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Printable Handouts
Navigable Slide Index
- Introduction
- The effects of stillbirth
- Best practice in maternity care
- Optimal clinical care after stillbirth
- Available clinical guidance
- Available clinical evidence
- Stillbirth in high resource settings (1)
- Stillbirth in high resource settings (2)
- Listening to Parents report (1)
- Listening to Parents report (2)
- Descriptive studies identify good care (1)
- Descriptive studies identify good care (2)
- Process of diagnosis and early care
- Diagnosis: language
- After a diagnosis is made
- Information giving
- Mode of delivery
- The time between diagnosis and birth
- Why have investigations after perinatal death?
- Value of investigations after perinatal death
- Why do parents have investigations after stillbirth?
- Parental decision making about PM
- Barriers to consent for autopsy (1)
- Barriers to consent for autopsy (2)
- Seeing and holding baby (1)
- Seeing and holding baby (2)
- Perinatal bereavement service
- Common experiences of parents
- Developing a regional guideline
- Impact of regional guideline (1)
- Impact of regional guideline (2)
- Specialist bereavement care after preeclampsia
- Parents’ experience: perinatal death & hypertension
- Unclear diagnosis & lack of control
- Impact on key grief activities
- Lactation suppression
- Need for aftercare
- Summary
- What can we do to improve care?
- Narrative-based medicine
- Evaluating stillbirth stories
- Impact on clinicians
- Listening to the archive changed views on stillbirth
- Conclusions
- Acknowledgements
Topics Covered
- Stillbirth diagnosis, investigation and aftercare
- Best practice in maternity care
- Clinical guidelines
- Preeclampsia
- Diagnosis of intrauterine fetal death
- Investigations following perinatal death
- Postmortem
- Barriers to consent for autopsy
- Bereavement care
- Lactation suppression
- Narrative-based medicine and stillbirth stories
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Heazell, A.E.P. (2024, March 31). Stillbirth: diagnosis, investigation and aftercare [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved October 6, 2024, from https://doi.org/10.69645/FXNM4774.Export Citation (RIS)
Publication History
Financial Disclosures
- There are no commercial/financial matters to disclose.
Other Talks in the Series: Periodic Reports: Advances in Clinical Interventions and Research Platforms
Transcript
Please wait while the transcript is being prepared...
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.