The scandal of stillbirths

I presume the article is behind a paywall.

Does the article suggest it is a GP problem, or midwife?

Do the figures take into account all the factors linked with stillbirth? For example stillbirths are more common if the mother is over 35 years of age and many women are delaying having their family.

Smoking, drinking alcohol or misusing drugs while pregnant is also a factor. My own sister had a stillbirth and she was a heavy smoker.

www.dailymail.co.uk/news/article-3405699/More-700-stillbirths-year-blamed-poor-care-mums-One-three-avoided-Britain-lags-wealthy-nations-reducing-death-rate.html
This is the Mail's version.
The BBC's and the Guardian's reports both point out the UK figures are part of a large worldwide study.

I'm sure any report published in The Lancet is accurate and well researched.

Thank you Jane I'll read your link.

I think midwives would like to give better care but they are overworked, due to staff shortages. My neighbour is a midwife and she tells me how it is on the frontline. The staff work extra hours every shift, they miss their breaks and they stay late. Personally I blame the government.

Sadie I'm sure all these factors were taken into consideration. Are you thinking that perhaps women in other European countries different from women in the UK?

No, it points the finger directly at poor and inadequate care in some areas of the country. The West Midlands has cut its stillbirth rate by 40% at an extra cost of 50p per mother - simply by measuring, weighing, recording and taking certain other factors into consideration.

Let us not turn this into another political thread please. That's just a cop out.

If some areas of the country can improve their cars and outcome then so can others.

cars care

We are talking about anti-natal care anyway.

Ante natal care is also up to the mother as Sadiesnan has said . I didn't understand what you meant Obie about a paywall. Would someone explain please?

Stansgran a paywall is when you have to pay to access online articles. The Times has a complete paywall, I think the Telegraph allows you 30 articles a month before they ask for a subscription.
<sticks head above the parapet>
Anya Although the articles I've read do implicate poor monitoring and antenatal care, sadly, I don't think that you can ignore the political aspects. The Government are the NHS paymasters and as such bear responsibility for a) how much money is spent on obstetric services and b) to a lesser extent, how that money is actually used in the front line.
However, healthcare professionals (not just talking about midwives here, it applies to others) have a responsibility to shout from the rooftops if the financial constraints that they are subject to, mean that they are unable to provide safe standards of care for their patients.
If healthcare professionals react to financial stringency by excusing substandard care, then they bear as much responsibility as the government.
Of course in the vast majority of cases the staff do their very best, but one of the findings of the inquiry into Stafford Hospital was that some staff had abnegated their professional responsibilities with the excuse that they were trying to reach targets imposed by management.

You can only read some articles online if you pay.

I'm sorry Anya but I think it is a political issue. What else is it? The NHS is used as a political tool to try and win votes. Successive governments make changes and with an organisation like the NHS things never recover before more changes are made. Some would argue that a Conservative government is also intent on privatising the NHS.

At present we have a shortage of midwives, health visitors and nurses. As this group of workers care about their patients they are taken advantage of. It's the same with the junior doctors.

We need more frontline services, yet these professionals are leaving due to poor morale. So we end up without enough well qualified staff, who are burnt out, tired and disillusioned.

On your point about areas of the country Anya, I'd be interested to know whether they make a link between stillbirth and women living in deprived areas. A number of studies have shown that these women face far more challenges than those living in middle class areas.

For a number of years we've also had a high teenage pregnancy rate, with some deprived areas of the country having the highest figures in Europe.

Some groups of women choose not to access ante-natal care, particularly teenage mothers and mothers with social problems such as drug and alcohol abuse.

There have been moves to establish good centres of care for young women and their families. At one time a woman could access ante-natal care at her local Sure Start Children's Centre. In the same building there were midwives, smoking cessation workers, health visitors, baby clinics, social workers etc. There is a high demand for these services yet, due to cuts they are closing down.

George Osborne has recently announced that local authority funding will be cut by another ten per cent in 2015-16 as part of the Comprehensive Spending Review. So I can only see more closures. Politics cannot be taken out of the situation. It is a political issue.

Please try and watch one of the 'recorded' and available to view now debates held in Parliament, I think Nov 2015. I watched it live and 2 Conservative MP's told of their child being born as stillbirths. There are times when Parliament pulls together on both sides of the House and partisan politics is not on show, this debate was one of them.

Also look at Conservative Tracey Crouch and her campaign on stillbirths also Jeremy Hunts statement re stillbirths and government funding in November 2015.

Here in the West Midlands stillbirths have dropped by 40%. It's not the ability to access ante-natal care - all expectant mothers can access anti-natal care- it's the level of care on offer. Very simple monitoring procedures, which simple aren't in place in some clinics.

Anyway, I've said all I want to on this thread as it's going the way of so many others, which, considering the sadness of the subject under discussion, I find unacceptable.

___________________________________________________________

When I lived in Edinburgh, I was 'next-door' to an area that had one of the highest infant mortality rates in Europe. The work of the local healthcare team was slowly making a difference (an impressive difference) and the way they were doing it was by raising awareness among women of child-bearing age of "pregnancy health" (lifestyle choices that make a difference to the health of the foetus, and so on). As I understand it, the difference was made by educating women, including by convincing them that coming to antenatal clinics was a good idea.

That sort of work does need funding. Extra funding even.

In early 1983 I was put in contact by my health visitor with a young immigrant Vietnamese woman. Her first child had been born in a refugee camp in HongKong. The second was due and my task was to try and prepare her (teach her some basic English) for a hospital birth in Edinburgh. She didn't want to go to hospital. Her husband delivered the baby and then called an ambulance. I got the impression she thought we made far too much fuss. I'm wondering if there is some of this in the West Midlands area the OP is talking about?

When my DGC were on the way, I was amazed to find that the free midwife-run antenatal classes we all attended back in the 80s were no more. There was some provision at Children's Centres in the most deprived areas, and the NCT classes, which had to be paid for and booked well in advance as they were over-subscribed. My DD and DDIL went to these, but I know other mums to be who missed out. I found the advice given at my classes invaluable, and I believe the lack of them must be detrimental to mother and baby health.

I must say I was also puzzled as to why, despite regular ante-natal checks, including one two days before he arrived, no one picked up on the fact that DGS3 would weigh in at well over 10 pounds, 3 pounds more than his brother. From what I've read since, this could have caused major problems during delivery.

Anya - as with a lot of things, there's no single reason for stillbirths. Many factors contribute and although in an ideal world all women should access good care, it doesn't always happen.

Yes all women could access ante-natal care, but there are groups of women who choose not to.

Yes, all care should be good but it's not always good and the reasons for that complex.

I'm struggling to understand your posts. Did you want a discussion on this very important matter? If so then you cannot dictate what other people can contribute. If not, then why start a thread?

*are complex

D'you know Sadie given my background I could probably give a lecture on the 'many factors' which contribute to a poor outcome in pregnancy.

Why did I start this thread? Not for more Tory bashing, but to raise awareness of something that has been an issue for many, many years. I'm not dictating anything, I simply asked that please this didn't turn into a political issue. Of course, anything to do with the NHS has political implications but, given the subject matter and how long this has been an issue (under governments of different political flavours) I had hoped that we could actually discuss the recommendations in The Lancet.

I'm sorry you struggle to understand where I was coming from

Go on then Anya, tell us about the many factors which contribute to a poor outcome in pregnancy, I'm really interested.

Your first post seemed to suggest that you think " simple monitoring procedures which ought to be the norm across the NHS" is the main reason.

Whilst no doubt that view is relevant, it's interesting to discuss what's behind that. Why don't we all have the access to the same level of care?

As we have a Conservative government in power at present, they make the decisions about the NHS and hold the purse strings. It's kind of inevitable that questions might be asked about their management and leadership of the NHS over this issue. I don't really see how you can rule them out of the discussion.

Yes, you did ask us not to turn this into a political issue but the fact is, it is political.

Can you outline the recommendations in The Lancet for us please, as it would be useful on this thread and we can perhaps discuss each point.

This and many other issues are a direct result of 'austerity'.
The rich can pay for services the rest of us fall further down the ladder whilst Chief Executives of NHS Trusts, Academy Chains, and other services pay themselves huge salaries and bonuses with public money. We should all be fighting this.

Why are you being so confrontational Sadie'snan?

Anya, I'd love to discuss this issue as it's really important. I'm trying my hardest to actually talk about the issues and I'm really interested in your views.

Please show where I've been confrontational? And I'll try to understand what you mean.