertson: Most babies lost during pregnancy or shortly after birth did not have to die
THE unbearable sadness of losing a child is impossible to put into words. The tragedy is even greater given that many lost babies did not have to die.
THE unbearable sadness of losing a child is impossible to put into words. When a baby dies during pregnancy and is stillborn or dies soon after birth, pain and grief strike just when parents are expecting the joy of a new family member.
The tragedy is even greater given that many lost babies did not have to die.
Today is International Infant Loss and Remembrance Day. Around the world, candles will be lit in honour and memory of the children who die during pregnancy or shortly after birth.
For women and their families who experience stillbirths, the loss can be devastating. Often, women are so shattered by the experience they prefer not to become pregnant again.
Some troubling oldwives tales about stillbirth persist. In the absence of a good explanation, women can blame themselves.
Worldwide, an extraordinary 2.65 million stillbirths occur every year. The cost to families and society of this loss is largely invisible.
In many countries stillborn babies are not counted and reported, and none of the leading campaigns to improve world health, such as the Millennium Development Goals, mention stillbirth or aim to reduce it.
In Australia the rate of stillbirth is considerably better than in countries of low and middle income. Major advances in hygiene and antenatal care, including emergency caesarean sections, have reduced the chance of death at delivery 10-fold since the 1940s.
Even so, 7 in every 1000 pregnancies will end in stillbirth. In 2010, this amounted to 2,206 babies lost Australia-wide.
Unfortunately the decline in stillbirth rates has slowed since 1980, mainly because of little improvement in saving babies that die before their term date. Unfairly, rural and disadvantaged groups can be disproportionately affected.
There is a common misconception that any baby who dies in the mother's uterus was never meant to live - but only about 1 in 5 stillbirths is caused by genetic abnormality or malformation.
That means many lost babies were not destined to die.
In high-income countries half of all stillbirths occur at more than 28 weeks of pregnancy, and if delivered in time, nearly all of these would have survived with good neonatal intensive care.
How can we do better to help children and their families avoid this tragedy?
One important way is to increase awareness of stillbirth and promote discussion of the topic in the media, by policymakers and in our local community.
If we ignore or are fatalistic about stillbirth, this will virtually guarantee that no progress is made.
There are many things that expecting mums and their doctors can do. Maintaining optimal maternal health, detecting and managing slow fetal growth, and diabetes in pregnancy, is crucial. Regular checking of fetal movements can make a big difference. Pregnancies should not progress more than 10 days beyond 40 weeks, when placental function diminishes.
Research into the factors that ensure a healthy pregnancy will help prevent stillbirth.
In the Robinson Institute, we are studying how care from conception can protect a woman and her baby. Scientists and medical doctors are working together to define the lifestyle factors and choices which build a strong placenta to better nurture the growing fetus.
Our shared belief is that by investing in this early time, all children can be given the best chance at life.
Professor Sarah Robertson is Director of the Robinson Institute at the University of Adelaide.