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Stillbirth: diagnosis, investigation and aftercare

Published on March 31, 2024   36 min

Other Talks in the Series: Periodic Reports: Advances in Clinical Interventions and Research Platforms

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0:00
My name is Alex Heazell. I'm a professor of obstetrics at the Tommy's Stillbirth Research Center of the University of Manchester. I'm going to talk to you today about stillbirth, aspects about the diagnosis, investigation, and after care.
0:17
It's important that we think about stillbirth because the effects of stillbirth affect mothers, their families, health services, society and government. Women bear the brunt of the emotional and psychological distress and can become very isolated. It was estimated in 2016 that there are about 2.6 million stilbirths per year. The current WHO estimate is there are about 1.9 million stillbirths per year globally. We know that women who experience stillbirth have an increased risk of family breakdown. There's also a great deal of stigma. Women can even be abandoned as a result of pregnancy loss or abused. We know that those of us working in healthcare, that this pregnancy loss is associated with increased healthcare costs and also a negative effect on staff. Also for those in government, that there is reduced earnings from employment, maternity and paternity leave, and also that in some countries the government meets the healthcare expenses. So the effect of stillbirth is not simply about the emotional and psychological distress on the mother, but it radiates out to affect us all.
1:29
I've paraphrased a well known saying that any society and nation is judged on the basis of how it treats its weakest members and I would argue that our maternity service should be judged on how it treats its most vulnerable clients and how we look after parents who have experienced a stillbirth I think is a good barometer for the quality of care we offer people, all the people using our service. Back in 2012, I in collaboration with Soo Downe, who's a professor of midwifery, we looked at parents experiences of stillbirth in UK hospitals. This shows many commonalities with themes from other very similar studies globally. But one thing that came out of this study is how enduring the effects are. So things could either be really bad. Here someone describes how their delivery was awful from beginning to end. They treated me like the woman with the dead baby. There was no sympathy. When I asked to see a doctor, this particular doctor came in and said, we are very busy. His exact words, I'll never forget them Well, with all due respect, your baby's dead already, which was just the most awful thing you could say. Then that goes through to actually a very positive experience of still being able to connect with their baby and a sense that there was still a sense of motherhood there. So the midwife made me feel incredibly proud. A natural reaction after just giving birth is reliving the birth and wanting to talk about the birth experience. It sounds odd, but because I'd had such a good birth, I felt I could behave like a normal mother. I could talk about that experience as a normal labor to close family. That was really important to acknowledge Zoe, her stillborn baby, in a way.

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Stillbirth: diagnosis, investigation and aftercare

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