What is stillbirth?
A stillbirth is the birth of a baby who has died during pregnancy (from 20 weeks) or during birth.
On average, 6 babies are stillborn every day in Australia. Despite advances in medicine, health and technology, rates of this tragedy haven’t reduced over the past 20 years and causes are still not well understood. In 2019, the Australian Government committed millions in funding to support stillbirth research and education, and are developing a Stillbirth National Action Plan. Some public awareness campaigns have already started but we will probably hear more in 2020. Hopefully this focus and investment will see a reduction in rates of stillbirths.
What causes stillbirth?
Heartbreakingly up to 50% of stillbirths in Australia are unexplained so it’s not always known why a baby dies during pregnancy or birth.
There are factors that may increase a pregnant woman’s risk of stillbirth, including:
- Overweight and obesity
- Advanced maternal age (over 35 years old)
- Pre-existing high blood pressure or diabetes
- Smoking, alcohol or drug use during pregnancy
- First pregnancy.
If you’re pregnant and are concerned about any of the risk factors above, speak with your midwife, GP or obstetrician.
Can stillbirth be prevented?
Stillbirth can’t always be prevented, especially if the cause is unknown. But there are things you can do to reduce your risk of stillbirth.
Pre-pregnancy planning and lifestyle changes such as taking folic acid, quitting smoking and losing weight may help reduce the risk of stillbirth.
Attending regular pregnancy check-ups (known as ‘antenatal care’ or ‘antenatal visits’) is important so a healthcare professional can assess the progress of your baby’s growth and any pregnancy-related health risks.
The ‘Safer Baby Bundle’ was developed in 2019 and includes best practice guidelines for Australian health professionals and hospitals that aims to prevent and reduce the rates of stillbirth in Australia. This program is based on a model from the UK which lead to a decrease in stillbirth rates by 20%. These guidelines include 5 key areas (known as ‘Elements’) and can help keep your baby safe.
Element 1: Stop smoking
Every puff of a cigarette that a pregnant woman takes can harm an unborn baby. Smoking can increase the risk of miscarriage, stillbirth, premature birth, low birthweight and other impairments to child growth and development. Any type of smoke, including second-hand smoke, shisha, hookah and e-cigarettes may be harmful.
It’s recommended that women quit smoking early in pregnancy, during the first trimester. But quitting at any time during pregnancy reduces the risk of stillbirth and other harms to your baby. If you smoke and are pregnant or planning to get pregnant in the near future, there are many free quit smoking services and resources.
Element 2: Get regular check-ups to monitor your baby’s growth
Fetal growth restriction (FGR) is a condition where an unborn baby (foetus) doesn’t reach its growth potential and is measured based on birth weight. Your midwife, GP or obstetrician will screen and look out for FGR throughout your pregnancy so they can detect issues early when medical treatment can be provided to improve an unborn baby’s growth. They measure your baby’s growth using a tape measure (called the Symphyseal Fundal Height assessment).
Element 3: Seek help immediately if your baby’s movements decrease
Like most pregnant women, you’ll notice your baby moving in the second trimester, starting out like a ‘flutter’ or ‘bubbles’. As a baby gets bigger as pregnancy progresses, their movements get stronger with kicking, rolling, pushing or stretching, and they may move more often.
It is no longer recommended that pregnant women count the number of baby kicks (called ‘kick charts’) because this may not be accurate or reliable. It’s better to pay attention to a baby’s pattern of movements, such as the time of day their baby moves most often. If you notice changes in your baby’s normal pattern, strength or frequency (how often) of movements then speak with your midwife, GP or obstetrician immediately.
Element 4: Sleep on your side in the third trimester
Research shows that 1 in 10 stillbirths could be prevented if pregnant women avoid going to sleep on their backs in the third trimester. This is because lying on the back presses on major blood vessels which can reduce blood flow from the womb and oxygen supply to a baby.
In the third trimester, it’s best to go to sleep on your side (either left or right is equally safe) including during naps. And it’s normal to change positions when you’re sleeping so don’t stress if you wake up in the middle of the night on your back. Simply roll back to sleeping on your side.
New research shows that the risk of stillbirth can be reduced by 50% for pregnant women who sleep on their side (compared to sleeping on the back) from 28 weeks.
Element 5: Give birth as close as possible to your due date
Research shows that the last few weeks of pregnancy are important for a baby’s health and development. Every week an unborn baby is in your womb, it continues to develop and become stronger. For healthy pregnancies, it’s recommended to wait for labour to start on its own and that delivery is as close to 39 or 40 weeks as possible, as long as it’s safe for mother and baby.
Resources
References
- Commonwealth of Australia (2018). Select Committee on Stillbirth Research and Education [Report]. The Senate
- Centre of Research Excellence Stillbirth (2019). Safer Baby Bundle Handbook and Resource Guide: Working together to reduce stillbirth. Australia.
