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Most stillbirths could be avoided if all hospitals followed the lead of top hospitals.
Mothers planning to give birth in London’s top teaching hospitals are usually the lucky ones. For example, the routine use of special scans to check that foetuses are growing normally can cut the rate of stillbirth by 50%. Mothers planning to give birth outside of London are entitled to similarly attentive care but are not always getting it.
Britain has slipped from 18th to 21st in the authoritative ranking of countries by rates of stillbirth. The improvement rates for stillbirth numbers are even worse. Britain ranks behind Croatia and Poland. Iceland has the least number of stillbirths per thousand births. Britain’s still birth rate is double that of Iceland.
The high incidence of stillbirths in NHS hospitals is a scandal that results in 3000 lost lives each year. More than half of these deaths are thought to be preventable through nothing more complex than diligence and common sense from Hospital staff. No scientific breakthroughs are needed, just more monitoring and less complacency.
When a baby is born still, there is no formal inquest into what happened and often there are no detailed answers for grieving parents who are left to console themselves with the false assumption that such tragedies are simply part of life.
One frequent cause of stillbirth is inadequate blood flow from the placenta to the foetus, resulting in slow foetal growth. Although this is not always easy to diagnose, experts believe that if slow growth is identified early the baby can be delivered earlier by Caesarean section and that 6 out of 10 of all stillbirths could be avoided.
Kypros Nicolaides, of King’s College Hospital, a pioneer of foetal Doppler scanning (used to measure baby’s blood flow) has offered this scan as standard for many years. When Doppler scanning at 20 weeks was adopted at nearby St Georges Hospital, the stillbirth rate fell by half in three years. Professor Nicolaides believes similar reductions could be achieved nationally but most hospitals only make these scans available to mothers whose babies are considered at risk for other reasons.
The cost of a Doppler scanning test is roughly £15.
Personalised growth charts for expectant mothers, taking into account such factors as: height, weight and ethnicity cut stillbirth rates by nearly 40% when introduced in the West Midlands. These growth charts cost just 50p per mother. One has to ask whether these crucial tests should be regularly available across the whole NHS.
The death of a newborn baby is tragic and impossibly hard to bear. Stillbirths should not be seen differently. They are, for example, often linked to years of depression for bewildered parents. The Health Secretary has, accordingly, vowed to half Britain’s rate of stillbirths by 2030.
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