There is a great deal of secrecy surrounding pregnancy and childbirth. Some of it makes sense. If most of us knew what was actually involved in growing and delivering a new life, we would probably keep our legs firmly crossed – just ask any childless woman who has watched One Born Every Minute.
Stillbirth – defined by the World Health Organisation as the death of a baby after 28 weeks of pregnancy, by which time most would survive outside the womb – is perhaps the biggest taboo. Literally nobody that you see during the nine long months of pregnancy talks about it: not the GP, not the midwives, not the sonographers who carry out the scans, not the consultants, not those who run antenatal classes.
Part of this is understandable: nobody wants to scare a pregnant woman. But if the worst happens, if the baby dies in the final weeks of pregnancy or during labour, this taboo leaves her woefully unprepared. It may be the first time she has even contemplated the possibility that she could carry her baby almost to term only for it to die days or hours before they meet for the first time.
A major new series of reports published yesterday by The Lancet reveals that stillbirth is far less rare in this country that people imagine – and explodes the popular assumption that most stillborn babies have something wrong with them.
Around 4,000 babies die unexpectedly in the last months of pregnancy or during labour every year in the UK, meaning that "11 sets of parents every day will take home their newborn baby in a coffin", in the stark words of Dr Zoe Mullan, senior editor the health journal.
The UK has one of the highest rates of stillbirth in Europe, ranking 33rd best globally - among high income countries, only France and Austria performed worse. While other nations have significantly reduced stillbirth rates over the past ten years, rates have remained static in the UK. The journal also found that a third of stillbirths in the UK are unexplained, although poor NHS maternity care is thought to play a part in half of these – around 600 a year.
The fact is that even with our highly developed health system, stillbirth is a risk for healthy women with normal pregnancies – and even more so for those who are overweight, smoke or are older than average. So why does nobody talk about it? It's not as though women aren't made aware of other risks, cot death being the most obvious example – yet the 1,000 unexplained stillbirths far exceed the 200 unexplained cot deaths every year.
Sands, the stillbirth and neonatal death charity, called the stillbirth rate "a national scandal" and put the UK's poor record down to a lack of awareness among health professionals, a lack of research into which women are at risk and poor quality maternity care.
As with so much to do with women's health, I get the sense of a rather cavalier attitude here. We may obsess about fertility and revere pregnant women, but when something goes wrong there seems to be an expectation that we should put up and shut up, accept that it's just "nature's way", that it "wasn't meant to be" and not ask too many questions.
Surely this can't be good enough? Surely it's worth trying to work out why this preventable tragedy happens to so many would-be parents? Alice Pullen, who lost her son at 39-and-a-half weeks after a normal pregancy, thinks so. "Our post-mortem came back inconclusive," she says. "I was 30 when I gave birth. I don't drink, don't smoke, I'm normal weight. Babies don't just die. There must be a reason."
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