The scandal of stillbirths

I suggest it's a distraction to blame "the management" and their salaries.
There has been a shortage of midwives in the UK for a long time. I think there is also a shortage of obstetric consultants (desperate where I live)
This select committee report is interesting. The sad fact is that politics has a powerful influence on health care.
According to the RCM there is stiff competition to gain a place on a course to train. And the places are limited by the amount of NHS funding. More places could be funded if shortage of midwives is a cause of stillbirth figures.
I note the plans to remove bursaries from student nurses and midwives.

www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news/maternity-services-report/

How many stillbirths could be prevented

It's not my views which are of interest. It's the views of those experts working in that field. I watched the BBC programme 'Born Asleep* several months (?) ago and it left a lasting impression on how some of the simple methods, mentioned at the end of the above article, could prevent a large proportion of stillbirths.

It left me wondering why are these procedures not being used nationwide, when the cost is as little as 50p per mother. I'm pleased that they are standard procedure here in the West Midland area.

I wonder how many stillbirths occur because all mums are now expected to go to hospital. I've had 3 children, and didn't want to go into hospital. Tbere were complications with my first pregnancy, due entirely to carelessness in my ante-natal hospital care, when my daughter was lucky to survive; for the second I was given no choice because they expected the same problems as with the first; - for the third my GP felt it was sensible because of my age; he booked me into the local "cottage hospital" type of facility, but they wouldn't take me because they felt I was too old to take the risk and again the birth was not at all straightforward. My midwide godmother was shocked at the careless attitude I experienced on all 3 occasions and would have been happier had I been given my wish, when, as she says, my own midwife would have been sufficiently experienced and knowledgeable to avoid the minor complications which, just because I was in hospital, turned into major ones!

It would seem from the above post that many people think that most stillbirths occur at delivery.

This is completely missing the point that at least half occur in the womb.

That is the point I'm trying to make about monitoring

Just joined this discussion. Many health professionals within obstetrics and midwifery have been concerned for years about the stillbirth and neonatal death rate.
I have just retired but spent my career trying to give women the latest evidence based information. There is a political issue with the NHS but stillbirth also happens to the rich and famous using private medical care and to the medical and midwifery staff themselves.
Perhaps we need to focus on how other countries are able to reduce the rate and get on and make the changes needed.

Obviously monitoring is essential but we need more midwives to do the monitoring.

The point raised by JessM about the withdrawal of bursaries is interesting. Schools of Nursing and Midwifery have always encouraged more mature students to apply, as they bring a wealth of life experience with them which is very valuable to the profession. With the withdrawal of the bursary I suspect the numbers of mature students applying will drop and perhaps applications from others will also be fewer. This is concerning, when you consider we already have a shortage of nurses, health visitors and midwives. We are already recruiting from abroad, which suggests we need to make our courses more appealing, not less.

We also need to encourage more mothers to take up the ante-natal care that is on offer. Those that refuse come from a variety of backgrounds. There are some middle class mothers who are into alternative ways of managing pregnancy and childbirth. There are teenage girls who simply don't understand the need, or sometimes don't even realise they're pregnant, or refuse to tell anyone due to worry about the consequences. Then there are those who are fearful of what the medical profession might say. I'm thinking of heavy smokers, drug abusers and those that abuse alcohol.

The advances in medical care does increase the survival rate of premature babies. I belong to a not for profit group Needles & Hooks Angels & preemies which provides clothing and blankets for special care units throughout the UK. If anyone would like to help there is a Facebook page which explains what we do

The safer staffing recommendation which pushed for a patient-nurse ratio of 8:1 was scrapped this year by health secretary Jeremy Hunt. As well as putting patients at risk, including on the labour wards, how effective will nurse training be if the wards are not staffed adequately?

This is yet another issue that implicates the government in it's failure to facilitate a safe NHS.

Throwing money at the NHS ( there has been plenty of that in the last 20 years) has obviously not improved the the high rate of still births in the UK.
Blaming austerity measures in place for the last few years has obviously nothing to do with it.It is ante natal practise that should change.As Anya says, at least half of the deaths take place in the womb.MIL09 makes a good point with her last sentence.

This wasn't meant as a Tory bashing thread Sadiesnan or to talk about nurses on general wards etc.It's a sad topic ( as I know only too well, even if it happened a long time ago for me) and I also think you are being confrontational in your posts.

Perhaps I am being confrontational! The thing is, I object to someone repeatedly telling me not to raise politics. As far as this particular topic is concerned it's clear that some of the underlying problem is government policy.

Surely as grans we're mature enough to have a sensible discussion. Why do posters feel the need to dictate terms? I thought Gransnet ran the site.

It's ridiculous to suggest cuts in services doesn't affect care. Without the midwives in post, who is doing the caring?

You see, I think it's more than clear that this long standing problem is NOT
Government policy.It goes back too far for that. Not everything is the fault of the present government, however some may think that is the case!
I too, am off this thread now.

I've found your posts interesting, sadie. If it's possible to make the same points as you have made without apportioning blame, I think they would go down better

What sort of monitoring (I mena, what needs to be monitored) makes a difference, anya, and how? Please.

It would be helpful/interesting if we could know the statistics based on women who do/don't attend regular anti-natal appointments as it is entirely possible/probable that those who do not attend make up the highest percentage of stillbirth.

Blimey! Just read this thread, and it's not sadiesnan who is being confrontational!

Surely NHS care is the same countrywide? Isn't it just a fact that all mothers get far fewer checks than we did? I was shocked that my DD wasn't invited for monthly checks, and didn't have that white record card that I remember so well.

I wonder if there is a different attitude to pregnancy these days. Has it been 'de-medicalised' too much? Or is it down to finance?

As is clear from the official statistics there has been a massive drop in stillbirths since the introduction of the NHS. Then it levelled off in the 1990s
But it is still one of the higher rates in Europe, along with France and Romania.
Other countries are doing a lot better. So there is scope for improvement. Monitoring in late pregnancy is often a two-way process with mothers flagging up to their midwives if the baby is moving less.
And there are still notable regional differences within UK.

www.ons.gov.uk/ons/rel/vsob1/characteristics-of-birth-1--england-and-wales/2013/sty-cb1-2013.html

RE the countryside there are two factors - one is getting access to antenatal care. The nearest consultant unit could be an hour or more from home by car.
Also - in some rural areas recruitment of consultants is more difficult than in cities.
As I've posted before, had a neighbour who was a young ob/gyn consultant. (N Wales) He was Romanian. He left to go and work in Australia. I think that highlights the problem in a nutshell.

jingl NHS care is not the same nationwide - how can it be, with different trusts and consultants running departments.
This is from the link that Anya posted
^Each year, more than 3,000 babies are stillborn in the UK, one of the worst rates in the developed world.
Prof Kypros Nicolaides says offering all women Doppler scans, which measure blood flow between the placenta and foetus, could save 1,500 babies a year.
The Department of Health said it has asked him to submit his research^

Prof Nicolaides has implemented the use of Doppler scans in his unit n London and reduced the number of stillbirths.
But the DOH has yet to recommend that they are used routinely within the NHS.

There's always going to be a time lag between someone discovering something that will make a difference, and that process or procedure being accepted as routine.
The question is whether things are not brought in because of cost(political) or whether there is bureaucratic delay (management) or non-acceptance if the evidence by other clinicians.

I'm new to Gransnet and so far I'm enjoying the chat and the discussion. However, I have a few things to say on this thread.

Within forum rules I see it as acceptable to post your point of view, which is what I've done on here. Some seem to take exception to someone else having a view that is different to theirs but surely if we all agreed with each other, it wouldn't be much of a discussion.

I've argued that some of the problems with NHS care is down to the government. Why are some so intent on stifling that view? I'm truly puzzled.

Tory bashing has been mentioned, but honestly if someone wants to bash the Tories, why shouldn't they? It's not insulting other forum members and doesn't involve being rude to each other.

My view is that successive governments, regardless of political persuasion, are guilty of mismanaging the NHS.

That's my point of view. I'm absolutely entitled to my point of view and other posters are entitled to theirs.

Thatbags posted "I've found your posts interesting, sadie. If it's possible to make the same points as you have made without apportioning blame, I think they would go down better".

I do blame the government, so how can I make a point without mentioning that? Anyway, I'm not interested in being everyone's friend. If you don't agree with me that's just fine.

I've looked back at my posts and I don't believe I have been confrontational. What I am guilty of is refusing to be told what I can post by Anya. Well tough Anya, I don't acknowledge that you can tell me what I can and cannot post.

it's standardised janeainsworth

It was just a suggestion, sadie. Doesn't bother me if you want to be an outspoken government-basher. I'm all for people speaking their minds. If it is the fault of several governments, then you are not criticising one political party aspect anyhow.

Moving on... while the UK's stillbirth rates are said to be worse than elsewhere in Europe, having looked at global figures, I'm less concerned about the UK rate than I was when I first read the OP. Globally the UK rate is not bad even though it's apparently not as good as it could be.

I still haven't really understood what would make the difference. The Doppler scan thing that janea mentioned sounds like a new technique, but the OP maintains nothing 'new' is needed, just "more monitoring and less complacency". Did you include the Doppler scans in that phraseology, anya? As to complacency, that could arise in pregnant women as well as in health care professionals. Which is it? Or is it both in the UK?

" Why are some so intent on stifling that view? I'm truly puzzled."

Because some of 'em feel the need to show how much more they know about everything than lesser mortals do.

#Gransnet

Perhaps all mothers don't want to have another scan. Of any kind.