The scandal of stillbirths

Jingl there may be standardised care pathways laid down, but that doesn't mean that when concerns are raised by a mother, for example that the baby doesn't seem to be moving as much as usual, that intervention will be standardised.
That is far more dependent on the clinicians involved and how much time they have available, and indeed whether the woman feels confident about expressing those concerns.
If you look at Jess's link, you will see that in SW England the rate of stillbirths is 3.6 per 1000 live births. In Yorkshire & Humberside it is 5.1, far higher than France which has the highest rate in Europe at 4.5.
What that means is that for every 10,000 live births in Yorkshire, there will be 15 more stillbirths than there would be for the same number of live births in the Southwest.
I'm not a statistician but that seems to me rather a large discrepancy and whatever the reasons, there isn't room for complacency.

So, why do you think there are more stillbirths in Yorkshire and Humberside than there are in the South-West? Fucked Blowed if I know.

Of course these problems are multi factorial, but the political aspect cannot be ignored. Up and down the country, maternity units are struggling to sustain their services because of the maternity tarrif. Successive governments have failed to grasp this particular nettle.

It is interesting too, to consider the effects of additional monitoring. Obviously there is a number of high risk groups, and these women do already benefit from additional screening. The trouble is that many still births occur in the low-risk group. Every woman - regardless of risk, would have to be closely monitored, scanned, Doppler-ed and examined throughout her pregnancy. This screening would mean medicalising large numbers of 'normal' pregnancies, which would bring its own problems. No easy answer.

Perhaps the women up there are fatter. Or smoke more. Perhaps women in the rest of Europe look after their health better than British women.

Do you read other people's posts, Jingl?

Yes. Nothing on here has been very informative though.

I cannot do links but has anybody read Jeremy Hunts statement, made at the ' 'Tommy's Research Centre ' ,St Thomas' Hospital, London which carries out marvellous research work into pregnancy problems. (Huffington Post is a good link to look at)

Or has anybody interested watched the available to view debate in Parliament I mentioned previously which is still available to view? It is politicians debating at their best, they can do it you know.

This is not a particularly new report , there was a study carried out for the Lancet in 2011 (remember Labour were in government upto 2010 ) which put the UK 33 out of 35 out the high-income countries for still birth rates.

Jeremy Hunt made the statement last November . He doesn't fight shy of the fact we in the UK lag behind . He talks of more support and transparency in maternity services. He says the government are working with consultants and midwives across the country to ensure best practice is applied ' consistently ' across the country . NHS Trusts are to receive a share of 4 million pounds to buy equipment such as cardiotocography (CTG) and provide more training for staff.

A new system for staff to review and learn from every stillbirth and neo natal death will also be set up and over £1 million pound will be invested in rolling out training packages developed in agreement with The Royal College of Midwives and the Royal College of Obstetricians and Gyneacologists.

I know this may sound like partisan politics coming from me but please before anybody judges look at the response from Judith Abela from the stillbirth and neonatal charity 'Sands'. Dr. David Richmond , President of the Royal College of Obstetricians and Gynecologists. and Jane Brewin CEO of Tommy's Charity and many others who welcome the governments stance.

Like all other GN's I hope in the future the UK can improve on it's ranking and I will be watching with interest , allowing time for improvements to filter down from the top.

The only person I know who had a stillbirth is middle class, professional, educated, attended NCT classes etc, so it would appear that this is not a simple case of targeting lower income groups/younger mothers etc.

Bags the 'nothing new' bit is the use of a measuring tape and scales to monitor the mothers abdominal growth which should be charted against the norm expected for her age and other known factors. The 50p bit, I tried to direct people's attention to at the end of my link.

Then the scan if results suggest further investigation. This is not routinely carried out, as the programme 'Born Asleep' made clear.

It's a shame that some posters who claim to be new, jump in with two feet and don't give a thought to those GNetters who have suffered the trauma of stillbirth and who, reading their comments, are upset by this issue being used as a political football. There but for the Grace of god go us as Gill says in her post.

Even in the best organised country there will be some babies that die in the womb or just after birth. You're never going to drive it down to zero. The number includes some who are born early or with serious birth defects.
I'm glad there are some top-down initiatives on this and hope that staff levels will enable them to be rolled out successfully.
There may be other things that might be done to reduce the numbers such as more research into helping young women and pregnant women to stop smoking (or better still, never start).

www.nhs.uk/news/2015/01January/Pages/Gift-vouchers-can-help-pregnant-smokers-quit.aspx

Fundamental scientific research is often the route to improved medical care. Deaths in the womb, I believe, are often down to a malfunctioning failing placenta, so funding research into the development, function and failure of the placenta might help.

Yes Jess it is obviously the case sadly. What can be done now at little extra cost, using simple techniques, in the first instance, could save the life of half of the 3000+ babies that are stillborn every year.

It's all very well blaming mothers who smoke, don't attend clinic, drink, etc..(actually it isn't all right but....) but there are those who do all the 'right' things and still lose their babies because the slowed growth in the womb wasn't recognised

I think jess and others who've mentioned smoking are blaming smoking, anya, not the young women who smoke. Subtle difference but it is there, I think. jess will perhaps confirm this.

If 1500 children were killed on the roads each year there would be a public outcry.

In 2011, 2412 children died in road accidents in the UK.

Sorry. That's wrong. That's the figure for deaths and serious unjuries.

If you want a public outcry, start one. Seriously. I'm not just being flippant.

Minibags started an outcry about her school exam system recently because she felt her school was being experimented on. Turned out a lot of other kids thought so too. Her 'outcry' got other pupils involved, who inturn got their parents involved, who in turn involved coucillors and MSPs.

The system has been changed to accommodate the kids demands. In short they wanted more opportunities to sit national exams. Don't want to hijack this thread so will stop there.

Anya Reading between the lines it would appear that you have experienced a stillbirth. My sympathies are with you and anyone else, if that is the case. As I posted earlier in the thread, my own sister had a stillbirth and my daughter in law lost three babies in miscarriage.

I haven't mentioned this but I'm a retired nurse and health visitor and I've supported a number of women after stillbirths. One lady I visited couldn't have any more children and I visited her every week for months. She was very depressed but did say afterwards that she couldn't have got through it all without me. I was a newly qualified health visitor at the time and I must admit I found her distress extremely upsetting and it's stayed with me.

Stillbirth has touched many of us in different ways and it's always tragic. Exploring what can be done about it interests me, and my experiences tell me that the political influences on care in this country are intrinsically part of the whole picture.

In my view any discussion about the NHS and care in this country cannot take place without considering government policy. Please do not take offence Anya, as none is intended.

Yes I recognise that smoking is highly addictive and that people have stressful lives and poor education both of which contribute to them starting and continuing. And that those who sell tobacco have a lot to answer for.
if it was discovered now it would be considered dangerous and probably made illegal.

No, I haven't experienced a stillbirth, but others on this thread have and my heart goes out to them. I accept you didn't mean offence. I intended that this thread would look purely at the clinical side of this problem and how improvements could be made immediately with just a few tweaks.

While we wait for successive government to move, every day that passes more babies are lost unnecessarily.

How many people know, for instance, that there doesn't have to be an inquest on a stillborn child?

This from today's Times

"Hospitals are failing to bring down the high stillbirth rate because they are allowed to investigate themselves, according to the author of a report into the Morecombe Bay scandal.

Brian Kirkup called for an end to a 1950s law that prevents coroners from opening an inquest unless a baby has drawn a breath.

Dr Kirkup, whose report last year concludes that a "lethal mix" of denial and failure by the NHS led to the death of 11 babies and one mother at the trust in Cumbria, said that poor internal investigations were a key reason why Britain's stillbirth rate remained high.

Nicholas Rheinberg, the Cheshire coroner who has been active in investigating baby deaths, wants the law to force staff to report to coroners all deaths after the start of labour"

Personally I'd take it further and ask that all deaths of babies in the womb in the third trimester ought to be investigated. Sloppy midwifery, as happened in Cumbria is not acceptable, not when there is such good practice going on elsewhere.

Bags once I would have had the strength and tenacity to start an outcry. Sadly I've used up all my energy coping with our own family tragedy.

You make some interesting points Anya and it would seem to me that Nicholas Rheinberg is on the right track about the law.

I accept what you say about your intentions for this thread, but perhaps others see Gransnet as similar to ordinary conversations, where people chip in and the conversation flows naturally. Personally, I don't think it's really up to anyone to dictate what can be posted. Surely as long as people are polite it's difficult to see a problem.

Politics are part of everyone lives and affect everything. When I was working we were very aware of how our jobs were directed from government policies. When I did my degree we did a module on social policy and nursing. Perhaps my background makes me more aware of the importance of existing legislation when considering policies and procedures within the NHS.

So is eating, sleeping, breathing, excreting, driving, shopping, sex showering, cleaning my teeth, watching TV, reading, singing.......but I don't bring them into every conversation with friends and family not into every blessed thread on GN !!!!!!!

Why would you? I don't bring politics into every conversation, just where it's relevant.

I've just discovered these Smileys, they're good fun aren't they?

The thing is that it needs political will to make the necessary changes, anya. Rheinberg's idea, for instance, won't happen without a change in the law and that depends on parliament. Politics is key to improvements, though not Party politics. Any MP could raise this as a private member's bill presumably. Do you know if anyone has?

Does it need an act of Parliameng to buy and use a tape measure or a pair of weighing scales and a chart?

Seems to me the tape measure is made of red tape. We need to cut out all this b****y bureaucrscy and replace it with action.

'Existing legislation..considering policies and procedures b***ocks.

X/posts bags